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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> QUICK REFERENCE <br /> Beginning Beginning <br /> on Page on Page <br /> INFORMATION PAGE PART TWO -Continued <br /> 1 G. Limits of Liability .............................................. 4 <br /> General Section.............................................................. 1 H. Recovery From Others..................................... 4 <br /> A. The Policy............................................................... 1 I. Actions Against Us........................................... 4 <br /> B. Who Is Insured....................................................... 1 <br /> C. Workers Compensation Law.................................. 1 PART THREE-OTHER STATES INSURANCE 4 <br /> ........ 1 A. How This Insurance Applies...................... . <br /> E. Locations................................................................ 1 B. Notice............................................................... 5 <br /> PART ONE-WORKERS COMPENSATION INSURANCE... 1 PART FOUR-YOUR DUTIES IF INJURY OCCURS..... 5 <br /> A. How This Insurance Applies................................... 1 <br /> B. We Will Pay............................................................ 1 PART FIVE - PREMIUM............................................... 5 <br /> C. We Will Defend....................................................... 1 A. Our Manuals..................................................... 5 <br /> D. We Will Also Pay.................................................... 1 B. Classifications.................................................. 5 <br /> E. Other Insurance...................................................... 2 C. Remuneration................................................... 5 <br /> F. Payments You Must Make...................................... 2 D. Premium Payments.......................................... 5 <br /> G. Recovery From Others........................................... 2 E. Final Premium.................................................. 5 <br /> H. Statutory Provisions................................................ 2 F. Records............................................................ 6 <br /> G. Audit................................................................. 6 <br /> PART TWO - EMPLOYERS LIABILITY INSURANCE...... 2 <br /> A. How This Insurance Applies................................... 2 PART SIX-CONDITIONS.................................... 6 <br /> B. We will Pay............................................................. 3 A. Inspection....................... 6 <br /> C. Exclusions..................................................I........... 3 B. Long Term Policy............................................. 6 <br /> D. We Will Defend...................................................... 3 C. Transfer of Your Rights and Duties.................. 6 <br /> E. We Will Also Pay.................................................... 4 D. Cancellation..................................................... 6 <br /> F. Other Insurance...................................................... 4 E. Sole Representative......................................... 6 <br /> IMPORTANT: This Quick Reference is not part of the Workers Compensation and Employers Liability Policy and does <br /> not provide coverage. Refer to the Workers Compensation and Employers Liability Policy itself for <br /> actual contractual provisions. <br /> PLEASE READ THE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CAREFULLY. <br /> Form WC 66 01 56 B Printed in U.S.A. <br /> Process Date: 11/04/25 Policy Expiration Date: 11/04/26 <br />