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NONPROFITS <br />INSURANCE <br />ALLIANCE OF CALIFORNIA <br />A Head for Insurance. A Heartfor Nonprofits. <br />NONPROFITS INSURANCE ALLIANCE <br />OF CALIFORNIA(NIAC) <br />www. i ns u ran cefo rn on p rofiits. org <br />COMMERCIAL UMBRELLA POLICY DECLARATIONS <br />PRODUCER: <br />Comprehensive Insurance Services <br />26429 Rancho Parkway South Suite 120 <br />Lake Forest, CA 92630 <br />Item 1 NAME OF INSURED AND MAILING ADDRESS <br />POLICY NUMBER: 2022-01376-UMB <br />Delhi Center <br />505 E, Central Avenue <br />Santa Ana, CA 92707 <br />Item 2 POLICY PERIOD: FROM 3/2/2022 TO 11/1/2022 <br />AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE <br />BUSINESS DESCRIPTION: Resource & referral services <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: <br />(premium includes Terrorism Coverage - Certified Acts: $33 <br />but only for policies that indicate coverage on Schedule A - Schedule of Underlying Insurance) <br />$434 <br />Item 4 LIMITS OF INSURANCE: <br />a. Occurrence / Accident / Injury/ Claim Limits (where applicable): .............. ............................. <br />1,000,000 <br />1) Each Occurrence - Commercial General Liability and Products - <br />Completed Operations Liability <br />11) Each Accident- Business Auto Liability <br />ili) Each Injury- Liquor Liability <br />iv) Each Claim - Employee Benefits Liability <br />b. Each Claim - Directors and Officers Liability.......................................................................... <br />Excluded <br />C. Each Claim - Improper Sexual Conduct and Physical Abuse Liability ..................................... <br />Excluded <br />d. Each Claim - Social Service Professional Liability.................................................................. <br />Excluded <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): .................................................................................................................. 11000,000 <br />f. Directors and Officers Liability Aggregate... ................ ............................................................ Excluded <br />g. Improper Sexual Conduct and Physical Abuse Liability Aggregate ........................................ Excluded <br />h. Social Service Professional Liability Aggregate....................................................................... Excluded <br />Item 5 RETROACTIVE DATES -SEE SCHEDULE OF UNDERLYING INSURANCE <br />FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICYAT INCEPTION (NUMBER AND EDITION DATE): <br />CU 21 3001 16, IL 09991220, NIAC-E003 UMB 08 20, NIAC-E180 UMB 0121, NIAC-E253 UMB 0821, NIAC-E42 UMB 0919, SCHEDULE A 01 80, UMB 231 0616. <br />UMB 232 0616, UMB-100 06 21, UMS166 1288, UMB81 0513 <br />^. RI%IeManPgnnutEDMe(on <br />REMEWED&APPRDVm Br. <br />8I�A'*4 Aida 4& <br />` Risk Management specialist <br />00 <br />