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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: 2021-01143-UMB-NPO <br />www.insurancefornonprofits.org <br />NAME OF INSURED: Human Options, Inc. Page 1 <br />UMBRELLA FORMS AND ENDORSEMENTS <br />FORM NUMBER/EDITION DATE <br />Exclusion of Terrorism <br />CU 21 33 01 15 <br />Member Criteria <br />NIAC-EO03 UMB 08 2 <br />Al - ISCPA - Exclusion <br />NIAC-E133 UMB 05 2 <br />Communicable Disease - Exclusion <br />NIAC-E180 UMB 01 2 <br />Workers' Compensation - Exclusion <br />NIAC-E253 UMB 08 2 <br />Nuclear, Chemical and Biological Hazard Exclusion <br />NIAC-E42 UMB 09 19 <br />Schedule A - Schedule of Underlying Insurance <br />SCHEDULE A 01 80 <br />Privacy Liability and Cyber Coverage Exclusion <br />UMB 231 06 16 <br />Medical Payments Exclusion <br />UMB 232 06 16 <br />Commercial Umbrella Policy <br />UMB-100 05 21 <br />Unimpaired Aggregate Limits Endorsement (Non-Concurrency) <br />UMB166 12 88 <br />Employers' Liability Following Form Endorsement <br />UMB62 05 13 <br />MwwgmwdDMskm <br />GL��� ■.. <br />W1Jll�t1.%nxi Y�Q6 <br />Risk Management CI a i-1 Aide <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 />