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CNA Workers Compensation And Employers Liability Insurance <br />Policy Endorsement <br />This endorsement modifies insurance provided under the WORKERS COMPENSATION AND EMPLOYERS <br />LIABILITY INSURANCE POLICY: <br />In the event of cancellation or material change that reduces or restricts coverage during the policy period, we <br />agree to send prior written notice in the manner prescribed, to the person or organization listed in the Schedule. <br />SCHEDULE <br />1. Number of days advance notice: 30 <br />For nonpayment of premium: <br />2. For any other reason: <br />3. Name and Address of Person or Organization: PER ATTACHED SCHEDULE OF HOLDERS <br />All other terms and conditions of the policy remain unchanged. <br />This endorsement, which forms a part of and is for attachment to the policy issued by the designated Insurers, <br />takes effect on the Policy Effective date of said policy at the hour stated in said policy, unless another <br />effective date (the Endorsement Effective Date) is shown below, and expires concurrently with said policy. <br />Form No: CNA87380XX 01-2016) <br />Endorsement Effective Date: 4/1/2020 <br />0 Copyright CNA All Rights Reserved. <br />REv1EwMp & MPPRp <br />BY (Ysk _ ftr to <br />