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HomeMy WebLinkAboutA8979.23 - SOROPTIMIST HOUSE OF HOPE INC.SOROHOU-01 CMA � CERTIFICATE OF LIABILITY INSURANCE DA812712u2TE a THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER License 1110757776 woUNFAcT Christy Mayo INSURED Tonal Insurance Services Inc. Ford Drive CRECEIVED A 92211 Soroptimist House o'MM IOE OF THE CITY 13525 Cielo Azul Way Desert Hot Springs, CA 92240 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. RIM TYPE OF INSURANCE ADDL SUMPOLICY NUMBER POLICY EFF POLICY EXPJILITL OMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE FIX OCCUR Liquor Liability-$ X X 2024.00530 9/8/2024 9/812025 EACH OCCURRENCE 1,000,000 DAMAGE TO RENTED 500,000 X MEDEXP M one 20,000 PERSONAL B ADV INJURY 3 1,000,000 GEML AGGREGATE LIMIT APPLIES PER: X POLICY ❑ JECTEl LOC OTHER: GENERAL AGGREGATE 2,000,000 PRODUCTS -COMPIOP AGG 2,000,000 PROFESSIONAL U 1,000,000 A AUTOMOBILE LIABILITY X ANY AUTO OWNED SCHEDULED AURTEOS ONLYMAUU�T�s1OSWWryry X AUTOS ONLY AUTOSONLDY X 2024-00530 91812024 9/8/2025 COMBINED SINGLE LIMIT 1,000,000 BODILY INJURY Per rsan BODILY INJURY Per accident IFera rs AMAGE A X UNBRELIALIAR EXf LWB X OCCUR CWMS-MADE 2024-00530-UMB 9/8/2024 9/8/2025 EACH OCCURRENCE 2,000,000 AGGREGATE 2,000,000 DED I X I RETENTIONS 10,000 WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN15T ANY PROPMETORIPARTNERIEXECUTIVE OOFFICEE1RMEMBER EXCLUDED? (IICryin NH) H yes des -he under DESCRIPTION OF OPERATIONS below N/A I PER OTH- T TE ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYE E.L. DISEASE -POLICY LIMIT "— A • Crime D&O Liability 2024-00530-PROP 2024-00530-DO-NPO 9/8/2024 918/2024 918/2025 918/2025 Employee Dishonesty Occurrence 500,000 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may ba attached If more space Is required) Re: Letter Agreement No. 8979 , The City of Palm Springs is included as an Additional Insured as per the attached endorsement. City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. A/ YUTTHIOORIIIZ(0 RRE/EPPRRESENTATNE UT v- _—"_�� ACORD 25 (2016I03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for ta0fanie. A Heert for Plonprofits. Policy No 2024-00530 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE ONLY In consideration of the premium charged, it is understood and agreed that the following is added as an additional insured: City of Palm Springs (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) But only as respects a legally enforceable contractual agreement with the Named Insured and only for liability arising out of the Named Insured's negligence and only for occurrences of coverages not otherwise excluded in the policy to which this endorsement applies. It is further understood and agreed that irrespective of the number of entities named as insureds under this policy, in no event shall the company's limits of liability exceed the occurrence or aggregate limits as applicable by policy definition or endorsement. NIAC Ai 03 91 Page 1 of 1 POLICY NUMBER: 2 0 2 4 -005 3 0 COMMERCIAL AUTO CA 04 44 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Soroptimist House of Hope Endorsement Effective Date: 09-08-2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 44 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICYNUMBER:- 2024-00530 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED PRIMARY AND NON-CONTRIBUTORY ENDORSEMENT FOR PUBLIC ENTITIES This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name of Person or Organization: A. Section II —WHO IS AN INSURED is amended to include: 4. Any public entity as an additional insured, and the officers, officials, employees, agents and/or volunteers of that public entity, as applicable, who may be named in the Schedule above, when you have agreed in a written contract or written agreement presently in effect or becoming effective during the term of this policy, that such public entity and/or its officers, officials, employees, agents and/or volunteers be added as an additional insured(s) on your policy, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by: a. Your negligent acts or omissions; or b. The negligent acts or omissions of those acting on your behalf; in the performance of your ongoing operations. No such public entity or individual is an additional insured for liability arising out of the sole negligence by that public entity or its designated individuals. