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16-064 Amendment #3 dated 10-6-23 General Fund Human Services Grants Program1 THIRD AMENDMENT TO GENERAL FUND HUMAN SERVICES GRANT (HSG) FUNDS CITY/NON-PROFIT CONTRACT (Services Only) This Third Amendment to Contract is entered into between CATHOLIC CHARITIES OF SANTA CLARA COUNTY ("CORPORATION") and the CITY OF CUPERTINO ("CITY") as of July 1, 2023 (the "Effective Date") to amend the General Fund HSG City/Non-Profit Contract (the "Contract") dated July 1, 2020. WITNESSETH WHEREAS, CITY has reserved a portion of its HSG funds to be used on activities that benefit Cupertino’s residents; and, WHEREAS, CITY has agreed to the use by CORPORATION of a portion of CITY’S HSG budget for the Program (as described below) to be operated within CITY for the benefit of low and very low-income households; THEREFORE, the parties agree as follows: 1. Section I, entitled "Program", is deleted in its entirety and replaced with the following: For the period of July 1, 2020 to June 30, 2021, CITY agreed to allocate a portion of its HSG funds to CORPORATION in the sum of Ten Thousand Dollars and No. Cents ($10,000) for the purpose of implementing the CORPORATION'S program, as more particularly described in Exhibits A-D to the Contract, and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. For the period of July 1, 2021 to June 30, 2022 CITY agrees to allocate a portion of its current HSG funds to CORPORATION in the sum of Ten Thousand Dollars and No. Cents ($10,000) for the purpose of implementing the CORPORATION'S Program, as more particularly described in Exhibits A-1, B-1, C-1, and D-1 to the Contract, and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. For the period of July 1, 2022 to June 30, 2023 CITY agrees to allocate a portion of its current HSG funds to CORPORATION in the sum of Ten Thousand Dollars and No. Cents ($10,000) for the purpose of implementing the CORPORATION'S Program, as more particularly described in Exhibits A-2, B-2, C-2, and D-2 to the Contract, and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. For the period of July 1, 2023 to June 30, 2024 CITY agrees to allocate a portion of its current HSG funds to CORPORATION in the sum of Ten Thousand Dollars and No. Cents ($10,000) for the purpose of implementing the CORPORATION'S Program, as more particularly described in Exhibits A-3, B-3, C-3, and D-3 to the Contract, and said Exhibits set forth below, as they may be amended or modified, are attached to this Contract and incorporated herein by reference. 2 Exhibit A-3: Program Description (FY 2023-24) Exhibit B-3: Program Work Plan (FY 2023-24) Exhibit C-3: Proposed Implementation Timeline Schedule (FY 2023-24) Exhibit D-3: Program Budget (FY 2023-24) Exhibit E: Basic Insurance and Bond Requirements For Non-Profit Contracts The total allocation for July 1, 2020 through June 30, 2024 shall not exceed Forty Thousand Dollars and No. Cents ($40,000). 2. Exhibits A-3, B-3, C-3, and D-3, including an updated Certificate of Insurance, are attached hereto and hereby added to the CONTRACT 3. The following sentence is added to the end of subsection B of Section II, “Term”: The Term of this Contract has been extended once per this Section II.B to end on June 30, 2024, unless otherwise amended or terminated earlier pursuant to Section VII or Section VIII of this contract. 4. Exhibit E to the CONTRACT is replaced with Exhibit E attached hereto. 5. All terms, covenants and conditions stated in the CONTRACT, which are not herein amended, remain in full force and effect. [Signatures on following page.] Page 3 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract IN WITNESS WHEREOF, the parties have executed this Second Amendment as of the Effective Date. CORPORATION: CITY: CATHOLIC CHARITIES OF SANTA CITY OF CUPERTINO, a municipal CLARA COUNTY, a California benefit corporation nonprofit public corporation ___________________________________ __________________________________ Greg Kepferle Date Benjamin Fu Date Chief Executive Officer Director of Community Development APPROVED AS TO FORM AND ATTEST: LEGALITY: ___________________________________ _________________________________ Christopher Jensen Date Kirsten Squarcia Date City Attorney City Clerk EXPENDITURE DISTRIBUTION PO # 2021-235 100-72-712-600-623 Original Contract: $10,000 Amendment #1: $10,000 Amendment #2: $10,000 Amendment #3: $10,000 Total $40,000 Oct 6, 2023 Christopher D. Jensen Oct 6, 2023 Oct 6, 2023 Page 4 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract EXHIBIT A-3 PROGRAM DESCRIPTION FY 2023-24 Agency Name: Catholic Charities of Santa Clara County DUNS: Not Applicable (Only for CDBG) Chief Executive Officer: Greg Kepferle Program Manager: Linda Dominguez Program # (For Office Use Only) 100-72-712 600-623 Street Address: 2625 Zanker Road, Ste 200 City: San Jose State: CA Zip Code: 95134 Telephone number: 408-944-0567 Fax Number: 408-944-0776 Manager E-mail Ldominguez@catholiccharitiesscc. org Name of Program: Long Term Care Ombudsman Program Location: 195 E. San Fernando Street, San Jose, CA 95112 Program Description: Catholic Charities of Santa Clara County (CCSCC) provides the only ombudsman services in Santa Clara County for frail and vulnerable long-term care facility residents, with a focus on low-income elderly individuals. Our Long-Term Care Ombudsman Program (LTCOP) promotes the interest, well-being and rights of such residents who often do not have a voice. Long Term Care (LTC) Ombudsmen protect and help improve the quality of care and life for the frailest of our senior and disabled population, functioning as advocates for the more than 11,000 residents living in long term care facilities in the County. Page 5 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract EXHIBIT B-3 PROGRAM WORK PLAN FY 2023-24 AGENCY NAME: Catholic Charities of Santa Clara County PROGRAM NAME: Long Term Care Ombudsman Objectives Benchmarks for Each Quarter 1st 2nd 3rd 4th TOTAL 60 unannounced site visits to Cupertino LTC Facilities 15 15 15 15 60 Ombudsmen will make contact with 20 unduplicated LTC Residents 5 5 5 5 20 Ombudsmen will investigate and resolve 16 complaints 4 4 4 4 16 Total Beneficiaries 24 24 24 24 96 Page 6 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract EXHIBIT C-3 PROPOSED IMPLEMENTATION TIMELINE SCHEDULE FY 2023-24 AGENCY NAME: Catholic Charities of Santa Clara County PROGRAM NAME: Long Term Care Ombudsman Activity Number & Description: Activity # Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun 1. Page 7 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract EXHIBIT D-2 PROGRAM BUDGET FY 2023-24 AGENCY NAME: Catholic Charities of Santa Clara County PROGRAM NAME: Long Term Care Ombudsman Proposed Program Expenses FY 2023-24 Salaries/Benefits/Payroll/Taxes $8,406.00 Office Supplies Communication $150.00 Publications/Printing/Advertising Travel Rent/Lease/Mortgage Utilities Insurance $90.00 Equipment Rental/Maintenance Audit/Legal/Professional Services (for CDBG portion only) IT Direct