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C� <br />9 <br />Item 3 of the Information Page are subject to <br />change if ordered by the Insurance Commissioner <br />of the State of California pursuant to Section 11737 <br />of the California Insurance Code. <br />Long Term Policy. If this policy is written for a <br />period longer than one year, all the provisions of <br />this policy shall apply separately to each <br />consecutive twelve-month period or, if the first or <br />last consecutive period is less than twelve months, <br />to such period of less than twelve months, in the <br />same manner as if a separate policy had been <br />written for each consecutive period. <br />Statutory Provision. Your employee has a first <br />lien upon any amount which becomes owing to you <br />by us on account of this policy, and in the case of <br />your legal incapacity or inability to receive the <br />money and pay it to the claimant, we will pay it <br />directly to the claimant. <br />Part Five, 'Premium", E, "Final Premium", is <br />amended to read as follows: <br />The premium shown on the Information Page, <br />schedules, and endorsements is an estimate. The <br />final premium will be determined after this policy <br />ends by using the actual, not the estimated, <br />premium basis and the proper classifications and <br />rates that lawfully apply to the business and work <br />Form WC 04 03 01 BB Printed in U.S.A. <br />covered by this policy. If the final premium is more <br />than the premium you paid to us, you must pay us <br />the balance. If it is less, we will refund the balance <br />to you. The final premium will not be less than the <br />highest minimum premium for the classifications <br />covered by this policy. <br />If this policy is canceled, final premium will be <br />determined in the following way unless our manuals <br />provide otherwise: <br />a. If we cancel, final premium will be calculated pro <br />rate based on the time this policy was in force. <br />Final premium will not be less than the pro rate <br />share of the minimum premium. <br />b. If you cancel, final premium may be more than <br />pro rate; it will be based on the time this policy <br />was in force, and may be increased by our <br />short -rate cancelation table and procedure. <br />Final premium will not be less than the pro rate <br />share of the minimum premium. <br />It is further agreed that this policy, including all <br />endorsements forming a part thereof, constitutes the <br />entire contract of insurance. No condition, provision, <br />agreement, or understanding not set forth in this policy or <br />such endorsements shall affect such contract or any <br />rights, duties, or privileges arising therefrom. <br />Rime Management DMsian <br />REV EWED & APPROVED By: <br />'� Risk Management Analyst <br />