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NOTICE OF CANCELLATION TO THIRD PARTIES <br />A. If we cancel this policy for any reason other than nonpayment of premium, we will notify the persons or <br />organizations shown in the Schedule below. We will send notice to the email or mailing address listed below at <br />least 10 days, or the number of days listed below, if any, before cancellation becomes effective. In no event <br />does the notice to the third party exceed the notice to the first named insured. <br />B. This advance notification of a pending cancellation of coverage is intended as a courtesy only. Our failure to <br />provide such advance notification will not extend the policy cancellation date not negate cancellation of the <br />policy. <br />Name of Other Person(s) <br />Organization(s): <br />Broker will provide list of <br />organizations and contacts at <br />least 10 days prior to the <br />advanced notification date <br />Schedule <br />Email Address or mailing address: <br />Broker will provide list of <br />organizations and contacts at <br />least 10 days prior to the <br />advanced notification date <br />All other terms and conditions of this policy remain unchanged. <br />Number Days Notice: <br />30 <br />Issued by Liberty Insurance Corporation21814 <br />Policy term 10-1-19 to 10-1-20 <br />For attachment to Policy No Work Camp Policy #WA7-69D458727-069 Premium $ <br />Issued to DMS Facility Services, Inc. <br />REVIEWED & APPROVED <br />By Risk MANAgEMENT UVi$iON <br />WC 99 20 75 C 2016 Liberty Mutual Insurance <br />Ed, 12/012016 Q �TA 7 2019 <br />�]V( '�' � ay- . <br />FRANCINE R. VILLAREAL <br />Page 1 of 1 <br />