FILED: NEW YORK COUNTY CLERK 11/01/ :22 PM

Transcription

1 Exhibit "2"

2 Policy Number: Philadelphia Indemnity Insurance Company COMMON POLICY DECLARATIONS PHPK Named Insured and Mailing Address: Mount Zion AME Church 1765 Madison Ave New York, NY Producer: Oxford Millin Insurance Agency PO Box 684 Jenkintown, PA Policy Period From: 09/12/2013 To: 09/12/2014 at 12:01 A.M. Standard Time at your mailing address shown above. Business Description: Religious Organization IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. THIS POLICY CONSISTS OF THE FOLLOWING COVERAGE PARTS FOR WHICH A PREMIUM IS INDICATED. THIS PREMIUM MAY BE SUBJECT TO ADJUSTMENT. PREMIUM Commercial Property Coverage Part Commercial General Liability Coverage Part Commercial Crime Coverage Part Commercial Inland Marine Coverage Part Commercial Auto Coverage Part Businessowners Workers Compensation Professional Liability Directors and Officers Total $ Total Includes Federal Terrorism Risk Insurance Act Coverage FORM (S) AND ENDORSEMENT (S) MADE A PART OF THIS POLICY AT THE TIME OF ISSUE Refer To Forms Schedule *Omits applicable Forms and Endorsements if shown in specific Coverage Part/Coverage Form Declarations CPD- PIIC (01/07) Countersignature Date Authorized Representative

3 Philadelphia Indemnity Insurance Company Form Schedule Policy Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form Recurring Payment Flyer CSNotice-1 BJP CPD-PIIC Location Schedule Loss Payee Schedule PP-0701 PI-BELL-1 NY PI-CME-1 IL0017 IL0023 IL0183 IL0185 IL0268 IL0952 IL0985 Edition Description Recurring Payment Flyer Making Things Easier Commercial Lines Policy Jacket Common Policy Declarations Location Schedule Loss Payee Schedule Privacy Policy Notice Bell Endorsement Crisis Management Enhancement Endorsement Common Policy Conditions Nuclear Energy Liability Exclusion Endorsement New York Changes - Fraud New York Changes - Calculation of Premium New York Changes - Cancellation and Nonrenewal Cap on Losses From Certified Acts of Terrorism Disclosure Pursuant to Terrorism Risk Insurance Act Page 1 of 1

4 Locations Schedule Philadelphia Indemnity Insurance Company Policy Number: PHPK Prems. Bldg. No. No. Address Madison Ave New York, NY Page 1 of 1

5 Philadelphia Indemnity Insurance Company Loss Payee Schedule Policy Number: PHPK Loss Payee Canon Financial Services Insurance Center SE 30th Pl Ste 100 Bellevue, WA NY - Loc #1 - Bld #1 - BUSINESS PERS PROPERTY (CHURCH/HOUSE OF WORSHIP) Page 1 of 1

6 NEW YORK EXCLUSION OF LOSS DUE TO VIRUS OR BACTERIA ADVISORY NOTICE TO POLICYHOLDERS COMMERCIAL PROPERTY CP P This Notice does not form a part of your insurance contract. No coverage is provided by this Notice, nor can it be construed to replace any provisions of your policy (including its endorsements). If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements) shall prevail. Carefully read your policy, including the endorsements attached to your policy. This Notice provides information concerning the following new endorsement, which applies to your new or renewal policy being issued by us: New York Exclusion Of Loss Due To Virus Or Bacteria Endorsement CP This endorsement makes an explicit statement regarding a risk that is not covered under your Commercial Property insurance. It points out that there is no coverage under such insurance for loss or damage caused by or resulting from any virus, bacterium or other microorganism that induces or is capable of inducing physical distress, illness or disease. The exclusion in this endorsement applies to all coverages provided by your Commercial Property insurance, including (if any) property damage and business income coverages. CP P ISO Properties, Inc., 2007 Page 1 of 1

7 WATER EXCLUSION ENDORSEMENT ADVISORY NOTICE TO POLICYHOLDERS COMMERCIAL PROPERTY CP P This Notice does not form a part of your insurance contract. No coverage is provided by this Notice, nor can it be construed to replace any provisions of your policy (including its endorsements). If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements) shall prevail. Carefully read your policy, including the endorsements attached to your policy. This Notice provides information concerning the following new endorsement, which applies to your new or renewal policy being issued by us: Water Exclusion Endorsement CP This endorsement replaces the current water exclusion in your policy with a revised exclusion. The revised exclusion contains language reinforcing the scope of the water exclusion, and explicitly states that such exclusion applies regardless of whether the water damage is caused by an act of nature or is otherwise caused. Specific mention is made of various boundary or containment systems such as dams and levees to further highlight this point. Further, express references to tsunami, storm surge and waterborne material are also added to the exclusion. The exclusion in this endorsement applies to all coverages provided by your Commercial Property insurance, including (if any) property damage and business income coverages, unless stated otherwise in your policy. CP P Insurance Services Office, Inc., 2008 Page 1 of 1