Services (Funding for specific service such as a meal, ride) Awards Indirect Cost/Administration Contracted Services Other $1,354.00 Total Expenses $10,000 Page 8 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract Exhibit E BASIC INSURANCE AND BOND REQUIREMENTS FOR NON-PROFIT CONTRACTS Definition of Contractor: The "Contractor" as the word is used in this Exhibit E is the party contracting with the City of Cupertino for the direct distribution of HSG funds. Indemnity The Contractor shall indemnify, defend, and hold harmless the City of Cupertino (hereinafter "City"), its officers, agents and employees from any loss, liability, claim, injury or damage arising out of, or in connection with performance of this Contract by Contractor and/or its agents, employees or subcontractors, excepting only loss, injury or damage caused solely by the acts or omissions of personnel employed by the City. It is the intent of the parties to this Contract to provide the broadest possible coverage for the City. The Contractor shall reimburse the City for all costs, attorneys' fees, expenses and liabilities incurred with respect to any litigation in which the Contractor is obligated to indemnify, defend and hold harmless the City under this Contract. Insurance Without limiting the Contractor's indemnification of the City, the Contractor shall provide and maintain at its own expense, during the term of this Contract, or as may be further required herein, the following insurance coverages and provisions: A. Evidence of Coverage Prior to commencement of this Contract, the Contractor shall provide on the City's own form or a form approved by the City's Insurance Manager an original plus one copy of a Certificate of Insurance certifying that coverage as required herein has been obtained and remains in force for the period required by this Contract. The contract number and program name must be stated on the Certificate of Insurance. The City's Special Endorsement form shall accompany the certificate. Individual endorsements executed by the insurance carrier may be substituted for the City's Special Endorsement form if they provide the coverage as required. In addition, a certified copy of the policy or policies shall be provided by the Contractor upon request. This verification of coverage shall be sent to the address as shown on the City's Certificate of Insurance form and to the Community Development Department at the address set forth in this Contract at Section VI. PROGRAM COORDINATION, Paragraph C., NOTICES. The Contractor shall not issue a Notice to Proceed with the work under this Contract until it has obtained all insurance required and such insurance has been approved by the City. This approval of insurance shall neither relieve nor decrease the liability of the Contractor. B. Notice of Cancellation of Reduction of Coverage All policies shall contain a special provision for thirty (30) days prior written notice of any cancellation or reduction in coverage to be sent to the Community Development Department, 10300 Torre Avenue, Cupertino, CA 95014. C. Qualifying Insurers Page 9 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract All policies shall be issued by companies which hold a current policy holder's alphabetic and financial size category rating of not less than A VIII, according to the current Best's Key Rating Guide, unless otherwise approved by the City's Insurance Manager. D. Insurance Required 1. Comprehensive General Liability Insurance - for bodily injury (including death) and property damage which provides limits of not less than one million dollars ($1,000,000) combined single limit (CSL) per occurrence. OR 2. Commercial General Liability Insurance - for bodily injury (including death) and property damage which provides limits as follows: a. General limit per occurrence - $1,000,000 b. General limit aggregate - $2,000,000 c. Products/Completed Operations- $1,000,000 aggregate d. Personal Injury limit - $1,000,000 If coverage is provided under a Commercial General Liability Insurance form, the carrier shall provide the City Insurance Manager with a quarterly report of the amount of aggregate limits expended to that date. If over 50% of the aggregate limits have been paid or reserved, the City may require additional coverage to be purchased by the Contractor to restore the required limits. 3. For either type of insurance, coverage shall include: a. Premises and Operations b. Products/Completed Operations with limits of one million dollars ($1,000,000) per occurrence/ aggregate to be maintained for two (2) years following acceptance of the work by the City. c. Contractual Liability expressly including liability assumed under this Contract. d. Personal Injury liability. e. Independent Contractors' (Protective) liability. f. Severability of Interest clause providing that the coverage applies separately to each insured except with respect to the limits of liability. 4. For either type of insurance, coverage shall include the following endorsements, copies of which shall be provided to the City: Page 10 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract a. Additional Insured Endorsement: Such insurance as is afforded by this policy shall also apply to the City of Cupertino, and members of the City Council, and the officers, agents and employees of the City of Cupertino, individually and collectively, as additional insureds. b. Primary Insurance Endorsement: Such insurance as is afforded by the additional insured endorsement shall apply as primary insurance, and other insurance maintained by the City of Cupertino, its officers, agents, and employees shall be excess only and not contributing with insurance provided under this policy. c. Notice of Cancellation or Change of Coverage Endorsement: This policy may not be cancelled nor the coverage reduced by the Company without 30 days prior written notice of such cancellation or reduction in coverage to the City of Cupertino at the address shown on the Certificate of Insurance. d. Contractual Liability Endorsement: This policy shall apply to liability assumed by the insured under written contract with the City of Cupertino. e. Personal Injury Endorsement: The provisions of this policy shall provide Personal Injury coverage. f. Severability of Interest Endorsement: The insurance afforded by this policy shall apply separately to each insured that is seeking coverage or against whom a claim is made or a suit is brought, except with respect to the Company's limit of liability. 5. Comprehensive Automobile Liability Insurance for bodily injury (including death) and property damage which provides total limits of not less than one million dollars ($1,000,000) combined single limit per occurrence applicable to all owned, non-owned and hired vehicles. 