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IMN �W ALI..IANCF OF CALIFORNIA A Head far insurance. A Heart far Nanprnfits. www.insurancofornonprofits.org COMMERCIAL GENERAL LIABILITY COVERAGE PART DECLARATIONS PRODUCER: Heffernan Insurance Brokers 18004 Sky Park Circle, Suite 210 Irvine, CA 92614 NAME OF INSURED AND MAILING ADDRESS: POLICY NUMBER: 2018-03104 RENEWAL OF NUMBER: 2017-03104 People for Irvine Community Health dba: 2-1-1 Orange County; OC Partnership 1505 East 17th St., Suite 108 Santa Ana, CA 92705 POLICY PERIOD: FROM 02/01/2018 TO 02/01/2019 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Community health 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 COVERAGE AS STATED IN THIS POLICY. LIMITS OF COVERAGE: GENERAL AGGREGATE LIMIT (OTHER THAN PRODUCTS - COMPLETED OPERATIONS) $2,000,000 PRODUCTS - COMPLETED OPERATIONS AGGREGATE LIMIT .......................... $2,000,000 PERSONAL AND ADVERTISING INJURY LIMIT ................................................. $1,000,000 EACH OCCURRENCE LIMIT................................................................................ $1,000,000 DAMAGE TO PREMISES RENTED TO YOU ........................ $500,000 any one premises SOCIAL SERVICE PROFESSIONAL COVERAGE PART ................................... $2,000,000 MEDICAL EXPENSE LIMIT...................................................................................... $20,000 any one person ADDITIONAL COVERAGES: EMPLOYEE BENEFITS LIABILITY Retroactive Date:2/1/2014 INCLUDED (EMPLOYEE BENEFITS LIABILITY IS A CLAIMS MADE FORM. LIMITS ARE INCLUDED IN THE GENERAL AGGREGATE AND EACH OCCURRENCE LIMIT LISTED ABOVE) CLASSIFICATION(S) SEE ATTACHED SUPPLEMENTAL DECLARATIONS SCHEDULE G PREMIUM $4,753 FORMS AND ENDORSEMENTS APPLICABLE TO THIS POLICY ARE INCLUDED IN COMMERCIAL LINES COMMMON POLICY DECLARATIONS COUNTERSIGNED: 01/31/2018 BY 00(:� /a (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS AND THE COMMON POLICY DECLARATIONS, IF APPLICABLE, TOGETHER WITH THE COMMON POLICY CONDITIONS, COVERAGE FORM(S) AND FORMS AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. NIAC - GL (00626)