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PROOF OF INSURANCE (2026 - 2026)CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DDIYYYY) 5/30/2025 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 riqhts to the certificate holder in lieu of such endorsement(s), PRODUCER Christian Risk Program Administrators a subsidiary of PHOM .' Arthur J. Gallagher Risk Management Services, LLC A41c 001-e ll 8o0-s AIL 2850 Golf Road ADDR SS. Rolling Meadows IL 60008 u ..........-,m....__.... .__......................... __ INSURERA: Old Re INSURED rS Of the ChrisCHRIBRO-14 NSURER B Old Re BrothI tian Schools & Affiliates M_" LOC #1177028 DOC POW ST VINCENT SENIOR CITIZEN NTR INsu-R-ER,c•,•,;,, 1205 Windham Parkway INSUREIR Romeoville IL 60446-1679 13 AFFORDING COVERAGE Insurance Comp .111111­Union Insurance COVERAGES CERTIFICATE NUMBER,/150110027 REVISION NUMBER: NAIC # 24147 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. .............................,.._.____ ....,� .._ � _ T ........ �.... ... ...°sees„-.._ � .... .... INSR AD L•'SL1BR POLICY EFF POLICY' EXP LTR TYPEOFINSURANCE iusnl POL1C`/NUMBER MMIDD M IDDIYYwkY. LIMITS B X COMMERCIAL GENERALLYYIABILITY N N 8225001325596 6/15/2025 6/15/2026EACH OCCURRENCE 000 000 $101uded CLAIMS %� OCCUR DAM1hAOE YG T i lS .. $ In -MADE ...... pIiFMI4F$ E a occurrence) d __ _ MED EXP (Any one person) $ 15 000 PERSONAL & ADV INJURY $ Included GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ Included POLICY PRO' JCC"r LOC [::] [J PRODUCTS- COMP/OP AGG - � ��� ............ _$ Included OTH'Eft: Irr $ A —i-- AUTOMOBILE LIABILITY Y Y MWTB 21543 6/15/2025 6/15/2026 I COMBINCD S NGLE. LIMIT $ 1,000 000 ANY AUTO BODILY INJURY (Per person) OWNED X SCHEDULED BODILY INJURY (Per accident) $ AUTOS ONLY AUTOS HIRED NON -OWNED I'�ROPERTYOAMAGE AUTOS ONLY ..._X..... AUTOS ONLY , gPcr gpccid0rzf), ............ $ ............... ......._ ........ Is UMBRELLA LIAB OCCUR I RENCE EXCESS LIAR CLAIMS -MADE _ ......... .,...... .. ....,..... AGGREGATE .....,........ ... ..._ $ ............ ...._ -- .....,.. DED !'RETENTION $ , $ WORKERS I PER ORB AN YIN YTORIP IA ILOITY — PROPRI ANYPROPRIETORIPARTNER/EXECUTIVE ❑ OFFICER/MEMBER EXCLUDED? NIA E, L EACH ACCIDENT .... I $ NH) (Mandatory ) E.L.DISEASE EA EMPLOYEE $ IfM endatorydescriin , ..E. DESCRIPTION OF OPERATIONS below E.,L DISEASE POLICY LIMIT $ B Excess Automobile Liability Y Y 822500 1325596 6/15/2025 6/15/2026 OcrJNo Agg $9,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Waiver of Subrogation (where allowed by law) per attached endorsement is provided under the Automobile Liability coverages per fully executed written contract. Certificate Holder is added as Additional Insured under Automobile Liability per agreement - per attached endorsements. solely, strictly and specifically with regards to: Consultant Services for the Community Development Block Grant Program for Home Delivered Meals. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of El Segundo its Official and Employees Office of City ACCORDANCE WITH THE POLICY PROVISIONS. Clerk El Segundo CA 90245 AUTHORIZED4,# REPRESENTATIV{ �7fJ 350 Main Street I ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.. ADDITIONAL INSURED This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person(s) or Organization(s): All persons or organizations as required by contract or agreement With respect to COVERED AUTOS LIABILITY COVERAGE, Who Is An Insured is changed with the addition of the following: Each person or organization shown