8 Philadelphia Indemnity Insurance Company COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS Policy Number: Named Insured: PHPK Mount Zion AME Church See Supplemental Schedule Agent # BUSINESS DESCRIPTION: Religious Organization DESCRIPTION OF PREMISES: Prem. Bldg No. No. Location, Fire Protection/Construction and Occupancy SEE SCHEDULE ATTACHED COVERAGES PROVIDED: Insurance at the described premises applies only for coverages for which a limit of insurance is shown or for which an entry is made. Prem. Bldg. Limit of Causes of No. No. Coverage Insurance Loss Form (1) Coinsurance(2) Deductible SEE SCHEDULE ATTACHED OPTIONAL COVERAGES: Prem. Bldg. Agreed Value Replacement Cost Inflation No. No. Coverage Amount Expiration Date Incl. Stock Guard SEE SCHEDULE ATTACHED OPTIONAL COVERAGES: APPLIES TO BUSINESS INCOME ONLY Prem. Bldg. Agreed Value Agreed Value Monthly Limit of Maximum Period of Extended Period of No. No. Date Amount Indemnity (Fraction) Indemnity Indemnity (Days) SEE SCHEDULE ATTACHED DEDUCTIBLE: SEE SCHEDULE ATTACHED MORTGAGE HOLDERS: Refer To Mortgagee/Loss Payee Schedule FORM(S) AND ENDORSEMENT(S) APPLICABLE TO THIS COVERAGE PART: Refer To Forms Schedule TOTAL PREMIUM FOR THIS COVERAGE PART $ 2, (1) EQ (if shown) = Earthquake (2) Coinsurance %, Extra Expense %, Limits on Loss Payment or Value Reporting Form Symbol Countersignature Date Authorized Representative

9 Philadelphia Indemnity Insurance Company Form Schedule Property Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: FORMS APPLICABLE TO ALL PREMISES AND COVERAGES Form Edition Description CP P NY-Exclusion of Loss Due to Virus or Bacteria CP P Water Exclusion Endt Advisory Notice to Policyholders Property Dec 0100 Property Declarations Property Schedule 0100 Property Supplemental Schedule CP Commercial Property Conditions CP New York Changes CP New York Changes - Fungus, Wet Rot and Dry Rot CP New York - Exclusion Of Loss Due To Virus Or Bacteria CP Water Exclusion Endorsement CP Loss Payable Provisions PI-BM-001 NY 1006 Equipment Breakdown Protection Endorsement FORMS APPLICABLE TO SPECIFIC PREMISES AND COVERAGES Form Edition Description CP Building and Personal Property Coverage Form NY PREMS 001 BLDG 001 BUILDING BUSINESS PERS PROPERTY CP Business Income (And Extra Expense) Coverage Form CP Causes of Loss - Special Form NY PREMS 001 BLDG 001 BUILDING BUSINESS PERS PROPERTY PI-EPE-RO-NY 0107 Elite Property Enhancement: Religious Organization PI-NP Loss of Income Due to Workplace Violence Page 1 of 1

10 Philadelphia Indemnity Insurance Company COMMERCIAL PROPERTY COVERAGE PART SUPPLEMENTAL SCHEDULE Policy Number: PHPK Named Insured: Mount Zion AME Church Agent # DESCRIPTION OF PREMISES: Prem. Bldg. No. No. Location, Fire Protection/Construction and Occupancy Madison Ave New York, NY CHURCH/HOUSE OF WORSHIP PC 04 FIRE RESISTIVE COVERAGES PROVIDED: Insurance at the described premises applies only for coverages for which a limit of insurance is shown or for which an entry is made. Prem. Bldg. Limit of Causes of (1) No. No. Coverage Insurance Loss Form Coinsurance(2) Deductible BUILDING BUSINESS PERS PROPERTY BOILER & MACHINERY PROPERTY ELITE 1,550, ,000 SPECIAL SPECIAL 80% 80% 1,000 1,000 OPTIONAL COVERAGES: Prem. Bldg. Agreed Value Replacement Cost Inflation No. No. Coverage Amount Expiration Date Incl. Stock Guard BUILDING BUSINESS PERS PROPERTY (X) (X) (X) OPTIONAL COVERAGES: APPLIES TO BUSINESS INCOME ONLY Prem. Bldg. Agreed Value Agreed Value Monthly Limit of Maximum Period of Extended Period of No. No. Date Amount Indemnity(Fraction) Indemnity Indemnity (Days) Deductible Exceptions: (1) EQ (if shown) = Earthquake (2) Coinsurance %, Extra Expense %, Limits on Loss Payment or Value Reporting Form Symbol (5) 10% or $5,000 minimum

11 COMMERCIAL GENERAL LIABILITY CG P RECORDING AND DISTRIBUTION OF MATERIAL OR INFORMATION IN VIOLATION OF LAW EXCLUSION ENDORSEMENT ADVISORY NOTICE TO POLICYHOLDERS This Notice does not form a part of your insurance contract. No coverage is provided by this Notice, nor can it be construed to replace any provisions of your policy (including its endorsements). If there is any conflict between this Notice and the policy (including its endorsements), the provisions of the policy (including its endorsements) shall prevail. Carefully read your policy, including the endorsements attached to your policy. This Notice provides information concerning the following new endorsement, which applies to your renewal policy being issued by us: Recording And Distribution Of Material Or Information In Violation Of Law Exclusion Endorsement CG This endorsement replaces the current Distribution Of Material In Violation Of Statutes Exclusion in your policy with a revised exclusion, newly titled Recording And Distribution Of Material Or Information In Violation Of Law Exclusion. The revised exclusion contains language that elaborates on the intent of the Distribution Of Material In Violation Of Statutes Exclusion to reflect that, in addition to the TCPA and CAN-SPAM Act of 2003, the exclusion will more explicitly exclude liability coverage for bodily injury, property damage or personal and advertising injury arising out of any action or omission that violates, or is alleged to violate, the Fair Credit Reporting Act (FCRA), and any amendment of or addition to such law, including the Fair and Accurate Credit Transactions Act (FACTA) and any other similar federal, state or local statute, ordinance or regulation concerning disposal and dissemination of personal information. CG P Insurance Services Office, Inc., 2008 Page 1 of 1