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. B. Section III — LIMITS OF INSURANCE is amended to include: 8. The limits of insurance applicable to the public entity and applicable individuals identified as an additional insured(s) pursuant to Provision A.4. above, are those specified in the written contract between you and that public entity, or the limits available under this policy, whichever are less. These limits are part of and not in addition to the limits of insurance under this policy. C. With respect to the insurance provided to the additional insured(s), Condition 4. Other Insurance of SECTION IV — COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: 4. Other Insurance a. Primary Insurance This insurance is primary if you have agreed in a written contract or written agreement: (1) That this insurance be primary. If other insurance is also primary, we will share with all that other insurance as described in c. below; or NIAC-E61 02 19 Page 1 of 2 NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. POLICY NUMBER: 2 0 2 4 —0 0 5 3 0 (2) The coverage afforded by this insurance is primary and non-contributory with the additional insured(s)' own insurance. Paragraphs (1) and. (2) do not apply to other insurance to which the additional insured(s) has been added as an additional insured or to other insurance described in paragraph b. below. b. Excess Insurance This insurance is excess over: 1. Any of the other insurance, whether primary, excess, contingent or on any other basis: (a) That is Fire, Extended Coverage, Builders Risk, Installation Risk or similar coverage for "your work'; (b) That is fire, lightning, or explosion insurance for premises rented to you or temporarily occupied by you with permission of the owner; (c) That is insurance purchased by you to cover your liability as a tenant for "property damage" to premises temporarily occupied by you with permission of the owner; or (d) If the loss arises out of the maintenance or use of aircraft, "autos" or watercraft to the extent not subject to Exclusion g. of SECTION 1— COVERAGE A— BODILY INJURY AND PROPERTY DAMAGE. (a) Any other insurance available to an additional insured(s) under this Endorsement covering liability for damages which are subject to this endorsement and for which the additional insured(s) has been added as an additional insured by that other insurance. (1) When this insurance is excess, we will have no duty under Coverages A or B to defend the additional insured(s) against any "suit" if any other insurer has a duty to defend the additional -insured(s) against that "suit". If no other insurer defends, we will undertake to do so; but we will be entitled to the additional insured(s)' rights against all those other insurers. (2) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: (a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self -insured amounts under all that other insurance. (3) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Methods of Sharing If all of the other insurance available to the additional insured(s) permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any other the other insurance available to the additional insured(s) does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. NIAC-E61 02 19 Page 2 of 2 POLICY NUMBER: 2024-00530 COMMERCIAL GENERAL LIABILITY Named Insured: Soroptimist House of Hope, Inc. CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or political subdivision that issues a permit or authorization to the named insured. j Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political - —subdivision-shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a B. permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury', "property damage" or "personal and advertising injury' arising out of operations -performed for the federal government, state or municipality; or b. "Bodily injury' or "property damage" included within the."products-completed operations hazard". With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contract or agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ,®NONPROFITS PQLICYNUMBER: 2024-00530 FORM: NIAC-E26 1117 INSURANCE. NAMED INSURED: Soroptimist House of Hope, Inc. ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage_ NIAC-E26 11 17 Page 1 of 1 p ppLM S. 'y N City of Palm Springs 1� * 3200 E. Tahquitz Canyon Way • Palm Springs, California 92262 •.