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NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA A Head for Insurance. A Heart for Nonprofits. NONPROFITS INSURANCE ALLIANCE OF CALIFORNIA (NIAC) www.insurancefornonprofits.org COMMERCIAL UMBRELLA POLICY DECLARATIONS PRODUCER: POLICY NUMBER: 2021-49231-UMB Poms & Associates Ins. Brokers 5700 Canoga Avenue, Suite 400 RENEWAL OF NUMBER: 2020-49231-UMB-NPO Woodland Hills, CA 91367 Item 1 NAME OF INSURED AND MAILING ADDRESS: Working Wardrobes for A New Start dba: Working Wardrobes 2000 E. McFadden Ave., Suite 100 Santa Ana, CA 92705 Item 2 POLICY PERIOD: FROM 9/17/2021 TO 9/17/2022 AT 12:01 A.M. STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE BUSINESS DESCRIPTION: Training services to re-enter the workforce funded by thriftshop IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE COVERAGE AS STATED IN THIS POLICY. Item 3 THE ANNUAL AND MINIMUM PREMIUM DUE AT INCEPTION: $5,982 Item 4 LIMITS OF INSURANCE: a. Occurrence / Accident / Injury / Claim Limits (where applicable): ............................................ 3,000,000 i) Each Occurrence - Commercial General Liability and Products - Completed Operations Liability ii) Each Accident - Business Auto Liability iii) Each Injury - Liquor Liability iv) Each Claim - Employee Benefits Liability b. Each Claim - Directors and Officers Liability.......................................................................... Excluded C. Each Claim - Improper Sexual Conduct and Physical Abuse Liability ..................................... Excluded d. Each Claim - Social Service Professional Liability.................................................................. 3,000,000 Aggregate limits: e. Commercial General Liability, Business Auto Liability, Products- Completed Operations Liability, Liquor Liability, and Employee Benefits Liability Aggregate (where applicable): ....................................................... .......................................................... 3,000,000 f. Directors and Officers Liability Aggregate................................................................................ Excluded g. Improper Sexual Conduct and Physical Abuse Liability Aggregate ........................................ Excluded h. Social Service Professional Liability Aggregate....................................................................... 3,000,000 Item 5 RETROACTIVE DATES - SEE SCHEDULE OF UNDERLYING INSURANCE FORMS AND ENDORSEMENTS ATTACHED TO THIS POLICY AT INCEPTION (NUMBER AND EDITION DATE): CU 21 33 01 15, NIAC-EO03 UMB 08 20, NIAC-E180 UMB 01 21, NIAC-E253 UMB 08 21, NIAC-E42 UMB 09 19, SCHEDULE A 01 80, UMB 231 06 16, UMB 232 06 16, UMB-100 05 21, UMB61 05 13 COUNTERSIGNED: 9/14/2021 BY 00'� (�' XQ' (AUTHORIZED REPRESENTATIVE) THESE DECLARATIONS, THE ATTACHED SCHEDULE OF UNDERLYING INSURANCE, TOGETHER WITH THE ATTACHED SCHEDULE OF FORMS AND ENDORSEMENTS, AND ANY FORMS AND ENDORSEMENTS WE MAY LATER ATTACH TO REFLECT CHANGES, MAKE UP AND COMPLETE THE ABOVE NUMBERED POLICY. Notice: This risk pooling contract is issued by a pooling arrangement authorized by California Cor 5005.1. The pooling arrangement is not subject to all of the insurance laws of the State of Califor regulation by the Insurance Commissioner. Insurance guaranty funds are not available to pay clai becomes insolvent. NIAC - UMB / 2-99 �oRaN i 9 `�' 'y RAManaganadDMsfan REVIEWED & APPROVED BY.- Risk Management Analyst