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Attachment Code: D568039 Certificate ID: 16059509 <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 02 B <br />(Ed. 12-13) <br />ADVANCE NOTICE OF CANCELLATION AND NON -RENEWAL ENDORSEMENT <br />It is hereby understood and agreed that all cancellation provisions in the policy addressing the required <br />number of days notice of cancellation by us or non -renewal by us are amended to be not less than: <br />a. 30 days will be given for notice of cancellation for non-payment of premium. <br />*b. 60 days will be given for notice of cancellation for any other reason. <br />c. 90 days will be given for non -renewal. <br />Notwithstanding the previsions above, in no event will the number of days notice for cancellation or for <br />non -renewal be fewer than the number of days required by statute. <br />*not applicable in Arizona, Pennsylvania. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The information below is required only when this endorsement is issued subsequent to preparation of the policy). <br />Endorsement Effective <br />Insured <br />Insurance Company <br />WC 99 06 02 B <br />(Ed. 12-12) <br />2/1 /2021 <br />Rincon Consultants, Inc. <br />Policy No. T10210329 <br />Policy Effective Date 2/1 /2021 <br />StarStone National Insurance Company <br />Endorsement No. 5 <br />cF IZAMwagmedDivisian <br />Jy/\'x REVIEWED & APPROVED BY.- <br />V"° <br />--� Risk janagement Analyst <br />