12 Philadelphia Indemnity Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS Policy Number: PHPK See Supplemental Schedule Agent # LIMITS OF INSURANCE $ 3,000,000 General Aggregate Limit (Other Than Products Completed Operations) $ 3,000,000 Products/Completed Operations Aggregate Limit (Any One Person Or Organization) $ 1,000,000 Personal and Advertising Injury Limit $ 1,000,000 Each Occurrence Limit $ 100,000 Rented To You Limit $ 5,000 Medical Expense Limit (Any One Person) FORM OF BUSINESS: RELIG ORGAN, ASSOC, LABOR ORGAN Business Description: Religious Organization Location of All Premises You Own, Rent or Occupy: SEE SCHEDULE ATTACHED AUDIT PERIOD, ANNUAL, UNLESS OTHERWISE STATED: This policy is not subject to premium audit. Rates Advance Premiums Premium Prem./ Prod./ Prem./ Prod./ Classifications Code No. Basis Ops. Comp. Ops Ops. Comp. Ops. SEE SCHEDULE ATTACHED TOTAL PREMIUM FOR THIS COVERAGE PART: $ 3, $ RETROACTIVE DATE (CG ONLY) This insurance does not apply to "Bodily Injury", "Property Damage", or "Personal and Advertising Injury" which occurs before the retroactive date, if any, shown below. Retroactive Date: FORM (S) AND ENDORSEMENT (S) APPLICABLE TO THIS COVERAGE PART: Refer To Forms Schedule Countersignature Date Authorized Representative

13 Philadelphia Indemnity Insurance Company Form Schedule General Liability Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form CGP011 Gen Liab Dec Gen Liab Schedule CG0001 CG0068 CG0104 CG0163 CG2022 CG2147 CG2170 CG2504 CG2621 CG3344 PI-AM-1 NY PI-GL-002 PI-RO-005 PI-RO-012 PI-RO-014 NY PI-SE-001 Edition Description Recording and Distribution of Material or Information Commercial General Liability Coverage Part Declaration General Liability Schedule Commercial General Liability Coverage Form Recording and Distribution of Material or Information New York Changes - Premium Audit New York Changes-Commercial General Liability Cov Form Addl Ins - Church Members and Officers Employment-Related Practices Exclusion Cap on Losses From Certified Acts of Terrorism Designated Location(s) General Aggregate Limit NY Changes-Transfer of Duties When Limit is Used Up New York Changes - Binding Arbitration Abuse or Molestation Sublimit - New York Exclusion - Asbestos Liability Exclusion Professional Liability Coverage General Liability Deluxe Endorsement: Religious Org Secession/Expulsion Exclusion Fund Raising Events Endorsement Page 1 of 1

14 Philadelphia Indemnity Insurance Company COMMERCIAL GENERAL LIABILITY COVERAGE PART SUPPLEMENTAL SCHEDULE Policy Number: PHPK Agent # Classifications Code No. Premium Rates Advance Premiums Basis Prem./ Prod./ Prem./ Prod./ Ops. Comp. Ops. Ops. Comp. Ops. NY PREM NO. 001 CHURCH/HOUSE OF WORSHIP PROD/COMP OP SUBJ TO GEN AGG LIMIT AREA 12, INCL 3,071 INCL NY LIABILITY DELUXE

15 Philadelphia Indemnity Insurance Company POLICY NUMBER: PHPK COMMERCIAL CRIME COVERAGE PART DECLARATIONS COMMERCIAL CRIME CR DS The Commercial Crime Coverage Part consists of this Declarations Form and the Commercial Crime Coverage Form. EMPLOYEE BENEFIT PLAN(S) INCLUDED AS INSUREDS: INSURING AGREEMENTS, LIMITS OF INSURANCE AND DEDUCTIBLES: INSURING AGREEMENTS 1. Employee Theft 2. Forgery Or Alteration 3. Inside The Premises - Theft Of Money And Securities 4. Inside The Premises - Robbery Or Safe Burglary Of Other Property 5. Outside The Premises 6. Computer Fraud 7. Funds Transfer Fraud 8. Money Orders And Counterfeit Paper Currency LIMIT OF INSURANCE DEDUCTIBLE AMOUNT Per Occurrence Per Occurrence See Schedule See Schedule Not Covered Not Covered See Schedule Not Covered Not Covered Not Covered If Added by Endorsement, Insuring Agreement(s): IF APPLICABLE, SEE SCHEDULE ATTACHED If "Not Covered" is inserted above opposite any specified Insuring Agreement, such Insuring Agreement and any other reference thereto in this policy is deleted. ENDORSEMENTS FORMING PART OF THIS COVERAGE PART WHEN ISSUED: SEE SCHEDULE ATTACHED CANCELLATION OF PRIOR INSURANCE ISSUED BY US: By acceptance of this Coverage Part you give us notice cancelling prior policy Nos. PHPK ; the cancellation to be effective at the time this Coverage Part becomes effective. COUNTERSIGNED (Date) BY: (Authorized Representative) CR DS ISO Properties, Inc., 2001 Page 1 of 1

16 Philadelphia Indemnity Insurance Company Form Schedule Crime Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form CRDS01 Crime Schedule CR0021 CR0155 CR0407 CR2012 Edition Description Commercial Crime Coverage Part Declarations Schedule of Insuring Agreements Commerical Crime Coverage Form (Loss Sustained Form) New York Changes Inside the Prem-Robbery or Safe Burg of Mon & Sec Binding Arbitration Page 1 of 1

17 Philadelphia Indemnity Insurance Company POLICY NUMBER: PHPK SCHEDULE OF INSURING AGREEMENTS INSURING AGREEMENT(S) LIMIT OF INSURANCE Per Occurrence NUMBER OF PREMISES DEDUCTIBLE Per Occurrence PREMIUM EMPLOYEE THEFT FORGERY OR ALTERATION OUTSIDE THE PREMISES INSIDE PREMISES-ROBBERY/SAFE BURG-M&S $ 10,000 $ 10,000 $ 5,000 $ 5, $ 500 $ 500 $ 500 $ 500 $ 77 $ 20 $ 4 $ 32 Total Premium $ 133 Page 1 of 1