6. Worker's Compensation and Employer's Liability Insurance for: a. Statutory California Workers' Compensation coverage including a broad form all- states endorsement. b. Employer's Liability coverage for not less than one million dollars ($1,000,000) per occurrence for all employees engaged in services or operations under this Contract. Page 11 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract c. Inclusion of the City and its governing board(s), officers, representatives, agents, and employees as additional insureds, or a waiver of subrogation. 7. Professional Errors and Omissions Liability Insurance This type of insurance should be provided by persons/entities you contract with to provide you with professional services. a. Limits of not less than one million dollars ($1,000,000). b. If this policy contains a self retention limit, it shall not be greater than ten thousand dollars ($10,000) per occurrence/event. c. This coverage shall be maintained for a minimum of two (2) years following termination of this Contract. The City must first approve any exceptions to the above requirements. 8. Bond Requirements Fidelity Bond - Before receiving compensation under this Contract, Contractor will furnish City with evidence that all officials, employees, and agents handling or having access to funds received or disbursed under this Contract, or authorized to sign or countersign checks, are covered by a BLANKET FIDELITY BOND in an amount of AT LEAST fifteen percent (15%) of the maximum financial obligation of the City cited herein. If such bond is cancelled or reduced, Contractor will notify City immediately, and City may withhold further payment to Contractor until proper coverage has been obtained. Failure to give such notice may be cause for termination of this Contract, at the option of the City. 9. Special Provisions The following provisions shall apply to this Contract: a. The foregoing requirements as to the types and limits of insurance coverage to be maintained by the Contractor and any approval of said insurance by the City or its insurance consultant(s) are not intended to and shall not in any manner limit or qualify the liabilities and obligations otherwise assumed by the Contractor pursuant to this Contract, including but not limited to the provisions concerning indemnification. b. The City acknowledges that some insurance requirements contained in this Contract may be fulfilled by self-insurance on the part of the Contractor. However, this shall not in any way limit liabilities assumed by the Contractor under this Contract. The City shall approve any self-insurance in writing. c. The City reserves the right to withhold payments to the Contractor in the event of material noncompliance with the insurance requirements outlined above. Page 12 of 12 First Amendment to Below Market Rate (BMR) Affordable Housing Fund (AHR) City/Non-Profit Contract d. If the Contractor fails to maintain such insurance as is called for herein, the City must order the Contractor to immediately suspend work at Contractor's expense until a new policy of insurance is in effect. 1195114.2 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES 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). 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. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD 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. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 7/7/2023 Waldorf Risk Solutions,LLC PO Box 590 Huntington NY 11743 631-423-9500 631-424-3610 info@wrs1928.com Church Mutual Insurance Co 18767 CCOSCC Certain Underwriters at Lloyds,London -AA1122000CatholicCharitiesofSantaClaraCounty 2625 Zanker Road San Jose CA 95134 1268983409 B X 1,000,000 X 1,000,000 X SIR $50,000 5,000 1,000,000 3,000,000 X Y 23W2137 7/1/2023 7/1/2024 3,000,000 A 1,000,000 X 0428846-09-604796 7/1/2023 7/1/2024 B X 10,000,000 X 23XS236 7/1/2023 7/1/2024 10,000,000 A X0428846-07-605058 7/1/2023 7/1/2024 1,000,000 1,000,000 1,000,000 B Professional Liability Sexual Misconduct Liability Crime 23W2137 7/1/2023 7/1/2024 Limit per Occ/Claim Aggregate SIR 1,000,000 1,000,000 50,000 Re:Catholic Charities of SC County 2625 Zanker Rd,#200 Santa Clara,CA 95135;operation of LTC Ombudsman Program to help residents of the City of Cupertino living in long term care facilities. Project #:100-72-712-600-623 Project Name:Long Term Care Ombudsman The City of Cupertino and members of the City Council and the officers,agents and employees of the City of Cupertino,individually and collectively,are named as Additional Insured,per policy language.30 Days prior written notice of cancellation or reduction in coverage is required to the City of Cupertino. City Of Cupertino Community Development Department 10300 Torre Avenue Cupertino CA 95014-3202 POLICY NUMBER: COMMERCIAL GENERAL LIABILITY CG 20 26 04 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 20 26 04 13 © Insurance Services Office, Inc., 2012 Page 1 of 1 ADDITIONAL INSURED – DESIGNATED 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): 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 your acts or omissions or the acts or omissions of those acting on your behalf: 1. In the performance of your ongoing operations; or 2. In connection with your premises owned by or rented to you. 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 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. 23W2137 City Of Cupertino Community Development Department 10300 Torre Avenue Cupertino CA 95014-3202 EFP-15001 Ed. 02-14 ©2014 The Travelers Indemnity Company. All rights reserved. Page 1 of 2 ERISA FIDELITY COVERAGE WITH INFLATION GUARD FOR EMPLOYEE BENEFIT PLANS DECLARATIONS POLICY NO.107490444 Travelers Casualty and Surety Company of America Hartford, Connecticut (A Stock Insurance Company, herein called the Company) ITEM 1 Name and Address of the entity sponsoring the Insured Plan(s): Catholic Charities of Santa Clara County 2625 Zanker Road SAN JOSE, CA 95134 ITEM 2 Insured Plan(s): Any and all Employee Benefit Plans that are sponsored by any entity set forth in ITEM 1 or its Subsidiaries and which are in existence or are hereinafter created or acquired by any such entity set forth in ITEM 1. or its Subsidiaries during the Policy Period. ITEM 3 Policy Period: Effective from 12:01 a.m. on August 17, 2021 to: (check one) 12:01 a.m. on ; or the effective date of the cancellation or termination of this Policy. ITEM 4 Limit of Insurance: $500,000.00 . (This amount is the summation of the Limits of Insurance for each Insured as of the Policy effective date and as more fully set forth in section III. LIMIT OF INSURANCE with Inflation Guard.) ITEM 5 Deductible Amount: Not Applicable. ITEM 6 Endorsements forming part of this Policy when issued: EFP-18003 02-14, California Cancellation or Termination Endorsement EFP-19007 02-14, Policy Premium Endorsement EFP-19004 02-18, Scheduled Insured Plans and Specified Limits Endorsement EFP-19014 02-18, Amendatory Endorsement For Certain ERISA Considerations ITEM 7 Cancellation of prior insurance: By acceptance of this Policy, the entity sponsoring the Insured Plans gives the Company notice canceling prior Policy or Bond Number issued by the Company. This cancellation is effective at the date and time this Policy becomes effective. ITEM 