� * palinspringsca.gov °g41roaN�P December 13, 2021 SENT VIA E-MAIL Soroptimist House of Hope, Inc. Attn: Rebecca Norton PO BOX 1055 Desert Hot Springs, CA 92240 Re: Letter Agreement No. 8979, 2021-22 Grant from City of Palm Springs to Soroptimist House of Hope, Inc. Congratulations on receiving an award of a grant from the City of Palm Springs ("City"). This letter agreement ("Agreement") memorializes the nature of the grant awarded to your organization, Soroptimist House of Hope, Inc. ("Grantee") for the (fiscal) year 2021-22 (the "Grant"), and the terms and conditions upon which the City provides it. The City's grant of assistance to Grantee (the "Assistance") may be summarized as follows: $2,500 cash grant in support of the Substance Use Disorders Treatment Program for Palm Springs Residents The City makes this grant upon the following terms and conditions ("Terms"). Your signature below and return of this Agreement to the City shall serve as evidence of Grantee's acceptance of, and promise to follow all of the Terms. Despite its informality, City and Grantee intend that this Agreement shall serve as a fully binding and enforceable contract between them in relation to the Assistance. The City will tender all Assistance as quickly as practicable, and in coordination with Grantee's reasonable requirements as expressed to City, upon Grantee's return of this Agreement, fully executed, to the City. 1. Grantee is known in the community for performing a function and/or providing services ("Services") that may reasonably be described as follows: Substance Use Disorders Treatment Program for Palm Springs residents. Grantee warrants and covenants to City that it will continue to provide Services throughout the 2021-22 fiscal year, and that it shall dedicate the entirety to the Assistance hereunder to funding and/or supporting Services. 2. In the event that Grantee anticipates or experiences any interruption of its provision of Services, Grantee shall provide written notice to City of that fact, and execute any amendment to this Agreement that City deems necessary and appropriate. 3. The following principal of Grantee is identified as being Grantee's representative, authorized to act on Grantee's behalf with respect to the Services and all interaction with City thereto: Rebecca Norton. �J Post Office Box 2743 0 Palm Springs, California 92263-2743 December 13, 2021 Soroptimist House of Hope, Inc. - Substance Use Disorders Treatment Program for Women 4. Grantee and its representative shall ensure that all communications and other interaction with City necessary in relation to Services, the provision of Assistance, and this Agreement shall be with Anthony J. Mejia, City Clerk. 5. Grantee shall comply with all applicable federal, state and local law and regulations ("Law") in providing Services, and shall secure any and all necessary licenses and permits required by Law in doing so. 6. Grantee agrees to use the official City logo to acknowledge the City's support on its website in the manner noted below (with a hyperlink to the City's website) and on any printed materials associated with its program or event. Grantee is also encouraged to include the City of Palm Springs in all relevant social media postings. Special Funding provided by The City of Palm Springs � 4s 7. Grantee shall, upon any reasonable City request, notify its employees, members and volunteers of opportunities to volunteer at City events. 8. Grantee is an independent organization, not affiliated with City except by way of this Agreement as a recipient of Assistance. Neither City nor any of its officials, employees, contractors, volunteers or agents (in the aggregate, "City's Related Parties") shall have any control over the manner, mode, or means by which Grantee, its managers, employees, contractors, volunteers or agents (in the aggregate, "Grantee's Related Parties") perform Services. Further, this Agreement does not establish any relationship whatsoever between City and any person(s) who receive or benefit from Grantee's Services ("Grantee's Beneficiaries"). Grantee warrants and covenants that none of Grantee's Related Parties or Grantee's Beneficiaries has any contractual or other relationship with City arising from or related to this Agreement. Grantee is merely a sponsored entity recognized by City as worthy of City's Assistance, for the sole and exclusive purpose of promoting Grantee's Services in the community. However, in recognition of the fact that Grantee is receiving public funds pursuant to this Agreement in the form of the Assistance, City shall have the right to review Grantee's work product, results, records, and advice in relation to any Services rendered to Beneficiaries that are funded or supported, in whole or in part, by the Assistance. 