Special Event - St. Nick 6 - December 2 - Revised Route

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ENDORSEMENT (TO BE ATTACHED TO CERTIFICATE) • Effective Date of Endorsement: 12/2/2023 Cancellation Date of Endorsement: 12/3/2023 Certificate Holder: The Diocese of Fort Wayne -South Bend. Inc. Chancery Office P O Box 390 Fort Wayne, IN 46801 Location: ST JOSEPH SCHOOL 216 N. HILL ST SOUTH BEND, IN 46617 Certificate No. 8679 of The Catholic Mutual Relief Society of America is amended as follows: SECTION II - ADDITIONAL PROTECTED PERSON(S) It is understood and agreed that Section II - Liability (only with respect to Coverage D - General Liability), is amended to include as an Additional Protected Person(s) members of the organizations shown in the schedule, but only with respect to their liability for the Protected Person(s) activities or activities they perform on behalf of the Protected Person(s). It is further understood and agreed that coverage extended under this endorsement is limited to and applies only with respect to liability assumed by contract or agreement: and this extension of coverage shall not enlarge the scope of coverage provided under this certificate or increase the limit of liability thereunder. Unless otherwise agreed by contract or agreement, coverage extended under • this endorsement to the Additional Protected Person(s) will not precede the effective date of this certificate of coverage endorsement or extend beyond the cancellation date. Schedule - ADDITIONAL PROTECTED PERSON(S) The City of South Bend Public Works Service Center 731 S. Lafayette Blvd. South Bend IN Remarks (the following language supersedes any other language in this endorsement or the Certificate in conflict with this language): City of South Bend, Special Events Committee, and Board of Public Works are named additional protected person(s) but only for claims arising out of St. Joseph School's St. Nick 6k and 3k Annual Run/Walk Event on December 2, 2023. 4Au PKS-122(10.11)