8 ALL NOTICES OF CLAIM OR LOSS MUST BE SENT TO THE COMPANY BY EMAIL, FACSIMILE, OR MAIL AS SET FORTH BELOW: Email: BSIclaims@travelers.com FAX: 888.460.6622 Travelers Bond & Specialty Insurance Claim 385 Washington Street Mail Code 9275-NB03F St. Paul, MN 55102 EFP-15001 Ed. 02-14 ©2014 The Travelers Indemnity Company. All rights reserved. Page 2 of 2 THE DECLARATIONS, THE APPLICATION, THE ERISA FIDELITY COVERAGE, AND ANY ENDORSEMENTS ATTACHED THERETO, CONSTITUTE THE ENTIRE AGREEMENT BETWEEN THE COMPANY AND THE ENTITY SPONSORING THE INSURED PLANS. _______________________________ Countersigned By IN WITNESS WHEREOF, the Company has caused this policy to be signed by its authorized officers. Executive Vice President Corporate Secretary EFP-16001 Ed. 02-14 Page 1 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. TABLE OF CONTENTS I. CONSIDERATION CLAUSE 2 II. INSURING AGREEMENT 2 III. LIMIT OF INSURANCE WITH INFLATION GUARD 2 IV. DEFINITIONS 2 V. EXCLUSIONS 4 VI. CONDITIONS 4 EFP-16001 Ed. 02-14 Page 2 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. ERISA FIDELITY COVERAGE WITH INFLATION GUARD FOR EMPLOYEE BENEFIT PLANS I. CONSIDERATION CLAUSE IN CONSIDERATION of the payment of the premium, and subject to the Declarations and pursuant to all the terms, conditions, exclusions and limitations of this Policy, and in compliance with certain provisions of ERISA, the Company will pay the Insured for direct loss that the Insured sustains which is directly caused by a Single Loss taking place before the effective date of cancellation or termination of the Policy and which is Discovered by the Insured during the Policy Period or during the Extended Period to Discover Loss pursuant to section V. CONDITIONS, A. GENERAL CONDITIONS, 1. Extended Period to Discover Loss. II. INSURING AGREEMENT The Company will pay the Insured for direct loss of, or direct loss from damage to, Property that belongs to the Insured directly caused through acts of Fraud or Dishonesty committed by a Fiduciary, whether identified or not, acting alone or in collusion with other persons. III. LIMIT OF INSURANCE WITH INFLATION GUARD The Limit of Insurance set forth in ITEM 4 of the Declarations is the summation of the Limits of Insurance for each Insured as of the Policy’s original effective date. The Single Loss Limit of Insurance applicable to each Insured is determined as of the date of Discovery of a Single Loss as follows: 1. the most the Company will pay to each Insured under this Policy for any Single Loss is an amount equal to 10% of the amount of the funds Handled by such Insured as of the Policy effective date, or $500,000, whichever amount is less, or 2. in the case of an Insured that holds employer securities (within the meaning of 29 United States Code Annotated Section 1112), this section will be applied by substituting “$1,000,000” for “$500,000” in the preceding paragraph. In no event will the Limit of Insurance be less than $1,000. Following the Policy effective date, the Company agrees to automatically increase, if necessary according to ERISA, the Single Loss Limit of Insurance for each Insured as of the beginning of the Insured’s most recent fiscal year to an amount equal to the Limit of Insurance required by ERISA. IV. DEFINITIONS Wherever appearing in this Policy, the following words and phrases appearing in bold type have the meanings set forth in this section IV. DEFINITIONS: A. Discover, Discovered, or Discovery means the moment when the entity sponsoring the Insured Plans or the Insured: 1. first becomes aware of facts that would cause a reasonable person to assume that a loss of a type covered by this Policy has been or will be incurred, regardless of when the act or acts causing or contributing to such loss occurred, even though the exact details of loss may not then be known; or 2. first receives notice of an actual or potential claim against the Insured alleging facts that, if true, would constitute a loss under this Policy. EFP-16001 Ed. 02-14 Page 3 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. B. Employee Benefit Plan means an employee welfare benefit plan or an employee pension benefit plan as more fully set forth in Title 1, Section 3 of ERISA. C. ERISA means the Employee Retirement Income Security Act of 1974, and any amendments thereto. D. Fiduciary means any natural person who is a trustee, officer, employee, or administrator of any Insured. Fiduciary does not mean any agent, broker, independent contractor, third-party administrator, broker- dealer, registered representative, investment advisor, custodian, or other person or entity of the same general character. E. Fraud or Dishonesty has the meaning set forth in Title 29, Code of Federal Regulations, Section 2580.412-9. F. Handled has the meaning set forth in Title 29, Code of Federal Regulations, Section 2580.412-6. G. Insured means any Insured Plan set forth in ITEM 2 of the Declarations. H. Policy means, collectively, the Declarations, the application, the ERISA Fidelity Coverage, and any endorsements attached thereto. I. Policy Period means the period from the Effective Date to the Expiration Date set forth in ITEM 3 of the Declarations, if any. In no event will the Policy Period continue past the effective date of cancellation or termination of this Policy. J. Property means “funds and other property” as this phrase is defined in Title 29, Code of Federal Regulations, Section 2580.412-4. K. Single Loss means: 1. an individual act; 2. the combined total of all separate acts; or 3. a series of related acts, committed by a Fiduciary or committed by more than one Fiduciary acting alone or in collusion with other persons during or before the Policy Period. L. Subsidiary means: 1. any corporation, partnership, limited liability company or other entity organized under the laws of any jurisdiction in which, on or prior to the effective date of the Policy Period, the sponsoring entity set forth in ITEM 1 of the Declarations owns, directly or indirectly, more than 50% of the outstanding securities or voting rights representing the right to vote for the election of or to appoint such organization’s board of directors, board of trustees, board of managers, or a functional equivalent thereof, or to exercise a majority control of the board of directors, board of trustees, board of managers or a functional equivalent thereof; or 2. any organization that the sponsoring entity set forth in ITEM 1 of the Declarations acquires or forms during the Policy Period and in which the sponsoring entity owns, directly or indirectly, more than 50% of the outstanding securities or voting rights representing the right to vote for the election of or to appoint such organization’s board of directors, board of trustees, board of managers, or a functional equivalent thereof or to exercise a majority control of the board of directors, board of trustees, board of managers, or a functional equivalent thereof. EFP-16001 Ed. 02-14 Page 4 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. V. EXCLUSIONS