9. Neither Grantee, nor any person who is one of Grantee's Related Parties or Grantee's Beneficiaries, shall at any time or in any manner represent that any person who is one of Grantee's Related Parties or Grantee's Beneficiaries is one of City's Related Parties, by virtue of this Agreement or otherwise. 10. Grantee shall prepare and deliver to City a Final Report that documents Grantee's application of the Assistance to the advancement of Services; these reports shall include but not be limited to expenditures of City funds by Grantee. Final Reports must be submitted in the format as outlined in Exhibit A. Final Report must accompany your application for the 2022-22 grant cycle, or be submitted by December 31, 2022, if you are not applying. 11. Grantee shall procure and maintain, at Grantee's sole cost and expense, policies of insurance as required by the City Attorney. December 13, 2021 Soroptimist House of Hope, Inc. - Substance Use Disorders Treatment Program for Women 12. To the fullest extent permitted by law, Grantee shall defend (at Grantee's sole cost and expense), indemnify, protect, and hold harmless City and City's Related Parties from and against any and all liabilities, actions, suits, claims, demands, losses, costs, judgments, arbitration awards, settlements, damages, demands, orders, penalties, and expenses including legal costs and attorney fees (collectively "Claims"), including but not limited to Claims arising from or related to (i) injuries to or death of persons, including without limitation Grantee's Related Parties and Grantee's Beneficiaries, (ii) damage to property, including property owned by any of Grantee's Related Parties, Grantee's Beneficiaries, or City, (iii) any violation of any federal, state, or local law or regulation, and (iv) actual or alleged errors and omissions of Grantee or any of Grantee's Related Parties, to the full extent not directly caused by the negligence or willful misconduct of the City or any of City's Related Parties. Under no circumstances shall the scope or nature of Grantee's insurance required by this Agreement be construed to limit Grantee's duty to indemnify, defend or hold City harmless hereunder. 13. In connection with Services under this Agreement, Grantee shall not discriminate against any employee or applicant for employment because of actual or perceived race, religion, color, sex, age, marital status, ancestry, national origin (i.e., place of origin, immigration status, cultural or linguistic characteristics, or ethnicity), sexual orientation, gender identity, gender expression, physical or mental disability, or medical condition (each a "prohibited basis"). Grantee shall ensure that Grantee's Related Parties are employed, and that contractors and volunteers are engaged (to the extent applicable), and that Grantee's Related Parties are treated during their employment or engagement by Grantee, without regard to any prohibited basis. As a condition precedent to City's entry into this Agreement, Grantee has warranted and covenanted that Grantee's actions and omissions hereunder shall not incorporate any discrimination arising from or related to any prohibited basis in any Grantee activity, including but not limited to the following: employment, upgrading, demotion or transfer; recruitment or recruitment advertising; layoff or termination; provision of benefits, rates of pay or other forms of compensation; and selection for training, including apprenticeship. Grantee shall fully comply with the provisions of Palm Springs Municipal Code Section 7.09.040 relating to non-discrimination in city contracting. 