18 POLICY NUMBER: PHPK PI-CA DS 03 NY (05/11) ITEM ONE Philadelphia Indemnity Insurance Company BUSINESS AUTO DECLARATIONS NEW YORK Named Insured: Mount Zion AME Church Mailing Address: 1765 Madison Ave New York, NY From: 09/12/2013 To: 09/12/2014 Previous Policy Number: PHPK Policy Period At 12:01 A.M. Standard Time at your mailing address. Form of Business: RELIG ORGAN, ASSOC, LABOR ORGAN In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. Premium shown is payable at inception: $ Audit Period (If Applicable): Annually Semi-Annually Quarterly Monthly Endorsements Attached To This Policy: See Schedule Attached Name: Countersignature Of Authorized Representative Title: Signature: Date: Page 1 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

19 PI-CA-DS-03 NY (05/11) ITEM TWO Schedule Of Coverages And Covered Autos This policy provides only those coverages which are indicated with a premium entry. Each of these coverages will apply only to those "autos" shown as covered "autos". "Autos" are shown as covered "autos" for a particular coverage by the entry of one or more of the symbols from the Covered Autos Section of the Business Auto Coverage Form next to the name of the coverage. Coverages Covered Autos Limits Premium Liability 08, 09 1,000,000 CSL Supplemental Spousal Liability New York Personal Injury Protection (P.I.P.) Total (See New York Supplemental Declarations) Auto Medical Payments Uninsured Motorists OR Supplementary Uninsured/Underinsured Motorists (SUM) The maximum amount payable under SUM coverage shall be the policy s SUM limits, reduced and thus offset by motor vehicle bodily injury liability insurance policy or bond payments received from, or on behalf of, any negligent party involved in the accident, as specified in the SUM endorsement. Page 2 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

20 PI-CA-DS-03 NY (05/11) ITEM TWO Schedule Of Coverages And Covered Autos (Cont'd) Coverages Physical Damage Comprehensive Coverage Covered Autos Limit Premium Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered Auto. See Item Four For Hired Or Borrowed Autos. $ Physical Damage Specified Causes Of Loss Coverage Physical Damage Collision Coverage Physical Damage Towing And Labor Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ 25 Deductible For Each Covered Auto For Loss Caused By Mischief Or Vandalism. See Item Four For Hired Or Borrowed Autos. Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered Auto. See Item Four For Hired Or Borrowed "Autos". $ For Each Disablement Of A Private Passenger Auto. Terrorism All Per Coverage Endorsement $ 1.00 $ $ $ *This Policy May Be Subject To Final Audit. Premium For Endorsements $ Estimated Total Premium* $ Page 3 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

21 PI-CA-DS-03 NY (05/11) ITEM THREE Schedule Of Covered Autos You Own Covered Auto Number: Town, or City & Zip and Territory where the covered auto will be principally garaged SEE SCHEDULE Description (Year, Model, Trade Name, Body Type, Serial Number (S), Vehicle Identification Number (VIN)) Purchased: Original Cost New $ Actual Cost New (N) Or Used (U) $ Classification Radius Of Operation Business Use s=service r=retail c=commercial Size GVW, GCW Or Vehicle Seating Capacity Age Group Liab. Primary Rating Factor Phy. Dam. Secondary Rating Factor Code Except For Towing, All Physical Damage Loss Is Payable To You And The Loss Payee Named To The Right As Interests May Appear At the Time Of The Loss. Coverages Premiums, Limits And Deductibles (Absence of a deductible or limit entry in any column below means that the limit or deductible entry in the corresponding Item Two column applies instead.) Coverages Limit Premium Liability $ $ Personal Injury Protection Optional Basic Economic Loss (O.B.E.L.) Additional Personal Injury Protection Auto Medical Payments Comprehensive Specified Causes Of Loss Collision Stated In Each Personal Injury Protection Endorsement Minus $ Deductible Shown $ Stated In Each Additional Personal Injury Protection Endorsement $ $ Stated In Item Two Minus $ $ Deductible Shown Stated In Item Two Minus $ $ Deductible Shown Stated In Item Two Minus $ $ Deductible Shown Towing And Labor $ Per Disablement $ $ $ Page 4 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

22 PI-CA-DS-03 NY (05/11) ITEM THREE Schedule Of Covered Autos You Own (Cont'd) Total Premiums Liability $ Personal Injury Protection $ Optional Basic Economic Loss (O.B.E.L.) $ Additional Personal Injury Protection $ Auto Medical Payments $ Comprehensive $ Specified Causes Of Loss $ Collision $ Towing And Labor $ ITEM FOUR Schedule Of Hired Or Borrowed Covered Auto Coverage And Premiums State Estimated Cost Of Hire For Each State $ SEE SCHEDULE, IF APPLICABLE Liability Coverage Rating Basis, Cost Of Hire Rate Per Each $100 Cost Of Hire Factor (If Liability Coverage Is Primary) $ $ Premium State Liability Coverage Rating Basis, Number Of Days (For Mobile Or Farm Equipment Rental Period Basis) Estimated Number Of Days Equipment Will Be Rented Base Premium Factor Premium $ $ Total Premium $ Cost of hire means the total amount you incur for the hire of "autos" you don't own (not including "autos" you borrow or rent from your partners or "employees" or their family members). Cost of hire does not include charges for services performed by motor carriers of property or passengers. Page 5 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