A. This Policy does not cover any expenses incurred by the Insured: 1. in establishing the existence of or the amount of any loss covered under this Policy; or 2. as a party to or in preparation for any legal proceeding whether or not such legal proceeding exposes the Insured to loss covered by this Policy. B. This Policy does not cover loss of income, whether or not earned or accrued, or potential income, including interest and dividends, not realized by the Insured as the result of any loss covered under this Policy. C. This Policy does not cover damages of any type for which the Insured is legally liable, except direct compensatory damages, but not multiples thereof, resulting from a loss covered under this Policy. D. This Policy does not cover indirect or consequential loss of any nature, including fines, penalties, or multiple or punitive damages. E. This Policy does not cover loss resulting directly or indirectly from the diminution in value of Property. F. This Policy does not cover loss caused directly or indirectly by any Fiduciary for whom this Policy has terminated pursuant to section VI. CONDITIONS, C. 4., provided, that this exclusion will not apply to loss of any Property already in transit in the custody of such Fiduciary at the time the Policy terminated or to loss resulting directly from dishonest or fraudulent acts occurring prior to the time the Policy terminated. G. This Policy does not cover loss caused by: 1. The unauthorized access to, use of, or disclosure of confidential information including patents, trade secrets, processing methods, customer lists, or beneficiary lists. 2. The unauthorized access to, use of, or disclosure of confidential or personal information of any customer, Fiduciary, Insured beneficiary, or any other person or entity, including financial information, credit card information, or any other type of non-public information. H. This Policy does not cover fees, costs, fines, penalties, and other expenses incurred by the Insured that are related to any unauthorized access to, use of, or disclosure of confidential or personal information of any customer, Fiduciary, Insured beneficiary, or any other person or entity, including financial information, credit card information, or any other type of non-public information. VI. CONDITIONS A. GENERAL CONDITIONS 1. Extended Period to Discover Loss The Company will pay the Insured for loss that the Insured sustained prior to the effective date of cancellation or termination of this Policy, which is Discovered by the Insured during the Policy Period or within one year after the date of cancellation or termination. Notwithstanding the above, this Extended Period to Discover Loss terminates immediately upon the effective date of any other insurance obtained by the entity sponsoring the Insured Plans or the Insured replacing in whole or in part the insurance afforded by this Policy. 2. Other Insurance This Policy applies only as excess insurance over, and will not contribute with: (1) any other valid EFP-16001 Ed. 02-14 Page 5 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. and collectible insurance available to any Insured unless such insurance is written specifically excess of this Policy by reference in such other policy to the Policy Number of this Policy; and (2) indemnification to which any Insured is entitled from any other entity other than any Insured. As excess insurance, this Policy will not apply to or contribute to the payment of any loss to the Insured until the amount of such other insurance or indemnity has been exhausted by loss covered under such other insurance or indemnity. If the limit of the other insurance or indemnity is insufficient to cover the entire amount of the loss, this Policy will apply to that part of the loss not recoverable or recovered under the other insurance or indemnity. This Policy will not be subject to the terms of any other insurance. Any loss to which this Condition A.2. applies is subject to the applicable Single Loss Limit of Insurance described in section III. LIMIT OF INSURANCE WITH INFLATION GUARD. If this Policy replaces prior insurance that provided the Insured with an extended period of time after the termination or cancellation of such prior insurance in which to Discover loss, then, and only with respect to loss Discovered during such extended period but sustained prior to the termination of such prior insurance, the coverage afforded by this Policy applies as follows: a. the Company will have no liability for such loss, unless the amount of such loss exceeds the limit of insurance of that prior insurance; provided, that in such case, the Company will pay the Insured for the excess of such loss subject to the terms and conditions of this Policy; and b. any payment the Company makes to the Insured for such excess loss will not be greater than the difference between the limit of insurance of the Insured’s prior insurance and the applicable Single Loss Limit of Insurance described in section III. Limit of Insurance with Inflation Guard. 3. Interests Covered This Policy is for the Insured’s benefit only and provides no rights or benefits to any other person or organization. Any claim for loss that is covered under this Policy must be presented by the Insured. 4. Representation, Concealment, Misrepresentation, or Fraud No statement made by or on behalf of the entity sponsoring the Insured Plans shown in ITEM 1 of the Declarations or the Insured, whether contained in the application, underwriting information, or otherwise, is deemed to be a warranty of anything except that it is true to the best of the knowledge and belief of the person making the statement. This Policy will not provide coverage in any case of fraud by the entity sponsoring the Insured Plans or the Insured as it relates to this Policy at any time. This Policy also will not provide coverage if the entity sponsoring the Insured Plans or the Insured, at any time, intentionally conceals or misrepresents a material fact concerning: a. this Policy; b. the Property; c. the entity sponsoring the Insured Plans’ or the Insured’s interest in the Property; or d. a claim under this Policy. 5. Premiums The sponsoring entity set forth in ITEM 1 of the Declarations is responsible for the payment of all premiums and will be the payee for any return premiums the Company pays. Any payment the Company makes to the sponsoring entity for the return of unearned premiums will be held by the EFP-16001 Ed. 02-14 Page 6 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. sponsoring entity for the use and benefit of the Employee Benefit Plans. 6. Transfer of Rights and Duties Under this Policy Rights and duties under this Policy may not be transferred without the Company’s written consent. 