14. This Agreement contains all of the agreements between City and Grantee, and cannot be amended or modified except by written agreement. If any portion of this Agreement is declared invalid or unenforceable by valid judgment or decree of a court of competent jurisdiction, such invalidity or unenforceability shall not affect any of the remaining portions of this Agreement, which shall be interpreted to carry out the intent of the parties hereunder. Each of the persons executing this Agreement on behalf of a party hereto warrants that he/she is duly authorized to execute this Agreement on behalf of said party, and that by so executing this Agreement the party hereto for which this Agreement is executed is formally bound to the provisions of this Agreement. The parties may execute this Agreement in any number of counterparts, received by the City as an original or as a digital image; together, all counterparts form a single document. December 13, 2021 Soroptimist House of Hope, Inc. - Substance Use Disorders Treatment Program for Women CITY 6F PALM SPRING By: Justin efifton City Manager APPROVED AS TO FORM: ATTEST: By: By AGREED Soroptimist House of Hope, Inc.: Re ecca Norton' December 13, 2021 Soroptimist House of Hope, Inc. - Substance Use Disorders Treatment Program for Women EXHIBIT A CITY OF PALM SPRINGS PROGRAM GRANTS AND SPONSORSHIPS FINAL REPORT I. Summary Information Grant Information Project Name Organization Name Grant Amount In U.S. dollars Project Duration In months Are there any unexpended funds remaining? Yes/No Amount Project Director Information € Prefix Email Address Last name Phone First name Fax Suffix Web Site Title Mailing Address Report Prepared by Date Submitted dd mm yyyy Phone Email December 13, 2021 Soroptimist House of Hope, Inc. - Substance Use Disorders Treatment Program for Women II. Project Final Results Progress Narrative (1-2 pages) In paragraphs or bullet points, please provide the following information: • General Results: Describe the general results of the project, including where the project results were achieved as expected, where they were not, and the reasons for both. In addition, please describe any unexpected results and their significance. • Sustainability: If your organization intends for this project to be sustained after the grant period has ended, what actions have your organization and project partners taken and what actions will you be taking to facilitate sustainability, and how will the project be continued? • Scalability: If your organization intends for this project to increase in scale after the grant period has ended, what actions have your organization and project partners taken and what actions will you be taking to facilitate that increase in scale? • Challenges: Discuss how you addressed both anticipated and unanticipated challenges in the course of the project. Is there anything that the foundation could do to assist you with addressing these challenges, and was there anything in the past that the foundation could have done? • Lessons Learned: What lessons have you learned during the course of this project that will help your organization and other organizations that may be involved in similar work? A89 7 .9, z� ----OON SOROHOU-01 CMAY TE '4`- CERTIFICATE OF LIABILITY INSURANCE AEX04111012023 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED previsions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsements). PRODUCER License 1110757776 HUB International Insurance Services Inc. 76030 Gerald Ford Drive Suite201 N ACT C.hrlSty Mayo (PHcNN , E,t: (760) 360r4700 4249 FiuVc Ne:(760) 200-0790 EA'ppaLss.christy.may hubintemational.com INSURER(SI AFFORDING COVERAGE NAICk Palm Desert, CA 92211 INSURER A : Nonprofits' Insurance Alliance of California Inc 01184 INSURED INSURERS: Service American Indemnity Company 39152 INSURERC: Soroptimist House of Hope, Inc. INSURER 0: 628 South 8th Street Banning, CA 92220 INSURER E: INSURER F: COVFRAr;FC CERTIFICATE NUMBER- REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY NUMBER POLICY EFF POLICY UP LIMITS A X COMMERCIALGENERAL LIABILITY CLAIMS -MADE � OCCUR X X 2022-00530 9/812022 9/812023 EACH OCCURRENCE E 1,000,000 DAMAGE TO RENTED PREMISES iEd 500,000 X MED UP (AnY one 20'000 Liquor Liability - S PERSONAL a ADV INJURY 1'000,000 GEN'L AGGREGATE LIMIT- APPLIES PER: X POLICY ❑ JEgL'T LOC GENERALAGGREGATE 2,000,000 PRODUCTS -COMP,OPAGG 2,000,000 PROFESSIONAL LI s 1,000,000 OTHER I I A AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1,000,000 BODILY INJURY Per on E X ANY AUTO OWNED SCHEDULED AIURTEO�SONLY AUTOS 20220530 9I81202 9IBI2023 BROq�pDILY INJURY Per accident BODILY E Perealtlenl MAGE f X AUTOS ONLY AUTOS ONLY A X UMBRELLA u" X OCCUR EACH OCCURRENCE f 2,000,000 EXCESS LUIB CLAIMS -MADE 2022-00530-UMP-NPO 9/812022 9/8/2023 AGGREGATE f 2,000,000 DEO X I RETENTIONS 10,000 B WORKERS COMPENSATION AND EMPLOYERS' LU1BILifY