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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 99 06 07C )Ed 9-14) <br />CALIFORNIA CANCELLATION <br />This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of <br />the Information Page. <br />The cancellation condition in Part Six (Conditions) of the policy is replaced by these conditions: <br />Cancellation: <br />1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation <br />is to take effect. <br />2. We may cancel this Policy for one or more of the following reasons: <br />a. Non-payment of premium; <br />b. Failure to report payroll; <br />c. Non-payment of deductible billing; <br />d. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued <br />by us; <br />e. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this policy <br />or any previous policy issued by us; <br />f. Material misrepresentation made by you or your agent; <br />g. Failure to cooperate with us in the investigation of a claim; <br />h. Failure to comply with Federal or State safety orders; <br />i. Failure to comply with written recommendations of our designated loss control representatives; <br />I. The occurrence of a material change in the ownership of your business; <br />k. The occurrence of any change in your business or operations that materially increases the hazard for <br />frequency or severity of loss; <br />I. The occurrence of any change in your business or operation that requires additional or different <br />classification for premium calculation; <br />in. The occurrence of any change in your business or operation which contemplates an activity excluded by our <br />reinsurance treaties, <br />3. If we cancel your policy for any of the reasons listed in (a) through (g), we will give you 10 days advance written <br />notice, stating when the cancellation is to take effect. Mailing that notice to you at your mailing address shown in Item 1 <br />of the Information Page will be sufficient to provide notice. If we cancel your policy for any of the reasons listed in Items <br />(h) through (m), we will give you 30 days advance written notice; however, we agree that in the event of cancellation and <br />reissuance of a policy effective upon a material change in ownership or operations, notice will not be provided. <br />4. The policy period will end on the day and hour stated in the cancellation notice. <br />5. If you cancel this policy or if we cancel due to non-payment of premium, failure to report payroll, or non-payment of <br />deductible billing. First, the premium computed in accordance with Section 1, Rule 2, will be multiplied by the quotient <br />of the number of days for which the policy was written divided by the number of days the policy remained in force to <br />produce the full policy premium. Second, the extended number of days will be determined by dividing the number of <br />days the policy was in force by the number of days for which the policy was written and multiplying the quotient by 365 <br />days. (When the Policy was written for a one -year period, the extended number of days will equal the number of days <br />the policy remained in force). Third, the short rate percentage corresponding to the extended number of days will be <br />obtained from the short rate cancellation table. Fourth, the short rate premium will be equal to the product of the full <br />policy premium times the short rate percentage. The Short Rate Table below will be used in computing the Short Rate <br />Premium. In no event will the final earned premium be less than the policy minimum premium. <br />WC 99 06 07C <br />,Fd 9-141 <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />J 121 <br />20 <br />Page 1 of 2 h ANCINE R. VIL _AI <br />