7. Loss payment under this Policy Loss payments made under this Policy will be made to the Insured. B. PROVISIONS AFFECTING LOSS ADJUSTMENT AND SETTLEMENT 1. The Insured’s Duties in the Event of a Loss After the entity sponsoring the Insured Plans or the Insured Discovers a loss or a situation that may result in loss of or loss from damage to Property the Insured must: a. notify the Company as soon as possible; b. submit to examination under oath at the Company’s request and give the Company a signed statement of the Insured’s answers; c. give the Company a detailed, sworn proof of loss within 120 days; and d. cooperate with the Company in the investigation and settlement of any claim. 2. Valuation/Settlement The value of any Property will be determined by the market value of such Property on the date the loss was Discovered. If no market price is quoted for such Property, the value may be fixed by agreement between the parties or by voluntary arbitration. Any Property that the Company pays the Insured for or replaces becomes the Company’s Property. 3. Records The Insured must keep records of all Property insured under this Policy so the Company can verify the amount of any loss. 4. Recoveries a. All recoveries for payments made under this Policy will be applied, after first deducting the costs and expenses incurred in obtaining such recovery, in the following order of priority: (1) first, to the Insured to reimburse the Insured for loss sustained that would have been paid under this Policy but for the fact that it is in excess of the Limit of Insurance; (2) second, to the Company in satisfaction of amounts paid or to be paid to the Insured in settlement of the Insured’s covered claim; (3) third, to the Insured in satisfaction of any loss not covered under this Policy. b. The value of all property received by the Insured from any source whatsoever and whenever received, in connection with any matter from which a loss has arisen, will be valued as of the date received and will be deducted from the covered loss. c. Recoveries do not include any recovery: EFP-16001 Ed. 02-14 Page 7 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. (1) from insurance, suretyship, reinsurance, security, or indemnity taken for the Company’s benefit; or (2) of original securities after duplicates of them have been issued. 5. Transfer of the Insured’s Rights of Recovery Against Others to the Company The Insured must transfer to the Company all the Insured’s rights of recovery against any person or organization for any loss the Insured sustained and for which the Company has paid or settled. The Insured must also do everything necessary to secure those rights and do nothing after loss to impair them. 6. Legal Action Against the Company The entity sponsoring the Insured Plans or the Insured may not bring any legal action against the Company involving loss: a. unless the Insured has complied with all the terms of this Policy; b. until 90 days after the Insured has filed proof of loss with the Company; and c. unless brought within two years from the date the Insured Discovers the loss. If any period of limitation in this section VI. CONDITIONS, B. PROVISIONS AFFECTING LOSS ADJUSTMENT AND SETTLEMENT, 6. Legal Action Against the Company is deemed to be inconsistent with any applicable law, such limitation is amended so as to equal the minimum period of limitation provided by such law. 7. Liberalization If the Company adopts any revision to the Terms and Conditions of this Policy that would broaden coverage and such revision does not require an additional premium or endorsement and the revision is adopted within 45 days prior to or during the Policy Period, the broadened coverage will apply to this Policy as of the date the revision is approved for general use by the applicable department of insurance. C. CANCELLATION OR TERMINATION 1. The entity sponsoring the Insured Plans or the Insured may cancel this Policy in its entirety by mailing or delivering to the Company advance written notice of cancellation. 2. The Company may cancel this Policy in its entirety by mailing or delivering to the entity sponsoring the Insured Plans or the Insured written notice of cancellation at least 20 days before the effective date of cancellation if the Company cancels for nonpayment of premium; or 60 days before the effective date of cancellation if the Company cancels for any other reason. The Company will mail or deliver notice to the last mailing address of the sponsoring company set forth in ITEM 1 of the Declarations known to the Company. Notice of cancellation will state the effective date of cancellation and the Policy Period will end on that date. If this Policy is cancelled, the Company will send the sponsoring entity any premium refund due calculated on a pro-rata basis. The Company will have the right to the premium amount for the portion of the Policy Period during which this Policy was in effect. Cancellation will be effective even if the Company has not yet made or offered a refund. If notice is mailed, proof of mailing will be sufficient proof of notice. 3. This Policy terminates in its entirety immediately upon the expiration of the Policy Period set forth in ITEM 3 of the Declarations. 4. This Policy terminates as to any Fiduciary as soon as any other individual with managerial or supervisory responsibility or any Fiduciary not in collusion with such Fiduciary of the entity EFP-16001 Ed. 02-14 Page 8 of 8 ©2014 The Travelers Indemnity Company. All rights reserved. sponsoring the Insured Plans or the Insured becomes aware of any dishonest or fraudulent act committed by such Fiduciary, whether before or after the effective date of this Policy. D. CHANGES Only the sponsoring entity set forth in ITEM 1 of the Declarations or the Insured is authorized to make changes in the terms of this Policy and solely with the Company’s prior written consent. This Policy’s terms can be changed, amended or waived only by endorsement issued by the Company and made a part of this Policy. Notice to any representative of the entity sponsoring the Insured Plans or the Insured or knowledge possessed by any agent or by any other person will not effect a waiver or change to any part of this Policy, or estop the Company from asserting any right under the terms, conditions and limitations of this Policy. E. ENTIRE AGREEMENT This Policy constitutes the entire agreement between the Insured and the Company. F. HEADINGS The titles of the various paragraphs of this Policy and its endorsements are inserted solely for convenience or reference and are not to be deemed in any way to limit or affect the provision to which they relate. