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®� NONPROFITS <br />INSURANCE <br />ALLIANCE OF CALIFORNIA <br />A Head far Insurance. A Heartfor Nonprofits. <br />NONPROFITS INSURANCE ALLIANCE <br />OF CALIFORNIA (NIAC) <br />INDEX OF FORMS ATTACHED TO THE POLICY <br />POLICY NUMBER: 2024-09201 <br />NAME OF INSURED: Orange County Children's Therapeutic Arts Center <br />www.insurancefornonpi-ofits.org <br />Page: 1 <br />LIABILITY FORMS AND ENDORSEMENTS FORM NUMBERIEDITION 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 12 19 <br />Additional Insured - Managers or Lessors of Premises <br />CG 20 11 12 19 <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 11 85 <br />Additional Insured - Volunteers <br />CG 20 21 07 98 <br />Additional Insured - Designated Person or Organization <br />CG 20 26 12 19 <br />Additional Insured - Lessor of Leased Equipment - Automatic Status - Lease <br />CG 20 34 12 19 <br />Additional Insured - Owners, Lessees or Contractors - Completed Operations <br />CG 20 37 12 19 <br />Access or Disclosure PI Confidential or Personal Information - Exclusion <br />CG 21 06 05 14 <br />Exclusion - Unmanned Aircraft <br />CG 21 09 06 15 <br />Coverage C - Medical Payments Exclusion <br />CG 21 35 10 01 <br />Employment -Related Practices Exclusion <br />CG 2147 12 07 <br />Cap on tosses from Certified Acts of Terrorism <br />CG 21 7001 15 <br />Silica - Exclusion <br />CG 21 96 03 05 <br />Colleges or Schools - Limited Form <br />CG 22 71 12 19 <br />Products/Completed Operations Hazard Redefined <br />CG 24 07 01 96 <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 07 20 <br />Disclosure Of Premium for Certified Acts,of Terrorism Coverage <br />IL 09 99 12 20 <br />OFAC Policyholder Notice <br />IL P 001 01 04 <br />OFAC Policyholder Notice <br />IL P 001 01 04 <br />OFAC Policyholder Notice <br />IL P 001 01 04 <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 />Blometric and Personal Information - Exclusion <br />NIAC-EO43 GL 11 23 <br />Blometric and Personal Information - Exclusion <br />NIAC-EO43 SSP 11 23 <br />Naloxone <br />NIAC-EO49 SSP 1123 <br />Construction - Exclusion <br />NIAC-EO53 GL 06 24 <br />Construction - Exclusion <br />NIAC-E053 SSP 06 24 <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 11 20 <br />Fireworks Exclusion <br />NIAC-EI I GL 09 19 <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 />