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NONPROFITS <br />INSURANCE <br />®� ALLIANCE OF CALIFORNIA. <br />A Head for Insurance. A Heart for Nonprofits. <br />NONPROFITS INSURANCE ALLIANCE <br />OF CALIFORNIA (NIAC) <br />INDEX OF FORMS ATTACHED TO THE POLICY <br />POLICY NUMBER: 2022-01376-UMB-NPO <br />NAME OF INSURED: Delhi Center <br />UMBRELLA FORMS AND ENDORSEMENTS <br />Cap on Losses for Certified Acts - Terrorism Coverage <br />Disclosure Of Premium For Certified Acts of Terrorism <br />Member Criteria <br />Communicable Disease - Exclusion <br />Workers' Compensation - Exclusion <br />Nuclear, Chemical and Biological Hazard Exclusion <br />Schedule A - Schedule of Underlying Insurance <br />Privacy Liability and Cyber Coverage Exclusion <br />Medical Payments Exclusion <br />Commercial Umbrella Policy <br />Unimpaired Aggregate Limits Endorsement (Non-Concurrency) <br />Employers' Liability Exclusion <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 />www.insurancefornonprofits.org <br />Page 1 <br />FORM NUMBERIEDITION DATE <br />CU 21 30 01 15 <br />IL 09 99 12 20 <br />NIAC-EO03 UMB 08 2 <br />NIAC-E180 UMB 012 <br />NIAC-E253 UMB 08 2 <br />NIAC-E42 UMB 09 19 <br />SCHEDULE A 0180 <br />UMB 23106 16 <br />UMB 232 06 16 <br />UMB-100 05 21 <br />UMB166 12 88 <br />UMB61 05 13 <br />¢,w,, Rish Manegr LDMa[on <br />REVIEWED^&APPROAVEDBY: <br />�l a�L®®F ��� F"fap A6,odd <br />lab <br />-�' Risk Management Specialist <br />