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EFP-19014 Ed. 02-18 Page 1 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. AMENDATORY ENDORSEMENT FOR CERTAIN ERISA CONSIDERATIONS This endorsement changes the ERISA Fidelity Policy: Policy Number: Issued By: Issued To: Effective date: 12:01 a.m. Process date: It is agreed that: 1.The following replaces section III. LIMIT OF INSURANCE WITH INFLATION GUARD: III.LIMIT OF INSURANCE WITH INFLATION GUARD The Limit of Insurance set forth in ITEM 4 of the Declarations is the summation of the Limits of Insurance for each Insured as of the Policy’s original effective date. The Single Loss Limit of Insurance applicable to each Insured is determined as of the date of Discovery of a Single Loss as follows: 1.the most the Company will pay to each Insured under this Policy for any Single Loss is an amount equal to 10% of the amount of the funds Handled by a Fiduciary, in accordance with ERISA, as of the policy effective date or $500,000, whichever amount is less, or 2.in the case of an Insured that holds employer securities (within the meaning of 29 United States Code Annotated Section 1112), this section will be applied by substituting “$1,000,000” for “$500,000” in the preceding paragraph. In no event will the Limit of Insurance for each Insured be less than $1,000 or less than the Limit of Insurance purchased for each Insured. Following the Policy effective date, the Company agrees to automatically increase the Single Loss Limit of Insurance for each Insured to an amount equal to the amount required by ERISA as of the date of Discovery of a Single Loss. 2.The following replaces section IV. DEFINITIONS, D. and F.: D.Fiduciary means: 1.any natural person who is a trustee, officer, employee, or administrator of any Insured; or 2.any natural person who is a member of the board of directors, an officer, a member of the board of trustees, a partner, an LLC manager or member, or an employee of any sponsoring entity set forth in ITEM 1 of the Declarations while that person is Handling Property that belongs to any Insured. Fiduciary does not mean any agent, broker, independent contractor, third party administrator, broker-dealer, registered representative, investment advisor, custodian or other person or entity of the same general character. F.Handled or Handling mean “handle”, “handled”, “handles” or “handling” as these terms are set forth in Title 29, Code of Federal Regulations, Section 2580.412-6. 107490444 Travelers Casualty and Surety Company of America Catholic Charities of Santa Clara County August 17, 2021 August 17, 2021 EFP-19014 Ed. 02-18 Page 2 of 2 © 2018 The Travelers Indemnity Company. All rights reserved. 3. The following replaces section V. EXCLUSIONS, E. and G.: E. This policy does not cover loss resulting directly or indirectly from the diminution in value of Property, provided this exclusion will not apply to loss that is otherwise covered under this Policy and caused by a Fiduciary’s acts of Fraud or Dishonesty. G. This policy does not cover loss caused by: 1. the unauthorized access to, use of, or disclosure of confidential information including patents, trade secrets, processing methods, customer lists or beneficiary lists; or 2. the unauthorized access to, use of, or disclosure of confidential information or personal information of any customer, Fiduciary, beneficiary of an Insured, or any other person or entity, including financial information, credit card information or any other type of non-public information, provided that this exclusion will not apply to loss that is otherwise covered under this Policy, caused by a Fiduciary’s access to, use of, or disclosure of confidential or personal information to commit acts of Fraud or Dishonesty. 4. The following replaces section VI. CONDITIONS, A. GENERAL CONDITIONS, 1.: 1. Extended Period to Discover Loss The Company will pay the Insured for loss that the Insured sustained prior to the effective date of cancellation or termination of this Policy, which is Discovered by the Insured during the Policy Period or within one year after the date of cancellation or termination of this Policy. Notwithstanding the above, this Extended Period to Discover loss terminates immediately upon the effective date of any other insurance obtained by the entity sponsoring the Insured Plans or the Insured that offers the same coverage afforded by this Policy in an amount no less than the minimum amount required under ERISA section 412 and that provides coverage for loss sustained prior to its effective date. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. © 2018 The Travelers Indemnity Company. All rights reserved. EFP-19004 Rev. 02-18 Page 1 of 1 Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. SCHEDULED INSURED PLANS AND SPECIFIED LIMITS ENDORSEMENT This endorsement changes the ERISA Fidelity Policy:Policy Number:107490444 Issued By:Travelers Casualty and Surety Company of America Issued To:Catholic Charities of Santa Clara County Effective date:August 17, 2021 12:01 a.m. Process date:August 17, 2021 It is agreed that: The following replaces ITEM 2 of the Declarations: ITEM 2 Insured Plan(s): Any and all Employee Benefit Plans set forth in the SCHEDULE below and any Employee Benefit Plans that are sponsored by any entity set forth in ITEM 1 or its Subsidiaries and which are in existence or are hereinafter created or acquired by any such entity set forth in ITEM 1. or its Subsidiaries during the Policy Period. SCHEDULE Insured Single Loss Limit of Insurance Catholic Charities of Santa Clara County 401(k) Plan $500,000.00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EFP-19007 Ed. 02-14 Page 1 of 1 © 2014 The Travelers Indemnity Company. All rights reserved. POLICY PREMIUM ENDORSEMENT This endorsement changes the ERISA Fidelity Policy: Policy Number: Issued By: Issued To: Effective date: 12:01 a.m. Process date: It is agreed that: The following is added to the Declarations: The premium charged for the period from to is . Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. 107490444 Travelers Casualty and Surety Company of America Catholic Charities of Santa Clara County August 17, 2021 August 17, 2021 August 17, 2021 August 17, 2024 $475.00 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. EFP-18003 Ed. 02-14 Page 1 of 2 © 2014 The Travelers Indemnity Company. All rights reserved. CALIFORNIA CANCELLATION OR TERMINATION ENDORSEMENT This endorsement changes the ERISA Fidelity Policy: Policy Number: Issued By: Issued To: Effective date: 12:01 a.m. Process date: It is agreed that: 1. The following is added to section VI. CONDITIONS, C. CANCELLATION OR TERMINATION: POLICIES IN EFFECT FOR MORE THAN 60 DAYS If this Policy has been in effect for more than 60 days, or is a renewal of a Policy the Company issued, the Company may cancel this Policy only upon the occurrence after the effective date of the Policy of one or more of the following: 1. nonpayment of premiums including payment due on a prior policy the Company issued and due during the current policy term covering the same risks; 2. discovery of fraud or material misrepresentation by: a. the sponsoring entity or the Insured or the Insured’s representative in obtaining this insurance; or b. the sponsoring entity or the Insured or the Insured’s representative in pursuing a claim under this Policy; 3. a judgment by a court or an administrative tribunal that the entity sponsoring the Insured Plans or the Insured has violated a California or Federal law, having as one of its necessary elements an act that materially increases any of the risks insured against; 4. discovery of willful or grossly negligent acts or omissions, or of any violations of state