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Philadelphia Indemnity Insurance Company <br /> Form Schedule — General Liability <br /> Policy Number: PHPK1880017 <br /> Forms and Endorsements applying to this Coverage Part and made a part of this <br /> policy at time of issue: <br /> Form Edition Description <br /> PI-GL-LEAD NOTICE 2 0917 Advisory Notice To Policyholders <br /> PI-SAM-NOTICE 2 0117 Advisory Notice To Policyholders <br /> Gen Liab Dec 1004 Commercial General Liability Coverage Part Declaration <br /> Gen Liab Schedule 0100 General Liability Schedule <br /> CG0001 0413 Commercial General Liability Coverage Form <br /> CG2026 0413 Additional Insured - Designated Person Or Organization <br /> CG2147 1207 Employment-Related Practices Exclusion <br /> CG2167 1204 Fungi or Bacteria Exclusion <br /> CG2170 0115 Cap On Losses From Certified Acts Of Terrorism <br /> CG2239 0413 Exclusion - Camps Or Campgrounds <br /> CG2402 1204 Binding Arbitration <br /> CG2404 0509 Waiver of Transfer of Rights of Recovery Against Other <br /> CG2416 1207 Canoes Or Rowboats <br /> CG3234 0105 California Changes <br /> PI-GL-001 0917 Exclusion - Lead Liability <br /> PI-GL-002 CA 0208 Exclusion - Asbestos Liability <br /> PI-GL-005 0712 Additional Insured Primary And Non-Contributory Ins <br /> PI-GLD-HS 1011 General Liability Deluxe Endorsement: Human Services <br /> PI-HS-005 0704 Exclusion - Professional Liability Coverage <br /> PI-MANU-1 0100 Additional Insured - LGS Recreation <br /> PI-MANU-1 0100 AI: Hawthorne School District- FULL NAME <br /> PI-MANU-1 0100 CG2026 Full Clause City of Novato <br /> PI-MANU-1 0100 AI: The City of Yorba Linda - FULL NAME <br /> PI-MANU-1 0100 CG2026 California State PTA complete name <br /> PI-MANU-1 0100 Additional Insured - Neuberger Berman Group LLC <br /> PI-MANU-1 0100 Full Name Manuscript WA 1290 Management LLC <br /> PI-SAM-006 0117 Abuse Or Molestation Exclusion <br /> PI-SE-001 1205 Fund Raising Events Endorsement <br /> Page 1 of 1 <br />