23 PI-CA-DS-03 NY (05/11) ITEM FOUR Schedule Of Hired Or Borrowed Covered Auto Coverage And Premiums (Cont'd) Physical Damage Coverage - SEE SCHEDULE, IF APPLICABLE Coverages Comprehensive Specified Causes Of Loss Collision Limit Of Insurance Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered Auto, But No Deductible Applies To Loss Caused By Fire Or Lightning. Estimated Annual Cost Of Hire Rate Per Each $100 Annual Cost Of Hire $ $ $ Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered Auto For Loss Caused By Mischief Or Vandalism. Estimated Annual Cost Of Hire Rate Per Each $100 Annual Cost Of Hire $ $ $ Actual Cash Value Or Cost Of Repair, Whichever Is Less, Minus $ Deductible For Each Covered Auto. Estimated Annual Cost Of Hire Rate Per Each $100 Annual Cost Of Hire $ $ $ Premium Premium Premium Total Premium: $ ITEM FIVE Schedule For Non-Ownership Liability Named Insured's Business Rating Basis Number Premium Other Than Garage Number Of Employees 25 $ Service Operations And Other Than Social Service Agencies Number Of Partners $ Garage Service Operations Social Service Agencies Number Of Employees Whose Principal Duty Involves The Operation Of Autos Number Of Employees $ Number Of Volunteers $ $ Total Premiums $ Page 6 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

24 PI-CA-DS-03 NY (05/11) ITEM SIX Schedule For Gross Receipts Or Mileage Basis Liability Coverage Public Auto Or Leasing Rental Concerns Location No: (Check One) Gross Receipts (Per $100) Mileage (Per Mile) Estimated Yearly: Rates Liability $ Auto Medical Payments $ Premiums Liability $ Auto Medical Payments $ Location No: (Check One) Gross Receipts (Per $100) Mileage (Per Mile) Estimated Yearly: Rates Liability $ Auto Medical Payments $ Premiums Liability $ Auto Medical Payments $ Location No: (Check One) Gross Receipts (Per $100) Mileage (Per Mile) Estimated Yearly: Rates Liability $ Auto Medical Payments $ Premiums Liability $ Auto Medical Payments $ Page 7 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

25 PI-CA-DS-03 NY (05/11) ITEM SIX Schedule For Gross Receipts Or Mileage Basis Liability Coverage Public Auto Or Leasing Rental Concerns (Cont'd) Total Premiums Minimum Liability $ Minimum Auto Medical Payments $ Liability $ Auto Medical Payments $ Location Number Address When used as a premium basis: FOR PUBLIC AUTOS Gross Receipts means the total amount to which you are entitled for transporting passengers, mail or merchandise during the policy period regardless of whether you or any other carrier originate the transportation. Gross Receipts does not include: A. Amounts you pay to railroads, steamship lines, airlines and other motor carriers operating under their own ICC or PUC permits. B. Advertising revenue. C. Taxes which you collect as a separate item and remit directly to a governmental division. D. C.O.D. collections for cost of mail or merchandise including collection fees. Mileage means the total live and dead mileage of all revenue producing units operated during the policy period. FOR RENTAL OR LEASING CONCERNS Gross receipts means the total amount to which you are entitled for the leasing or rental of "autos" during the policy period and includes taxes except those taxes which you collect as a separate item and remit directly to a governmental division. Mileage means the total of all live and dead mileage developed by all the "autos" you leased or rented to others during the policy period. Page 8 of 8 Includes copyrighted material of Insurance Services Office, Inc., with permission.

26 Philadelphia Indemnity Insurance Company Form Schedule Commercial Auto Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form PI-CADS03 NY Hired or Borrowed Auto Sche CA0001 CA0112 CA0225 Edition Description Business Auto Declarations New York Schedule of Hired or Borrowed Covered Auto Business Auto Coverage Form New York Changes in Business Auto New York Changes - Cancellation Page 1 of 1

27 Policy Number: PHPK Schedule Of Hired Or Borrowed Covered Auto Coverage And Premiums Coverage State Cost of Hire Deductible Rate Premium Liability Coverage NY $ 1 Total Premium - $ 1 Page of 1 1

28 PI-RO-003D (11/06) PHILADELPHIA INDEMNITY INSURANCE COMPANY RELIGIOUS ORGANIZATION PROFESSIONAL LIABILITY COVERAGE PART DECLARATIONS POLICY NO. PHPK Effective Date: 09/12/ :01 A.M. Standard Time LIMITS OF INSURANCE AGGREGATE LIMIT $ 3,000,000 EACH PROFESSIONAL INCIDENT LIMIT $ 1,000,000 BUSINESS DESCRIPTION Form of Business: RELIG ORGAN, ASSOC, LABOR ORGAN Business Description: Religious Organization PREMIUM: $ 1, FORMS AND ENDORSEMENTS (Other than Applicable Forms and Endorsements Shown Elsewhere in the Policy) Forms and Endorsements Applying to this Coverage Part and Made Part of this Policy at Time of Issue: SEE SCHEDULE THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. Includes Copyrighted Material of the Insurance Service Office, Inc Used with its Permission. Page 1 of 1

29 Philadelphia Indemnity Insurance Company Form Schedule Professional Liability Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form PI-RO-003D PI-ARB-1 PI-RO-003 NY PI-RO-NY-1 Edition Description Religious Org Professional Liability Coverage Part Dec Binding Arbitration Religious Organization Professional Liability Coverage New York Amendatory Endorsement Page 1 of 1

