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NONPROFITS <br />INSURANCE <br />ALLIANCE OF CALIFORNIA <br />A Head for Insurance. A Heart far Nonprofits. <br />NONPROFITS INSURANCE ALLIANCE <br />OF CALIFORNIA (NIAC) <br />www.insurancefomonprofits.org <br />COMMERCIAL UMBRELLA POLICY DECLARATIONS <br />PRODUCER: POLICY NUMBER: 2021-45659-UMB <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South Suite 120 RENEWAL OF NUMBER: 2020-45659-UMB-NPO <br />Lake Forest, CA 92630 <br />Item 1 NAME OF INSURED AND MAILING ADDRESS: <br />Kidworks Community Development Corporation <br />1902 W Chestnut Ave. <br />Santa Ana, CA 92703 <br />Item 2 POLICY PERIOD: FROM 7/1/2021 TO 7/1/2022 <br />AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE <br />BUSINESS DESCRIPTION: Services to the underserved in Santa Ana <br />IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS <br />POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. <br />Item 3 THE ANNUAL AND MINIMUM PREMIUM DUE AT INCEPTION: $1,937 <br />(premium includes Terrorism Coverage - Certified Acts: $50 <br />but only for policies that indicate coverage on Schedule A - Schedule of Underlying Insurance) <br />Item 4 LIMITS OF INSURANCE: <br />a. Occurrence / Accident / Injury / Claim Limits (where applicable): ............................................ <br />i) Each Occurrence - Commercial General Liability and Products - <br />Completed Operations Liability <br />ii) Each Accident - Business Auto Liability <br />iii) Each Injury - Liquor Liability <br />iv) Each Claim - Employee Benefits Liability <br />b. Each Claim - Directors and Officers Liability.......................................................................... <br />C. Each Claim - Improper Sexual Conduct and Physical Abuse Liability ..................................... <br />d. Each Claim - Social Service Professional Liability.................................................................. <br />Aggregate limits <br />e. Commercial General Liability, Business Auto Liability, Products- Completed Operations <br />Liability, Liquor Liability, and Employee Benefits Liability Aggregate <br />(where applicable): ........................................................ ...................................................... <br />f. Directors and Officers Liability Aggregate ............................. ........... .... --..... ....... .................... <br />g. Improper Sexual Conduct and Physical Abuse Liability Aggregate ........................................ <br />h. Social Service Professional Liability Aggregate....................................................................... <br />Item 5 RETROACTIVE DATES - SEE SCHEDULE OF UNDERLYING INSURANCE <br />1,000,000 <br />Excluded <br />Excluded <br />Excluded <br />1,000,000 <br />Excluded <br />Excluded <br />Excluded <br />FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY AT INCEPTION (NUMBER AND EDITION DATE): <br />CU 2130 01 15, CU 2133 a 01 15, CU 2133 a 01 15, IL 09 99 12 20, NIAC-EO03 UMB 0B 20, NIAC-E180 UMB 0121, NIAC-E42 UMB 09 19, SCHEDULE A 0180, UMB <br />231 06 16. UMB 232 06 16, UMB-100 05 21, UMB166 12 88, UMB62 05 13 <br />RldeMuugen adDMsbn <br />@- REMEWED&APPRQVBDBY: <br />A+ fe Aea4ta <br />Risk Management Specialist <br />OF <br />