in the Schedule for whom you are doing work is an "insured". But only for "bodily injury" or "property damage" that results from the ownership, maintenance or use of a covered "auto" by: 1. You; 2. an "employee" of yours; or 3. anyone who drives a covered "auto" with your permission or with the permission of one of your "employees". However, the insurance afforded to the person or organization shown in the Schedule shall not exceed the scope of coverage and/or limits of this policy. Not withstanding the foregoing sentence, in no event shall the insurance provided by this policy exceed the scope of coverage and/or limits required by the contract or agreement. PCA 001 10 13 MWTB 21543 Religious and Charitable Risk Pooling Trust 06/15/25 - 06/15/26 IL 10 (12/06) OLD REPUBLIC INSURANCE COMPANY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY, WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM SCHEDULE Name of Person or Organization: Only those persons or organizations for whom you are required to waive your rights of recovery under the terms of a written contract. (If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.) The Transfer Of Rights Of Recovery Against Others To Us Condition is changed by adding the following: We waive any right of recovery we may have against the person(s) or organization(s) shown in the Schedule because of payments we make for injury or damage. This waiver applies only to the person or organization shown in the Schedule. PCA 024 10 13 Page 1 of 1 MWTB 21543 Religious and Charitable Risk Pooling Trust 06/15/25 - 06/15/26 OLD REPUBLIC UNION INSURANCE ENDORSEMENT No 26 Attaching to and forming part of Policy No. 822500 1325596 Named Insured: THE RELIGIOUS AND CHARITABLE RISK POOLING TRUST OF THE BROTHERS OF THE CHRISTIAN SCHOOLS AND AFFILIATES Effective date of this endorsement is June 15, 2025 ADDITIONAL INSURED ENDORSEMENT It is understood and agreed that the members as on file with Arthur J. Gallagher & Co. and/or ARTEX RISK SOLUTIONS, INC. (A DIVISION OF ARTHUR J. GALLAGHER & COMPANY) are added as Additional Insureds in respect of the coverage as afforded under this Policy. It is further understood and noted that Brothers of the Christian Schools may issue written confirmation where the Insured or the Insured's members are obligated to provide proof of the cover provided by this Policy to Additional Insured's, Loss Payees and Mortgagors who have an insurable interest in the property or operations of the Insured. Except as amended in this Endorsement, this insurance is subject to all coverage terms, clauses and conditions in the policy to which this Endorsement is attached. Page 58 of 87 OLD REPUBLIC UNION INSURANCE COMPANY Attaching to and forming part of Policy No. 822500 1325596 Named Insured: THE RELIGIOUS AND CHARITABLE RISK POOLING TRUST OF THE BROTHERS OF THE CHRISTIAN SCHOOLS AND AFFILIATES Effective date of this endorsement is June 15, 2025 COMBINED PROPERTY AND CASUALTY AND CRIME PACKAGE THE FOLLOWING WORDING HAS BEEN EXTRACTED FROM THE ABOVE MENTIONED POLICY FORM TO PROVIDE PROOF OF COVERAGE. PLEASE READ IT CAREFULLY. SECTION IV - GENERAL CONDITIONS 15. WAIVER OF SUBROGATION: This Insurance shall not be invalidated if the Insured by written agreement has waived or shall waive its right of recovery from any party for loss or damage covered hereunder; provided, that any such waiver is made prior to the occurrence of said loss or damage. