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WORKERS COMPENSATION AND EMPLOYERS <br /> LIABILITY INSURANCE POLICY <br /> In return for the payment of the premium and subject to all terms of this policy, we agree with you as follows: <br /> GENERAL SECTION <br /> A. The Policy law of each state or territory named in Item 3.A. of the <br /> This policy includes at its effective date the Information Page. It includes any amendments to <br /> Information Page and all endorsements and schedules that law which are in effect during the policy period. It <br /> listed there. It is a contract of insurance between you does not include any federal workers or workmen's <br /> (the employer named in Item 1 of the Information compensation law, any federal occupational disease <br /> Page) and us (the insurer named on the Information law or the provisions of any law that provide <br /> Page). 'The only agreements relating to this insurance nonoccupational disability benefits. <br /> are stated in this policy. The terms of this policy may D. State <br /> not be changed or waived except by endorsement State means any state of the United States of <br /> issued by us to be part of this policy. America, and the District of Columbia. <br /> B. Who Is Insured E. Locations <br /> You are insured if you are an employer named in Item This policy covers all of your workplaces listed in <br /> 1 of the Information Page. If that employer is a Items 1 or 4 of the Information Page; and it covers all <br /> partnership, and if you are one of its partners, you are other workplaces in Item 3.A. states unless you have <br /> insured, but only in your capacity as an employer of other insurance or are self-insured for such <br /> the partnership's employees. workplaces. <br /> C. Workers Compensation Law <br /> Workers Compensation Law means the workers or <br /> workmen's compensation law and occupational disease <br /> PART ONE -WORKERS COMPENSATION INSURANCE <br /> A. Flow This Insurance Applies C. We Will Defend <br /> This workers compensation insurance applies to We have the right and duty to defend at our expense <br /> bodily injury by accident or bodily injury by disease. any claim, proceeding or suit against you for benefits <br /> Bodily injury includes resulting death. payable by this insurance. We have the right to <br /> 1. Bodily injury by accident must occur during the investigate and settle these claims, proceedings or <br /> policy period. suits. <br /> 2. Bodily injury by disease must be caused or We have no duty to defend a claim, proceeding or <br /> aggravated by the conditions of your employment. suit that is not covered by this insurance. <br /> The employee's last day of last exposure to the D. We Will Also Pay <br /> conditions causing or aggravating such bodily We will also pay these costs, in addition to other <br /> injury by disease must occur during the policy amounts payable under this insurance, as part of any <br /> period. claim, proceeding or suit we defend: <br /> B. We Will Pay 1. reasonable expenses incurred at our request, but <br /> We will pay promptly when due the benefits required not loss of earnings; <br /> of you by the workers compensation law. <br /> Form WC 00 00 00 C Printed in U.S.A. Page 1 of 6 <br /> Process Date: 11/04/26 Policy Expiration Date: 11/04/26 <br />