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® NoNPROFITS <br />INSURANCE LLIANCE OF CALIFORWA <br />A Head far Insurance. A Heart far Atanpraflts. <br />COMMERCIAL GENERAL LIABILITY <br />EXTENSION OF DECLARATIONS <br />NONPROFITS INSURANCE ALLIANCE <br />OF CALIFORNIA (NIAC) <br />www.insurancefornonprofits.org <br />Schedule G <br />POLICY NUMBER: 2018-03104-NPO Page 1 <br />NAME OF INSURED: People for Irvine Community Health dba: 2-1-1 Orange County; OC Partnership <br />PREMISES <br />PREMIUM <br />*ADVANCED <br />CODE/CLASS <br />*LOC <br />BASIS <br />RATE <br />PREMIUM <br />47366/Sales, Service or Consulting Organizations - <br />1 <br />33,600 <br />2.625 <br />$88 <br />NOC - includes products and/or completed <br />operations <br />61225/Buildings or Premises - office - premises <br />1 <br />1,987 <br />104.633 <br />$208 <br />occupied by employees of the insured - NFP <br />61225/Buildings or Premises - office - premises <br />2 <br />489 <br />104.633 <br />$52 <br />occupied by employees of the insured - NFP <br />61225/Buildings or Premises - office - premises <br />3 <br />5,650 <br />104.633 <br />$591 <br />occupied by employees of the insured - NFP <br />61225/Buildings or Premises - office - premises <br />4 <br />2,685 <br />104.633 <br />$281 <br />occupied by employees of the insured - NFP <br />ADDITIONAL COVERAGES <br />Activities/Field Trips: <br />Event # # of people <br />Description <br />1 N/A <br />Various <br />outreach seminars <br />$100 <br />Increased Aggregate <br />$59 <br />Employee Benefits Liability <br />$375 <br />Social Service Professional <br />$2 999 <br />*See Common Declarations for Total Advanced Premium and Schedule'L' for locations. <br />� e Q. <br />COUNTERSIGNED: 01/31/2018 BY <br />NIAC . SCHEDULE G - NPO (AUTHORIZED REPRESENTATIVE) (00626) <br />