30 PI-RO-013D NY (03/11) RELIGIOUS ORGANIZATION DIRECTORS & OFFICERS LIABILITY INSURANCE Philadelphia Indemnity Insurance Company DECLARATIONS Policy Number: PHPK NOTICE: EXCEPT TO SUCH EXTENT AS MAY OTHERWISE BE PROVIDED HEREIN, THIS POLICY IS WRITTEN ON A CLAIMS MADE BASIS AND COVERS ONLY THOSE CLAIMS FIRST MADE DURING THE POLICY PERIOD AND REPORTED IN WRITING TO THE INSURER PURSUANT TO THE TERMS HEREIN. THE LIMITS OF LIABILITY AVAILABLE TO PAY JUDGMENTS OR SETTLEMENTS AND THE RETENTION MAY BE REDUCED BY AMOUNTS INCURRED AS DEFENSE COSTS. Item 1. Parent Organization and Address: Mount Zion AME Church 1765 Madison Ave New York, NY Item 1a. Agent Name and Address: Oxford Millin Insurance Agency PO Box 684 Jenkintown, PA Item 2. Policy Period: From: 09/12/2013 To: 09/12/2014 (12:01 A.M. Standard Time) Item 3. Limits of Liability: $ 1,000,000 Aggregate (including Defense Costs) Item 4. Retention: $ 2,500 Retention per Claim Item 5. Retroactive Date: 11/02/2007 Item 6. Prior and Pending Date: 11/02/2007 Item 7. Premium: $ Item 8. Additional Premium for Extended Reporting Period: 1 year: 50% of Annual Premium 2 years: 75% of Annual Premium 3 years: 100% of Annual Premium Page 1 of 1

31 Philadelphia Indemnity Insurance Company Form Schedule Directors and Officers Policy Number: PHPK Forms and Endorsements applying to this Coverage Part and made a part of this policy at time of issue: Form PI-RO-013D NY PI-RO-013 NY PI-RO-015 NY PI-NY-CM Addendum 2 PI-PL-NY-1 PI-PL-NY-2 PI-PL-NY-4 PI-PL-NY-5a PI-PL-NY-5b PI-RO-NY-2 Edition Description Religious Organization Directors & Officers Liab Dec Religious Organization Directors & Officers Liability Secession/Expulsion Exclusion New York Application and Declaration Page Addendum New York Amendatory Endt Insured Participation New York Amendatory Endt Legal Defense Costs Offset New York Amendatory - Retention and Coinsurance Defense Costs Within Limits of Liability Consent Form Defense Costs Within Limits of Liability Consent Form New York Amendatory Endorsement Page 1 of 1

32 PRIVACY POLICY NOTICE PP The Philadelphia Indemnity Insurance Company values your privacy and we are committed to protecting personal information that we collect during the course of our business relationship. The collection, use and disclosure of certain nonpublic personal information are regulated by law. This notice is for your information only and requires no action on your part. It will inform you about the types of information we collect and how it may be disclosed. This does not reflect a change in the way we do business or handle your information. Information We Collect: We collect personal information about you from the following sources: Applications or other forms such as claims forms or underwriting questionnaires completed by you; Information about your transactions with us, our affiliates or others; and Depending on the type of transaction you are conducting with us, information may be collected from consumer reporting agencies, health care providers, employers and other third parties. Information We Disclose: We will only disclose the information described above, as permitted by law, to our affiliates and non-affiliated third parties when necessary to conduct our normal business activities. For example, we may make disclosures to the following types of third parties: Your agent or broker; Parties who perform a business, professional or insurance function for our company, including our reinsurance companies; Independent claims adjusters, investigators, other insurers, medical care institutions and attorneys who need the information to investigate, defend or settle a claim involving you; Insurance regulatory agencies in connection with the regulation of our business; and Lienholders, mortgagees, lessors or other persons shown on our records as having legal or beneficial interest in your policy. We do not sell your information to others for marketing purposes. We do not disclose the personal information of persons who have ceased to be our customers. Protection of Information: The Philadelphia Indemnity Insurance Company maintains physical, electronic and procedural safeguards that comply with state and federal regulations to protect the confidentiality of your personal information. We also limit employee access to personally identifiable information to those with a business reason for knowing such information. How to Contact Us: Philadelphia Indemnity Insurance Company Feel free to call or write to us for additional information. Philadelphia Indemnity Insurance Company One Bala Plaza, Suite 100 Bala Cynwyd, Pennsylvania (877) Philadelphia Indemnity Insurance Company

33 PI-BELL-1 NY (11/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BELL ENDORSEMENT Unless otherwise stated herein, the terms, conditions, exclusions and other limitations set forth in this endorsement are solely applicable to coverage afforded by this endorsement, and the policy is amended as follows: I. SCHEDULE OF ADDITIONAL COVERAGES AND LIMITS The following is a summary of Limits of Liability or Limits of Insurance and/or additional coverages provided by this endorsement. This endorsement is subject to the provisions of the policy to which it is attached. COVERAGE LIMITS OF INSURANCE Conference Cancellation $25,000 Emergency Real Estate Consulting Fee $50,000 Fundraising Event Blackout $25,000 Identity Theft Expense $50,000 Image Restoration and Counseling $50,000 Key Individual Replacement Expenses $50,000 Kidnap Expense $50,000 Political Unrest $5,000 per employee: $25,000 policy limit Temporary Meeting Space Reimbursement $25,000 Terrorism Travel Reimbursement $50,000 Travel Delay Reimbursement $1,500 Page 1 of Philadelphia Indemnity Insurance Company

