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REVIWES-02 JSTETSON ACORD" DATE (MMIDDNYYY) ~ CERTIFICATE OF LIABILITY INSURANCE I 5/11/2026 THIS CERTIFICATE IS ISSUED AS A MATTER DF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the tenlls and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER 92t•n;~cr Jamie Stetson Ll~htwell Insurance Advisors of New York, LLC P. . Box 1310 rim~Jo, Ext\: (800) 326-7200 1 r.e~. N,\,(111) 763-5511 Mechanicsburg, PA 17055 it~~ss· Jamie1mbowerlns.com INSURER/SI AFFORDING COVERAGE NAIC# tNsURERA :Brotherhood Mutual Ins Co 13528 INSURED INSURERS: Revive Wesleyan INSURERC: 4999 McKinley Pkwy INSURER 0: Hamburg, NY 14075 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER· REVISION NUMBER· THIS !S 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 SHO'tv'N MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~tr 1 TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 - - ~ CLAIMS·MAOE 0 OCCUR X 31MLA0499812 6/1/2026 61112027 DAMAGE TO RENTED ..,,,E.MlSES rEa u-----' $ 1,000,000 MED EXP IAnv one nersonl $ 5,000 - PERSONAL & ADV INJURY $ 1,000,000 - GEN.'L AGGREGATE LIMIT APPLIES PER: 3,000,000 GENERAL AGGREGATE '$ 1i POLICY □ ff& □ LOC OTHER: ~TOMOBILE LIABILITY General Aggregate PRODUCTS - COMP/OP AGG ~OM~l~..~~"S!NGLE LIMIT 's 3,000,000 ANY AUTO BODILY INJURY 'Per nerson1 $ - OWNED - SCHEDULED AUTOS ONLY AUTOS BODIL y INJURY /Per accidenll $ - - P,ROPERTY DAMAGE - ~lfT'Ws ONL y - ~8¥oi~t.9 Per accident $ ' s H UMBRELLA LIAB OCCUR EACH OCCURRENCE $ - EXCESS UAB CLAIMS-MADE AGGREGATE $ OED I I RETENTION$ WORKERS COMPENSATION I ~.1;~~,~- I I 1i?~H- ' ANO EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE □ PJt~Jif¾~i~~m EXCLUDED? NIA E.L. EACH ACC10ENT ' E.L. DISEASE- EA EMPLOYEF $ If yes, describe under DESCRIPTION OF OPERATIONS below EL DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS/ LOCATIONS /VEHICLES (ACORD 101, Addl!lonal Remarks Schedule, maybe attached If more space is required) This certificate Is proof of Insurance for the church In Hamlin Park on Sundays in August 2026 on mutually agreed times and location. The certificate holder rs recognized as an additional Insured for these event(s) and Is subject to the terms of the policy. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN VIiiage of East Aurora ACCORDANCE WITH THE POUCY PROVISIONS. 585 Oakwood Avenue East Aurora, NY 14052 AUTHORIZED REPRESENTATIVE I ~ ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD