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DocuSign Envelope ID: 7F8DFDB2-D81A-4AOF-AF96-9B69F601FC96 <br /> 1a>r1C 'nf ALLIANCE OF NONPROFITS FOR INSURANCE <br /> 1�, <br /> RISK RETENTION GROUP <br /> Mff <br /> Nonprofits P.O. Box 8546, Santa Cruz, CA 95061 <br /> AV f-Insurance P: (804)359-6422 <br /> Risk Retention Group F: (831)459-0853 <br /> COMMERCIAL GENERAL LIABILITY <br /> EXTENSION OF DECLARATIONS <br /> Schedule G <br /> POLICY NUMBER: 2013-37160 Page 1 <br /> NAME OF INSURED: North Carolina Public Health Foundation <br /> PREMISES PREMIUM *ADVANCED <br /> CODEICLASS *LOC BASIS RATE PREMIUM <br /> 47356 1Sales, Service or Consulting Organizations- 1 833,996 .652 $543 <br /> NOC-includes products and/or completed <br /> operations <br /> ADDITIONAL COVERAGES <br /> .ncreased Aggregate $117 <br /> Additional Premium to Meet Minimum $184 <br /> *See Common Declarations for Total Advanced Premium and Schedule'L'for locations. <br /> x- <br /> 07/29/2013 BY <br /> (AUTHORIZED REPRESENTATIVE) <br /> "NOTICE : This Policy is issued by your risk retention group.Your risk retention group may not be subject to all <br /> the insurance laws and regulations of your State.State insurance insolvency guaranty funds are not available for <br /> your risk retention group." <br /> ANI -RRG -SCHEDULE G (02522) <br />