34 PI-BELL-1 NY (11/09) II. CONDITIONS A. Applicability of Coverage Coverage provided by your policy and any endorsements attached thereto is amended by this endorsement where applicable. B. Limits of Liability or Limits of Insurance When coverage is provided by this endorsement and another coverage form or endorsement attached to this policy, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect on it or not. But we will not pay more than the applicable Limit of Insurance. C. Claim Expenses Coverages provided herein are not applicable to the generation of claim adjustment costs by you; such as fees you may incur by retaining a public adjuster or appraiser. III. ADDITIONAL COVERAGES A. Conference Cancellation We will reimburse the insured for any business-related conference expenses, paid by the insured and not otherwise reimbursed, for a canceled conference that an employee was scheduled to attend. The cancellation must be due directly to a natural catastrophe or a communicable disease outbreak that forces the cancellation of the conference. With respect to a conference cancellation claim, it is further agreed as follows: 1. The insured employee must have registered for the conference at least thirty (30) days prior to the cancellation; and 2. The cancellation must be ordered by a local, state or federal Board of Health or other governmental authority having jurisdiction over the location of the conference. The limit of insurance for this coverage is $25,000 per policy period for all insureds combined. No deductible applies to this coverage. B. Emergency Real Estate Consulting Fee We will reimburse the insured any realtor s fee or real estate consultant s fee necessitated by the insured s need to relocate due to the unforeseeable destruction of the insured s principal location listed in the Declarations during the policy period. The limit of insurance for this coverage is $50,000 per policy period for all insureds combined. No deductible applies to this coverage. C. Fundraising Event Blackout We will reimburse the insured for fundraising expenses that are incurred due to the cancellation of a fundraising event caused by the lack of electric supply resulting in a power outage, provided the fundraising event is not re-scheduled. The fundraising event must have been planned at least thirty (30) days prior to the power outage. The limit of insurance for this coverage is $25,000 per policy period for all insureds combined. No deductible applies to this coverage. Page 2 of Philadelphia Indemnity Insurance Company

35 PI-BELL-1 NY (11/09) D. Identity Theft Expense We will reimburse any present director or officer of the named insured for identity theft expenses incurred as the direct result of any identity theft first discovered and reported during the policy period; provided that it began to occur subsequent to the effective date of the insured s first policy with us. The limit of insurance for this coverage is $50,000 per policy period for all insureds combined. No deductible applies to this coverage. E. Image Restoration and Counseling We will reimburse the insured for expenses incurred for image restoration and counseling arising out of improper acts by any natural person. Covered expenses are limited to: 1. The costs of rehabilitation and counseling for the accused natural person insured, provided the natural person insured is not ultimately found guilty of criminal conduct; this reimbursement to occur after acquittal of the natural person insured; 2. The costs charged by a recruiter or expended on advertising, for replacing an officer as a result of improper acts ; and 3. The costs of restoring the named insured s reputation and consumer confidence through image consulting. The limit of insurance for this coverage is $50,000 per policy period for all insureds combined. No deductible applies to this coverage. F. Key Individual Replacement Expenses We will pay key individual replacement expenses if the Chief Executive Officer or Executive Director suffers an injury during the policy period which results in the loss of life during the policy period. The limit of insurance for this coverage is the lesser of $50,000 or ten (10) times the annual premium paid for this policy. No deductible applies to this coverage. G. Kidnap Expense We will pay on behalf of any director or officer of the insured, reasonable fees incurred as a result of the kidnapping of them or their spouse, domestic partner, parent or child during the policy period. Coverage will not apply to any kidnapping by or at the direction of any present or former family member of the victim. Reasonable fees will include: 1. Fees and costs of independent negotiators; 2. Interest costs for any loan from a financial institution taken by you to pay a ransom demand or extortion threat; 3. Travel costs and accommodations incurred by the named insured; 4. Reward money paid to an informant which leads to the arrest and conviction of parties responsible for loss covered under this insurance; and Page 3 of Philadelphia Indemnity Insurance Company

36 PI-BELL-1 NY (11/09) 5. Salary, commissions and other financial benefits paid by you to a director or officer. Such compensation applies at the level in effect on the date of the kidnap and ends upon the earliest of: a. Up to thirty (30) days after their release, if the director or officer has not yet returned to work; b. Discovery of their death; c. One hundred twenty (120) days after the last credible evidence following abduction that they are still alive; or d. Twelve (12) months after the date of the kidnapping. The limit of insurance for this coverage is $50,000 each policy period for all insureds combined. No deductible applies to this coverage. H. Political Unrest Coverage We will reimburse any present director, officer, employee or volunteer of the named insured while traveling outside the United States of America for emergency evacuation expenses that are incurred as a result of an incident of political unrest. This political unrest must occur during the policy period. No coverage is granted for travel to countries in a state of political unrest at the time of departure of the travel. The limit of insurance for this coverage is $5,000 per covered person, subject to a maximum of $25,000 per policy period for all insureds combined. No deductible applies to this coverage. I. Temporary Meeting Space Reimbursement We will reimburse the insured for rental of meeting space which is necessitated by the temporary unavailability of the insured s primary office space due to the failure of a climate control system, or leakage of a hot water heater during the policy period. Coverage will exist only for the renting of temporary meeting space required for meeting with parties who are not insured under this policy. The limit of insurance for this coverage is $25,000 per policy period for all insureds combined. No deductible applies to this coverage. J. Terrorism Travel Reimbursement We will reimburse any present director or officer of the named insured in the event of a certified act of terrorism during the policy period which necessitates that he/she incurs emergency travel expenses. The limit of insurance for this coverage is $50,000 per policy period for all insureds combined. No deductible applies to this coverage. K. Travel Delay Reimbursement We will reimburse any present director or officer of the named insured for any nonreimbursable expenses they incur as a result of the cancellation of any regularly scheduled business travel on a common carrier. The limit of insurance for this coverage is $1,500 per policy period for all insureds combined. A seventy-two (72) hour waiting period deductible applies to this coverage. IV. DEFINITIONS For the purpose of this endorsement, the following definitions apply: A. Certified act of terrorism means any act so defined under the Terrorism Risk Insurance Act, Page 4 of Philadelphia Indemnity Insurance Company