ANY PROPRIETORIPARTNER/EXECUTtVE YIN Wp�n ERRAEEMgg��qq EXCLUDED'! � IMandatoryln Nll) NIA X ATIS0394002 112612023 1/2612024 X PER OTH- EL EACH ACCIDENT 1,000,000 EL. DISEASE - EA EMPLOYE E 1,000,000 If yes. deacnbe under DESCRIPTION OF OPERATIONS balox E.1- DISEASE-POUCYLIMIT f 1,000,000 A A Come Professional Liab. 2022-00530-PROP 2022-00530-DO-NPO 9/8/2022 9/812022 91812023 9/8/2023 Employee Dishonesty Ocurrence 600,0001 1,000'000 MSCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IACORD IOI, AddMonal Remarks Scheduk, maybe a"cMd N more apace b re9u I Re: Letter Agreement No. 8979 , 2021.22 Grant RECEIVED The City of Palm Springs is included as an Additional Insured as per the attached endorsement. JAN 12 2023 City Hall Reception Desk City of Palm Springs 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. ACORD 25 (2016103) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD POLICY NUMBER: 2022-00530 COMMERCIAL GENERAL LIABILITY Named Insured: Soroptimist House of Hope, Inc. CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Locations Of Covered Operations Any person or organization that you are required to All insured premises and operations. add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behalf; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury' or "property damage" occurring after: 1. All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2 NoNONPROFITS POLICY NUMBER: 2022-00530 FORM: NIAC-E26 11 17 I INSURANCE NAMED INSURED: Somptimist House of Hope, Inc. ALLIANCE OF CALIFORNIA A Head for Insurance. A Heartfor Nonproflrs. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT—CALIFORNIA We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 . 020 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Blanket waiver of Subrogation as required by written Job Description Contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 0 1 / 2 6 / 2 0 2 3 Policy No. SATIS0394002 Endorsement No. Policy Effective Date: O1/26/2023 to 01/26/2024 Premium $ Insured: Soroptimist House of Hope, Inc. DBA: Carrier Name / Code: Service American Indemnity Company Countersigned by WC 04 03 06 (Ed.4-84) Page 1 of 1 POLICY NUMBER: 2022-00530 COMMERCIAL GENERAL LIABILITY Named Insured: Soroptimist House of Hope, Inc. CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or political subdivision that issues a permit or authorization to the named insured. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section II —Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a permit or authorization. However 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury"arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury' or "property damage" included within the "products -completed operations hazard". B. With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: a. The insurance afforded to such additional If coverage provided to the additional insured is insured only applies to the extent permitted required by a contract or agreement, the most we by law; and will pay on behalf of the additional insured is the b. If coverage provided to the additional amount of insurance: insured is required by a contract or 1. Required by the contract or agreement; or agreement, the insurance afforded to such 2. Available under the applicable Limits of additional insured will not be broader than Insurance shown in the Declarations; that which you are required by the contract whichever is less. or agreement to provide for such additional insured. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 POLICY NUMBER: 2022-00530 COMMERCIAL AUTO CA 04 4410 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Soroptimist House of Hope Endorsement Effective Date: 09-08-2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident" or the 'loss" under a contract with that person or organization. CA 04 44 10 13 ©insurance Services Office, Inc., 2011 Page 1 of 1 7-S--y�f ;-Y fYs7Ys77CN1IIrii CMAYO 7 A� o' CERTIFICATE OF LIABILITY INSURANCE _ _ DA 8/9/ 022 YI THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endomemen s . pRODuceR License # 0757776 cNRAjACT Christy Mayo HUB International Insurance Services Inc. tOi 75030 Gerald Ford Drive WED Suite 201 IP17No, Est: (760) 360-4700 4249 (a. No :(760) 200-0790 EA -MIL .christy.mayo@hubintemational.com INSURE S AFFORUNG COVERAGE NNCf Palm Desert, CA 92211 15 2U22 INSURER A: Nonprofits' Insurance Alliance of California Inc 01184 AUG