laws or regulations establishing safety standards, by the entity sponsoring the Insured Plans or the Insured or the Insured’s representative, which materially increase any of the risks insured against; 5. failure by the entity sponsoring the Insured Plans or the Insured or the Insured’s representative to implement reasonable loss control requirements, agreed to by the entity sponsoring the Insured Plans or the Insured as a condition of Policy issuance, or which were conditions precedent to the Company’s use of a particular rate or rating plan, if that failure materially increases any of the risks insured against; 6. a determination by the Commissioner of lnsurance that the: a. loss of, or changes in, the Company’s reinsurance covering all or part of the risk would threaten the Company’s financial integrity or solvency; or b. continuation of the Policy coverage would: i. place the Company in violation of California law or the laws of the state where the Company is domiciled; or 107490444 Travelers Casualty and Surety Company of America Catholic Charities of Santa Clara County August 17, 2021 August 17, 2021 EFP-18003 Ed. 02-14 Page 2 of 2 © 2014 The Travelers Indemnity Company. All rights reserved. ii. threaten the Company’s solvency; or 7. a change by the entity sponsoring the Insured Plans or the Insured or the Insured’s representative in the activities or property of the commercial or industrial enterprise, which results in a materially added, increased or changed risk, unless the added, increased or changed risk is included in the Policy. The Company will mail or deliver advance written notice of cancellation, stating the reason for cancellation, to the sponsoring entity set forth in ITEM 1 of the Declarations, and to the producer of record, at least: 1. 10 days before the effective date of cancellation if the Company cancels for a reason listed in paragraph 1. or 2. above; or 2. 30 days before the effective date of cancellation if the Company cancels for any other reason listed in paragraphs 3. – 7. above. 2. The following is added to section VI. CONDITIONS: NONRENEWAL 1. Subject to the provisions of paragraph 2. below, if the Company elects not to offer to renew this Policy, the Company will mail or deliver written notice stating the reason for nonrenewal to the sponsoring entity set forth in ITEM 1 of the Declarations and to the Insured’s agent or broker of record, at least 60 days, but not more than 120 days, before the expiration or anniversary date. The Company will mail or deliver the Company’s notice to the sponsoring entity set forth in ITEM 1 of the Declarations, and to the Insured’s agent or broker of record, at the mailing address shown in the Policy. 2. The Company is not required to send notice of nonrenewal in the following situations: a. if the transfer or renewal of a Policy, without any changes in terms, conditions, or rates, is between the Company and a member of the Company’s insurance group; b. if the Policy has been extended for 90 day or less, provided that notice has been given in accordance with paragraph 1. above; c. if the entity sponsoring the Insured Plans or the Insured has obtained replacement coverage, or if the sponsoring entity set forth in ITEM 1 of the Declarations or the Insured has agreed, in writing, within 60 days of the termination of the Policy, to obtain that coverage; d. if the Policy is for a period of no more than 60 days and the entity sponsoring the Insured Plans or the Insured is notified at the time of issuance that it will not be renewed; e. if the sponsoring entity set forth in ITEM 1 of the Declarations or the Insured requests a change in the terms or conditions or risks covered by the Policy within 60 days of the end of the Policy Period; or f. if the Company has made a written offer to the entity sponsoring the Insured Plans set forth in ITEM 1 of the Declarations of the Insured, in accordance with the timeframes shown in Paragraph 1., to renew the Policy under changed terms or conditions or at an increased premium rate, when the increase exceeds 25%. Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the above-mentioned policy, except as expressly stated herein. This endorsement is part of such policy and incorporated therein. ILT-1037 Ed. 01-09 Printed in U.S.A. Page 1 of 1 ©2009 The Travelers Companies, Inc. All Rights Reserved IMPORTANT NOTICE REGARDING COMPENSATION DISCLOSURE For information about how Travelers compensates independent agents, brokers, or other insurance producers, please visit this website: www.travelers.com/w3c/legal/Producer_Compensation_Disclosure.html If you prefer, you can call the following toll-free number: 1-866-904-8348. Or you can write to us at Travelers, Enterprise Development, One Tower Square, Hartford, CT 06183. General Fund Human Services Grants Program Final Audit Report 2023-10-06 Created:2023-10-03 By:City of Cupertino (webmaster@cupertino.org) Status:Signed Transaction ID:CBJCHBCAABAAdt7CKRlL0SXEPOCa-8DUZJP69W5FaXWZ "General Fund Human Services Grants Program" History Document created by City of Cupertino (webmaster@cupertino.org) 2023-10-03 - 0:23:14 AM GMT- IP address: 35.229.54.2 Document emailed to Araceli Alejandre (aracelia@cupertino.org) for approval 2023-10-03 - 0:25:28 AM GMT Document approved by Araceli Alejandre (aracelia@cupertino.org) Approval Date: 2023-10-03 - 0:28:11 AM GMT - Time Source: server- IP address: 71.204.144.228 Document emailed to Gregory Kepferle (gkepferle@catholiccharitiesscc.org) for signature 2023-10-03 - 0:28:16 AM GMT Email viewed by Gregory Kepferle (gkepferle@catholiccharitiesscc.org) 2023-10-03 - 0:28:23 AM GMT- IP address: 66.249.84.225 Document e-signed by Gregory Kepferle (gkepferle@catholiccharitiesscc.org) Signature Date: 2023-10-06 - 4:12:37 PM GMT - Time Source: server- IP address: 208.74.182.45 Document emailed to christopherj@cupertino.org for signature 2023-10-06 - 4:12:42 PM GMT Email viewed by christopherj@cupertino.org 2023-10-06 - 4:47:23 PM GMT- IP address: 104.47.73.254 Signer christopherj@cupertino.org entered name at signing as Christopher D. 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Jensen (christopherj@cupertino.org) Signature Date: 2023-10-06 - 4:47:39 PM GMT - Time Source: server- IP address: 136.24.22.111 Document emailed to Benjamin Fu (benjaminf@cupertino.org) for signature 2023-10-06 - 4:47:43 PM GMT Email viewed by Benjamin Fu (benjaminf@cupertino.org) 2023-10-06 - 4:55:28 PM GMT- IP address: 104.47.73.126 Document e-signed by Benjamin Fu (benjaminf@cupertino.org) Signature Date: 2023-10-06 - 4:56:44 PM GMT - Time Source: server- IP address: 67.188.118.217 Document emailed to Kirsten Squarcia (kirstens@cupertino.org) for signature 2023-10-06 - 4:56:48 PM GMT Email viewed by Kirsten Squarcia (kirstens@cupertino.org) 2023-10-06 - 5:13:56 PM GMT- IP address: 104.28.111.137 Document e-signed by Kirsten Squarcia (kirstens@cupertino.org) Signature Date: 2023-10-06 - 6:12:47 PM GMT - Time Source: server- IP address: 162.245.20.145 Agreement completed. 2023-10-06 - 6:12:47 PM GMT