37 PI-BELL-1 NY (11/09) and its amendments or extensions. B. Communicable disease means an illness, sickness, condition or an interruption or disorder of body functions, systems or organs that is transmissible by an infection or a contagion directly or indirectly through human contact, or contact with human fluids, waste, or similar agent, such as, but not limited to Meningitis, Measles or Legionnaire s Disease. C. Domestic partner means any person who qualifies as a domestic partner under the provisions of any federal, state or local statute or regulation, or under the terms and provisions of any employee benefit or other program established by the named insured. D. Emergency evacuation expenses mean: 1. Additional lodging expenses; 2. Additional transportation costs; 3. The cost of obtaining replacements of lost or stolen travel documents necessary for evacuation from the area of political unrest ; and 4. Translation services, message transmittals and other communication expenses. provided that these expenses are not otherwise reimbursable. E. Emergency travel expenses mean: 1. Hotel expenses incurred which directly result from the cancellation of a scheduled transport by a commercial transportation carrier, resulting directly from and within forty-eight (48) hours of a certified act of terrorism ; and 2. The increased amount incurred which may result from re-scheduling comparable transport, to replace a similarly scheduled transport canceled by a commercial transportation carrier in direct response to a certified act of terrorism ; provided that these expenses are not otherwise reimbursable. F. Fundraising expenses mean deposits forfeited and other charges paid by you for catering services, property and equipment rentals and related transport, venue rentals, accommodations (including travel), and entertainment expenses less any deposits or other fees refunded or refundable to you. G. Identity theft means the act of knowingly transferring or using, without lawful authority, a means of identification of any director or officer (or spouse or domestic partner thereof) of the named insured with the intent to commit, or to aid or abet another to commit, any unlawful activity that constitutes a violation of federal law or a felony under any applicable state or local law. H. Identity theft expenses mean: 1. Costs for notarizing affidavits or similar documents attesting to fraud required by financial institutions or similar credit grantors or credit agencies; 2. Costs for certified mail to law enforcement agencies, credit agencies, financial institutions or similar credit grantors; and Page 5 of Philadelphia Indemnity Insurance Company

38 PI-BELL-1 NY (11/09) 3. Loan application fees for re-applying for a loan or loans when the original application is rejected solely because the lender received incorrect credit information. I. Improper acts means any actual or alleged act of: 1. Sexual abuse; 2. Sexual intimacy; 3. Sexual molestation; or 4. Sexual assault; committed by an insured against any natural person who is not an insured. Such improper acts must have been committed by the insured while in his or her capacity as an insured. J. Injury means any physical damage to the body caused by violence, fracture or an accident. K. Key individual replacement expenses mean the following necessary expenses: 1. Costs of advertising the employment position opening; 2. Travel, lodging, meal and entertainment expenses incurred in interviewing job applicants for the employment position opening; and 3. Miscellaneous extra expenses incurred in finding, interviewing and negotiating with the job applicants, including, but not limited to, overtime pay, costs to verify the background and references of the applicants and legal expenses incurred to draw up an employment contract. L. Natural catastrophe means hurricane, tornado, earthquake or flood. M. Non-reimbursable expenses means the following travel-related expenses incurred after a seventy-two (72) hour waiting period, beginning from the time documented on the proof of cancellation, and for which your director or officer produces a receipt: 1. Meals and lodging; 2. Alternative transportation; 3. Clothing and necessary toiletries; and 4. Emergency prescription and non-prescription drug expenses. N. Political unrest means: 1. A short-term condition of disturbance, turmoil or agitation within a foreign country that poses imminent risks to the security of citizens of the United States; 2. A long-term condition of disturbance, turmoil or agitation that makes a foreign country dangerous or unstable for citizens of the United States; or 3. A condition of disturbance, turmoil or agitation in a foreign country that constrains the United States Government s ability to assist citizens of the United States, due to the closure or inaccessibility of an embassy or consulate or because of a reduction of its staff Page 6 of Philadelphia Indemnity Insurance Company

39 PI-BELL-1 NY (11/09) for which either an alert or travel warning has been issued by the United States Department of State. O. Principal location means the headquarters, home office or main location where most business is substantially conducted. P. Unforeseeable destruction means damage resulting from a certified act of terrorism, fire, collision or collapse which renders all of the insured s principal locations completely unusable. Page 7 of Philadelphia Indemnity Insurance Company

40 PI-CME-1 (10/09) THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CRISIS MANAGEMENT ENHANCEMENT ENDORSEMENT Unless otherwise stated herein, the terms, conditions, exclusions and other limitations set forth in this endorsement are solely applicable to coverage afforded by this endorsement, and the policy is amended as follows: Solely for the purpose of this endorsement: 1) The words you and your refer to the Named Insured shown in the Declarations, and any other person or organization qualifying as a Named Insured under this policy. 2) The words we, us and our refer to the company providing this insurance. I. SCHEDULE OF ADDITIONAL COVERAGE AND LIMITS The following is the Limit of Liability provided by this endorsement. This endorsement is subject to the provisions of the policy to which it is attached. Crisis Management Expense $25,000 II. CONDITIONS A. Applicability of Coverage Coverage provided by your policy and any endorsements attached thereto is amended by this endorsement where applicable. All other terms and conditions of the policy or coverage part to which this endorsement is attached remain unchanged. B. Limits of Liability or Limits of Insurance When coverage is provided by this endorsement and any other coverage form or endorsement attached to this policy, we will pay only for the amount of covered loss or damage in excess of the amount due from that other insurance, whether you can collect on it or not. But we will not pay more than the applicable Limit of Liability or Limit of Insurance. C. Claim Expenses Coverages provided herein are not applicable to the generation of claim adjustment costs by you; such as fees you may incur by retaining a public adjuster or appraiser. III. ADDITIONAL COVERAGES A. We will reimburse you for crisis management emergency response expenses incurred because of an incident giving rise to a crisis to which this insurance applies. The amount of such reimbursement is limited as described in Section II. CONDITIONS, B. Limits of Liability or Limits of Insurance. No other obligation or liability to pay sums or perform acts or services is covered. B. We will reimburse only those crisis management emergency response expenses which are incurred during the policy period as shown in the Declarations of the policy to which this coverage is attached and reported to us within six (6) months of the date the crisis was initiated. Page 1 of 2