INSURED Cl URERB:Service American Indemni Company 39162 Soroptimist House of Hope, Inc.ce of the City INSURER C: INsuITER D: 628 South 8th Street Banning, CA 92220 INSURER E: WSURERF: COVFRAr-Es rFRTIFICATF NIIMRFR• RFVISION NIIMRER- THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADD SUER POLICY NUMBER POLICY EFF POLICY UP LIMITS A *XCOA MERCIAL GENERAL LIABILITY CLAIMS.MADE [X]OCCUR uor Liability - $ X X 022-00530 918/2022 9/812023 EACH OCCURRENCE f 1,000,000 DAMAGE TO RENTED PREMISES (Ea occuitergal S 600,000 MED EXP (Any one $ 20,000 PERSONAL A ADV INJURY S 1,000,000 FENL AGGREGATE pLIRMpIT. APPLIES PER. X POLICY ElJECT LOC OTHER: GENERAL AGGREGATE S 2,000,000 PRODUCTS - COMPIOP AGG S 2,000,000 PROFESSIONAL LI 11000,000 A AUTOMOBILE NUBILITY ANY AUTO ONMED SCHEDULED AUgT�O�SONLY A�UTTOSSV�.� p A61�4B ONLY AUTOS O X X 2022-00530 91812022 91812023 COMBINED SINGLE LIMIT f 1,DDB,OOD BODILY INJURY Per S BODILY INJURY PeraradM9 f Ix PPerra %d t AMAGE f f A X UMBRELLA LIAB EXCESS meCLAMS-MADE X OCCUR _ 12022-00530-UMP-NPO 9/8/2022 918/2023 EACH OCCURRENCE f 2,000,000 AGGREGATE 2,000,000 DED X RETENTIONS 10,000 S 8 WORKERS COMPENSATION ANDEMPLOYERS'LJA6N3iY ANY PROPRIETORIPARTNERIEXECUTNE Y❑ Wp�15ERIMEMg�p EXCLUDED? IwndatoryIn NN) ff yes, descnea under DESCRIPTION OF OPERATIONS Odow NIA X ATI$0394001 1/2612D22 1/26/2023 X I PER OTH- ER E.L. EACH ACCIDENT S 1,000,000 EL.DISEASE-EA EMPLOYEE $ 1,000,000 E.L. DISEASE - POLICY LIMIT f 1,000,000 A A Crime Professional Liab. 2022-00530-PROP 022-00530-DO-NPO 9/812022 9/812022 9IW2023 918/2023 Employee Dishonesty Ocurrence 500,000 1,000,000 DESCRIPTION OF OPERATIONS LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may O aus ched I mare space Is required) Re: Letter Agreement No. 8979 , 2021-22 Grant The City of Palm Springs is included as an Additional Insured as per the attached endorsement. CFRTIFICATF Hint nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City Of Palm Springs CE WILL BE DELIVERED IN THE EXPIRATION DATE THEREOF, ACCORDANCE WITH THE POLICY PROVISIONS. 3200 E Tahquitz Canyon Way Palm Springs, CA 92262 AUTHORi EO REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD NONPROFITS POLICY NUMBER: 2022-00530 FORM: NIAC-E26 1117 INSURANCE NAMED INSURED: Soroptimist House of Hope, Inc. ALLIANCE OF CALIFORNIA A Head for Insurance. A Htart far Nonprofits. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SOCIAL SERVICE PROFESSIONAL LIABILITY COVERAGE FORM SCHEDULE Name of Person or Organization: Where you are so required in a written contract or agreement currently in effect or becoming effective during the term of this policy, we waive any right of recovery we may have against that person or organization, who may be named in the schedule above, because of payments we make for injury or damage. NIAC-E26 11 17 Page 1 of 1 POLICY NUMBER: 2022-00530 Named Insured: Soroptimist House of Hope, Inc. COMMERCIAL GENERAL LIABILITY CG 20 10 12 19 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS - SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organizations) I Location(s) Of Covered Operations Any person or organization that you are required to add as an additional insured on this policy, under a written contract or agreement currently in effect, or becoming effective during the term of this policy. The additional insured status will not be afforded with respect to liability arising out of or related to your activities as a real estate manager for that person or organization. All insured premises and operations. I Information required to complete this Schedule, if not shown above, will be shown in the Declarations. I A. Section II — Who Is An Insured is amended to include as an additional insured the person(s) or organization(s) shown in the Schedule, but only with respect to liability for "bodily injury', "property damage" or "personal and advertising injury' caused, in whole or in part, by: 1. Your acts or omissions; or 2. The acts or omissions of those acting on your behaff; in the performance of your ongoing operations for the additional insured(s) at the location(s) designated above. However: 1. The insurance afforded to such additional insured only applies to the extent permitted by law; and 2. