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THIS ENDORSEMENT <br />WORKERS' COMPENSATION BROAD FORM ENDORSEMENT <br />k <br />Pa88cyNumber: 72 WEC LR3783 Endorsement Number: <br />Effective Date: 09/28/14 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address: WESTBOUND CObIMUNICATSONS, INC. <br />625 THE CITY DR, SUITE 360 <br />ORANGE, CA 92868 <br />Section I of this endorsement expands coverage provided under WC 00 00 00. <br />Section ll of this endorsement provides additional coverage usually Only provided by endorsement. <br />Section III of this endorsement is a Schedule of Covered States. <br />You may use the index to locate these coverage features quickly: <br />UBJECT INDEX <br />PAGE I SUBJECT <br />SECTION I <br />PARTS ONE and TWO <br />01 We WIII Also Pay <br />PART -THREE <br />02 How This Insurance Works <br />PART - SIX <br />03 Transfer of Your Rights and Duties <br />04 Liberalization <br />SECTION II <br />VOLUNTARY COMPENSATION INSURANCE <br />05 Voluntary Compensation Insurance <br />A. How This Insurance Applies <br />a. We Will Pay <br />C. Exclusions <br />D. Before We Pay <br />E. Recovery From Others <br />F. Employers' Liability Insurance <br />EMPLOYERS' LIABILITY STOP GAP <br />ENDORSEMENT <br />06 Employers' Liability Stop Gap <br />Coverage <br />A. Stop Gap Coverage Limited to <br />Montana, North Dakota, Ohio, <br />Washington, West Virginia and <br />Wyoming <br />Form WC 99 03 03 B Printed in U.S.A. (Ed. $100) <br />Process Date: 08/09/14 <br />am <br />B. Part One Does Not Apply <br />3 <br />C, Application of Coverage <br />3 <br />D. Additional Exclusions <br />3 <br />E. West Virginia <br />3 <br />EXTENDED OPTIONS <br />4 <br />01 Employers' Liability insurance <br />4 <br />02 Unintentional Failure to Disclose <br />4 <br />Hazards <br />03 Waiver of Our Right to Recover from <br />4 <br />Others <br />04 Foreign Voluntary Compensation <br />4 <br />A. Haw This Reimbursement Applies <br />4 <br />B. We Will Reimburse <br />4 <br />C. Exclusions <br />4 <br />D. Before We Pay <br />5 <br />E. Recovery From Others <br />5 <br />F. Reimbursement For Actual Loss <br />5 <br />Sustained <br />G. Repatriation <br />5 <br />H. Endemic Disease <br />5 <br />05 Longshore and Harbor Workers' <br />5 <br />Compensation Act Coverage <br />Endorsement <br />SECTION 811 <br />5 <br />01 Schedule of Covered States <br />e <br />© 2000, The Hartford <br />Page 1 of 6 <br />Policy Expiration Date: o9/2a/1_5 <br />