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,-❑I NONPROFITS <br />NONPROFITS INSURANCE ALLIANCE <br />_ INSURANCE OF CALIFORNIA(NIAC) <br />ALLIANCE OF CALIFORNIA www.insurancefornonprofits.org <br />A Head far Insurance. A Heart far Nonprofits. <br />INDEX OF FORMS ATTACHED TO THE POLICY <br />POLICY NUMBER: 2020-09201 <br />NAME OF INSURED: Orange County Children's Therapeutic Arts Center <br />Page:1 <br />LIABILITY FORMS AND ENDORSEMENTS <br />FORM NUMBER/EDITION DATE <br />Commercial General Liability Coverage Form <br />CG 00 01 04 13 <br />Liquor Liability Coverage Form <br />CG 00 33 04 13 <br />Additional Insured - Owners, Lessees or Contractors <br />CG 20 10 04 13 <br />Additional Insured - State or Political Subdivisions - Permits <br />CG 20 12 04 13 <br />Additional Insured - Mortgagee, Assignee or Receiver <br />CG 20 18 04 13 <br />Additional Insured - Charitable Institutions <br />CG 20 20 1185 <br />Additional Insured - Volunteers <br />CG 20 2107 98 <br />Additional Insured - Designated Person or Organization <br />CG 20 26 04 13 <br />Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease <br />CG 20 34 04 13 <br />Additional Insured - Owners, Lessees or Contractors - Completed Operations <br />CG 20 37 04 13 <br />Exclusion - Unmanned Aircraft <br />CG 21 09 06 15 <br />Coverage C - Medical Payments Exclusion <br />CG 2135 10 01 <br />Employment -Related Practices Exclusion <br />CG 2147 12 07 <br />Cap on Losses from Certified Acts of Terrorism <br />CG 21 70 01 15 <br />Silica - Exclusion <br />CG 21 96 03 05 <br />Colleges or Schools - Limited Form <br />CG 22 7104 13 <br />Products/Completed Operations Hazard Redefined <br />CG 24 07 0196 <br />Common Policy Conditions <br />IL 00 17 11 98 <br />Nuclear Energy Liability Exclusion Endorsement (Broad Form) <br />IL 00 21 09 08 <br />California Changes - Cancellation and Nonrenewal <br />IL 02 70 12 19 <br />Disclosure Of Premium for Certified Acts of Terrorism Coverage <br />IL 09 99 12 20 <br />Business Auto Coverage Part Declarations <br />NIAC-AL-NPO <br />Member Criteria <br />NIAC-EO03 GL 08 20 <br />Additional Insured - Primary and Non -Contributory -for Designated Person or Organization <br />NIAC-E02 01 17 <br />Fiscal Sponsor Limitation <br />NIAC-EO69 GL 02 19 <br />Fiscal Sponsor Limitation <br />NIAC-EO69 ISC 02 19 <br />Fiscal Sponsor Limitation <br />NIAC-EO69 SSP 02 19 <br />Professional Services Exclusion <br />NIAC-EO78 12 18 <br />Fireworks Exclusion <br />NIAC-El1 GL 09 19 <br />Fireworks Exclusion <br />NIAC-E11 SSP 09 19 <br />Lead Liability- Exclusion <br />NIAC-E120 09 19 <br />Firearms Sublimit Endorsement <br />NIAC-E123 09 19 <br />Disciplinary Action <br />NIAC-E125 11 19 <br />AI - Designated Person or Organization (ET) <br />NIAC-E131 ISC 05 20 <br />Blood Testing Exclusion <br />NIAC-E15 09 20 <br />Asbestos Exclusion <br />NIAC-E22 09 19 <br />Additional Insured - Designated Person or Organization <br />NIAC-E25 12 15 <br />Waiver of Transfer of Rights of Recovery Against Others <br />NIAC-E26 11 17 <br />Property Damage to Personal Property in the Care, Custody or Control of the Insured <br />This list of forms is not part of the actual policy, but is for your information only <br />Please refer to the policy(s) for actual limits, coverages and exclusions. <br />py,. �uve meneg�m�t wwsen <br />i REVIEWERS APPROV®Bv: <br />w " fnarr,:�s.a �.. V�PkAnebP <br />Rtsk Managentent Analyst <br />