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I NONPROFITS <br /> IeTSURANGF, NONPROFITS INSURANCE ALLIANCE <br /> OF CALIFORNIA(NIAC) <br /> ALLIANCE or CALIFORNIA www.insuraincefornonprofits.org <br /> A Head far Insurance,A Heart for Nnnprofks. <br /> INDEX OF FORMS ATTACHED TO THE POLICY <br /> POLICY NUMBER:2024-09201-UMB-NPO <br /> NAME OF INSURED: Orange County Children's Therapeutic Arts Center Page 1 <br /> UMBRELLA FORMS AND ENDORSEMENTS FORM NUMBERIEDITION DATE <br /> Cap on Losses for Certified Acts-Terrorism Coverage CU 21 30 01 15 <br /> Exclusion of Certified Acts of Terrorism -Automobile Liability Underlying Insurance Only CU 2133 a 01 15 <br /> Disclosure Of Premium For Certified Acts of Terrorism It_09 99 12 20 <br /> OFAC Policyholder Notice IL P 001 0104 <br /> Member Criteria NIAC-EO03 UMB 08 2 <br /> Communicable Disease- Exclusion NIAC-E180 UMB 01 2 <br /> Workers' Compensation-Exclusion NIAC-E253 UMB 08 2 <br /> Nuclear, Chemical and Biological Hazard Exclusion NIAC-E42 UMB 09 19 <br /> Schedule A-Schedule of Underlying Insurance SCHEDULE A 01 80 <br /> Privacy Liability and Cyber Coverage Exclusion UMB 23106 16 <br /> Medical Payments Exclusion UMB 232 06 16 <br /> Commercial Umbrella Policy UMB-100 05 21 <br /> Employers' Liability Exclusion UMB61 05 13 <br /> i <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 /> i <br />