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. B. With respect to the insurance afforded to these additional insureds, the following additional exclusions apply: This insurance does not apply to "bodily injury" or "property damage" occurring after: All work, including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by or on behalf of the additional insured(s) at the location of the covered operations has been completed; or CG 20 10 12 19 © Insurance Services Office, Inc., 2012 Page 1 of 2 POLICY NUMBER: 2022-00530 COMMERCIAL GENERAL LIABILITY Named Insured: Soroptimist House of Hope, Inc. CG 20 12 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. ADDITIONAL INSURED - STATE OR GOVERNMENTAL AGENCY OR SUBDIVISION OR POLITICAL SUBDIVISION - PERMITS OR AUTHORIZATIONS This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE State Or Governmental Agency Or Subdivision Or Political Subdivision: Any state or political subdivision that issues a permit or authorization to the named insured. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A. Section II —Who Is An Insured is amended to include as an additional insured any state or governmental agency or subdivision or political subdivision shown in the Schedule, subject to the following provisions: 1. This insurance applies only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision or political subdivision has issued a B. permit or authorization. However: a. The insurance afforded to such additional insured only applies to the extent permitted by law; and b. If coverage provided to the additional insured is required by a contract or agreement, the insurance afforded to such additional insured will not be broader than that which you are required by the contract or agreement to provide for such additional insured. 2. This insurance does not apply to: a. "Bodily injury", "property damage" or "personal and advertising injury"arising out of operations performed for the federal government, state or municipality; or b. "Bodily injury' or "property damage" included within the "products -completed operations hazard". With respect to the insurance afforded to these additional insureds, the following is added to Section III — Limits Of Insurance: If coverage provided to the additional insured is required by a contract or agreement, the most we will pay on behalf of the additional insured is the amount of insurance: 1. Required by the contractor agreement; or 2. Available under the applicable Limits of Insurance shown in the Declarations; whichever is less. This endorsement shall not increase the applicable Limits of Insurance shown in the Declarations. CG 20 12 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed.4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT— CALIFORNIA We have the right to recover our payments from anyone liable far an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you per- form work under a written contract that requires you to obtain this agreement from us.) You must maintain payroll records accurately segregating the remuneration of your employees while engaged in the work described in the Schedule. The additional premium for this endorsement shall be 0 . 02 0 % of the California workers' compensation premium otherwise due on such remuneration. Schedule Person or Organization Blanket waiver of Subrogation as required by written Job Description Contract This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective Date: 0 1 / 2 6 / 2 0 2 2 Policy No. SATIS0394001 Endorsement No. Policy Effective Date: O1/26/2022 to O1/26/2023 Premium $ Insured: Soroptimist House of Hope, Inc. DBA: Carrier Name/Code: Service American Indemnity Company Countersigned by WC 04 03 06 (Ed.4-84) Page 1 of 1 POLICY NUMBER: 2022-00530 COMMERCIAL AUTO CA04441013 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US (WAIVER OF SUBROGATION) This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Soroptimist House of Hope Endorsement Effective Date: 09-08-2022 SCHEDULE Name(s) Of Person(s) Or Organization(s): Any person or organization with whom you have a written contract currently in effect or becoming effective during the term of this policy. Information required to complete this Schedule, if not shown above, will be shown in the Declarations. The Transfer Of Rights Of Recovery Against Others To Us condition does not apply to the person(s) or organization(s) shown in the Schedule, but only to the extent that subrogation is waived prior to the "accident' or the 'loss" under a contract with that person or organization. CA 04 4410 13 © Insurance Services Office, Inc., 2011 Page 1 of 1