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ENDORSEMENT <br />(TO BE ATTACHED TO CERTIFICATE) <br />Effective Date of Endorsement: 5/6/2023 <br />Cancellation Date of Endorsement: 5/7/2023 <br />Certificate Holder: The Diocese of Fort Wayne -South Bend, Inc. <br />Chancery Office <br />P O Box 390 <br />Fort Wayne, IN 46801 <br />Location: ST ADALBERT CHURCH <br />2505 GRACE STREET <br />SOUTH BEND, IN 46619-0000 <br />Certificate No. 8679 of The Catholic Mutual Relief Society of America is amended as follows: <br />SECTION II - ADDITIONAL PROTECTED PERSON(S) <br />It is understood and agreed that Section II - Liability (only with respect to Coverage D - General <br />Liability), is amended to include as an Additional Protected Person(s) members of the organizations shown <br />in the schedule, but only with respect to their liability for the Protected Person(s) activities or <br />activities they perform on behalf of the Protected Person(s). <br />It is further understood and agreed that coverage extended under this endorsement is limited to and <br />applies only with respect to liability assumed by contract or agreement; and this extension of <br />coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit <br />of liability thereunder. Unless otherwise agreed by contract or agreement, coverage extended under <br />this endorsement to the Additional Protected Person(s) will not precede the effective date of this <br />certificate of coverage endorsement or extend beyond the cancellation date. <br />Schedule - ADDITIONAL PROTECTED PERSON(S) <br />City of South Bend, Special Events Committee and Board of Public <br />Works, 731 S Lafayette Blvd, South Bend, IN <br />Remarks (the following language supersedes any other language in this endorsement or the Certificate in <br />conflict with this language): <br />Coverage only extends for claims arising out of St. Adalbert Church for their Cinco De Mayo Festival on <br />May 6, 2023 from l2pm-5pm. <br />�. <br />Authoriz Representative <br />