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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY U-WC-3078-A CW <br />(08/17) <br />CANCELLATION AND NONRENEWAL NOTICE ENDORSEMENT <br />A. Part Six — Conditions, Paragraph D.2. is replaced by the following: <br />D. Cancellation <br />2. We may cancel this policy. We must mail or deliver to you not less than 90 days advance written <br />notice stating when the cancellation is to take effect except for cancellation for non-payment of <br />premium. If we cancel this policy for non-payment of premium we must mail or deliver to you not less <br />than ten days advance written notice. Mailing that notice to you at your mailing address shown in <br />Item 1 of the Information Page will be sufficient to prove notice. <br />B. Part Six— Conditions, Paragraph F. is added. <br />F. Nonrenewal Notice <br />We will mail or deliver to you not less than 90 days advance written notice of our intention to nonrenew <br />this policy. Mailing that notice to you at your mailing address shown in Item 1 of the Information Page will <br />be sufficient to prove notice. <br />All other terms, conditions, provisions and exclusions of this policy remain the same. <br />APPROVED <br />By Cynthia Mora at 5:12 pm, Dec 10, 2024 <br />U-WC-3078-A CW (08117) Page 1 of 1 <br />Policy # WC4197282-03 <br />