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5/11/2020 <br />THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />This endorsement changes the policy to which it is attached effective on the inception date of the policy unless a different <br />date is indicated below <br />(The following "attaching clause" need be completed only when this endorsement Is issued subsequent to preparation of the policy). <br />This endorsement, effective 12:01 AM 04/01/2020 forms a part of Policy No. WC015853342 (AOS) <br />Issued to Wiss, Janney, Elstner Associates, Inc <br />Attn: Sam Barbera <br />By <br />New Hampshire Ins, Co. <br />LIMITED ADVICE OF CANCELLATION PROVIDED VIA E-MAIL <br />TO ENTITIES OTHER THAN THE NAMED INSURED <br />(WORKERS' COMPENSATION ONLY) <br />This policy is amended as follows <br />In the event that the Insurer cancels this policy for any reason other than non-payment of premium, and <br />1. the cancellation effective date is prior to this policy's expiration date, <br />2 the Named Insured or, if applicable, any other employers named in Item 1 of the Information Page is under an <br />existing contractual obligation to notify a certificate holder when this policy Is canceled (hereinafter, the <br />" Certificate Holder(s)" ) and the Named Insured has provided to the Insurer, either directly or through Its <br />broker of record, the email address of a contact at each such entity, and <br />3 the Insurer received this information after the Named Insured receives notice of cancellation of this policy and <br />prior to this policy' s cancellation effective date, via an electronic spreadsheet that is acceptable to the Insurer, <br />the Insurer will provide advice of cancellation (the " Advice" ) via e-mail to each such Certificate Holders within 30 days <br />after the Named Insured provides such information to the Insurer, provided, however, that if a specific number of days <br />is not stated above, then the Advice will be provided to such Certificate Holder(s) as soon as reasonably practicable <br />after the Named Insured provides such information to the Insurer <br />Proof of the Insurer emailing the Advice, using the information provided by the First Named Insured, will serve as <br />proof that the Insurer has fully satisfied its obligations under this endorsement. <br />This endorsement does not affect, in any way, coverage provided under this policy or the cancellation of this policy or <br />the effective date thereof, nor shall this endorsement invest any rights in any entity not insured under this policy <br />The following definitions apply to this endorsement: <br />1 Named Insured means the insured first named employer in Item 1 of the Information Page of this policy <br />2. Insurer means the insurance company shown in the header on the Information Page of this policy. <br />All other terms, conditions and exclusions shall remain the same. <br />WC 99 00 56 <br />(Ed. 04/11) <br />AUTHORIZED REPRESENTATIVE <br />REVIEWED & APPROVED <br />By Risk MANAGEMENT DIVISION <br />20 <br />55413323 1 20121 cc Au ec I sam samera 1 5111/2n20 3u05,55 ea mori I eaye s oe 3 <br />