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DocuSign Envelope ID:91F43AFA-8CB4-4861-887A-F304C7A6614B <br /> ALLIANCE OF <br /> 010 NONPROFITS FOR ALLIANCE OF NONPROFITS FOR INSURANCE <br /> INSURANCE RISK RETENTION GROUP(ANI) <br /> www.insurancefornonprofits.org <br /> A Head for Insurance.A Heart for Nonprofits. <br /> COMMERCIAL GENERAL LIABILITY <br /> EXTENSION OF DECLARATIONS <br /> Schedule L <br /> POLICY NUMBER: 201 5-371 60 Page 1 <br /> NAME OF INSURED: North Carolina Public Health Foundation <br /> PREMISES DESIGNATED PREMISES ADDITIONAL INSUREDS <br /> LOC/BLDG ADDRESS. CITY. STATE. ZIP AND OTHER INTERESTS <br /> 1 308-F West Millbrook Road,Suite 1 <br /> Raleigh, NC 27609 <br /> 07/16/2015 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 L (02651) <br />