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) 11 /28/2024 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 Risk Program Administrator a division of Arthur J. Gallagher Risk. Management Services, LLC. 2850 Golf Road Rolling Meadows IL 60008 INSURED CHRI Brothers of the Christian Schools & Affiliates LOC #1177028 DOC POW ST VINCENT SENIOR CITIZEN NTR 1205 Windham Parkway Romeoville IL 60446-1679 Christian Brothers Services �ru• 8807 030mm ITm ....... -- 00- --- 0 FWE Nn9 630-378.2508 __ Old RINSURER S AFFORDINGCOVE _ AlC# I RAGE N eoublic Insurance COmDanv 24147 COVERAGES CERTIFICATE NUMBER: 762143708 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. ......[ .. .Y .....POLIGYNUMBER..._ . EFF ADDI SUI d , �... ..... ..... .MM ..ICY ...._y,.........._ ._._ ........ ,........._ ....... r DC�_�.._ TRTYPE OF INSURANCE DNYYYI MM/IDDR`M LIMITS COMMERCIAL GENE� L 1 LIABILITY [ EACH OCCURRENCE I � DAMAGE 15 iiLki°i=iJ"..., ..... I CLAIMS -MADE OCCUR pRFMISF a occ rrenge $ -,�.L u..� ! .............. MED EXP (Any one person) $ ,,, .. ........, PERSONAL 8 ADV INJURY S _ GEN'L AGGREGATE LIMIT APPLIES PER: ,GENERA.,,_._..... ......_...... . .... ....... ....... ..,. L AGGREGATE $ ..,...� POLICY I,. ...� ,IEG� T LOC _ P.RODUCTS„-.COMP/OPAG,G � $....._ .. OTHER .AUTOMOBILE LIABILITY ' t:"OMMNEDSINGLELIMIT $ ANY AUTO BODILY INJURY(Perperson) $ ...,:OWNED SCHEDULED AUTOS ONLY AUTOS ODILY INJURY (Per occ ''.B_..._L .iden[) $ ...�,,..,.. HIRED NON -OWNED I'RC7PLRTYf�AMAGE $ �,--_ AUTOS ONLY AUTOS ONLY (eur ,ccujprhlA.........,, .... .............r __.. ------ $ . ,.. UMBRELLA LIAB I I OCCUR yyI i EACH OCCU RENCE i� ,$ M EXCESS LIAB I I CLAIMS -MADE AGGREGATE $ DE RETENTION$ q WORKERS COMPENSATION Y MWC 117226 13 1/1/2025 1I1I2026 X STATUTE ERH_ A AND EMPLOYERS' LIABILITY y d N MWC 305311 10 1l1/2025 1I1I2026 ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N NIA E„L EACH ACCIDENT •• ••••�•— $ 1 000 000 — -•• (Mandatory in NH) E.L. DISEASE EA EMPLOYEE( $ 1,000,000 F$ DEESCRIPTION OF OPERATIONS below E,L DISEASE- POLICY LIMIT 1,000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) Waiver of Subrogation, per the attached endorsement, (where allowed by law) is provided under the Workers' Compensation coverage when required by fully executed, written contract. Consultant Services for the Community Development Block Grant Program for Home Delivered Meals. k;LK l 11-11%iA I C r1ULIJLK City of El Segundo its Official and Employees Office of City Clerk 350 Main Street El Segundo CA 90245 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE 01988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) POLICY NUMBER: MWC 117226 13 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT 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 perform, work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ALL PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT. APPLICABLETHIS FORM IS NOT DATE OF ISSUE: 10-09-24 WC000313 (Ed. 4-84) © 1983 National Council on Compensation Insurance. WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 03 06 (Ed. 04-84) 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 perform 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 % of the California workers' compensation premium otherwise due on such remuneration. PERSON OR ORGANIZATION ALL PERSONS OR ORGANIZATIONS WHERE REQUIRED BY WRITTEN CONTRACT DATE OF ISSUE: 10-09-24 SCHEDULE JOB DESCRIPTION @1998 by the Workers' Compensation Insurance Rating Bureau of California. All rights reserved. From the WCIRB's California Workers' Compensation Insurance Forms Manual@ 1999.