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B. Notice <br />Tell us at once if you begin work in any state <br />listed in Item 3.C. of the Information Page. <br />PART FOUR <br />YOUR DUTIES IF INJURY OCCURS <br />Tell us at once if injury occurs that may be cov- <br />ered by this policy. Your other duties are listed <br />here. <br />1. Provide for immediate medical and other ser- <br />vices required by the workers compensation <br />law. <br />2. Give us or our agent the names and ad- <br />dresses of the injured persons and of wit- <br />nesses, and other information we may need. <br />3. Promptly give us all notices, demands and <br />legal papers related to the injury, claim, pro- <br />ceeding or suit. <br />4. Cooperate with us and assist us, as we may <br />request, in the investigation, settlement or <br />defense of any claim, proceeding or suit. <br />5. Do nothing after an injury occurs that would <br />interfere with our right to recover from others. <br />6. Do not voluntarily make payments, assume <br />obligations or incur expenses, except at your <br />own cost. <br />PART FIVE <br />PREMIUM <br />A. Our Manuals <br />All premium for this policy will be determined by <br />our manuals of rules, rates, rating plans and clas- <br />sifications. We may change our manuals and ap- <br />ply the changes to this policy if authorized by law <br />or a governmental agency regulating this insur- <br />ance. <br />B. Classifications <br />Item 4 of the Information Page shows the rate <br />and premium basis for certain business or work <br />classifications. These classifications were as- <br />signed based on an estimate of the exposures <br />you would have during the policy period. If your <br />actual exposures are not properly described by <br />those classifications, we will assign proper classi- <br />fications, rates and premium basis by endorse- <br />ment to this policy. <br />WC000000(C) <br />(Ed. 1-15) <br />C. Remuneration <br />Premium for each work classification is deter- <br />mined by multiplying a rate times a premium ba- <br />sis. Remuneration is the most common premium <br />basis. This premium basis includes payroll and all <br />other remuneration paid or payable during the <br />policy period for the services of: <br />1. all your officers and employees engaged in <br />work covered by this policy; and <br />2. all other persons engaged in work that could <br />make us liable under Part One (Workers <br />Compensation Insurance) of this policy. If <br />you do not have payroll records for these <br />persons, the contract price for their services <br />and materials may be used as the premium <br />basis. This paragraph 2 will not apply if you <br />give us proof that the employers of these <br />persons lawfully secured their workers com- <br />pensation obligations. <br />D. Premium Payments <br />You will pay all premium when due. You will pay <br />the premium even if part or all of a workers com- <br />pensation law is not valid. <br />E. Final Premium <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, pre- <br />mium basis and the proper classifications and <br />rates that lawfully apply to the business and work <br />covered by this policy. If the final premium is <br />more than the premium you paid to us, you must <br />pay us the balance. If it is less, we will refund the <br />balance to you. The final premium will not be less <br />than the highest minimum premium for the classi- <br />fications covered by this policy. <br />If this policy is canceled, final premium will be <br />determined in the following way unless our <br />manuals provide otherwise: <br />1. If we cancel, final premium will be calculated <br />pro rata based on the time this policy was in <br />force. Final premium will not be less than the <br />pro rata share of the minimum premium. <br />2. If you cancel, final premium will be more than <br />pro rata; it will be based on the time this pol- <br />icy was in force, and increased by our short - <br />rate cancelation table and procedure. Final <br />premium will not be less than the minimum <br />premium. <br />© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. <br />RbAManagementDivision <br />Revi w & APPROVED BY. <br />Risk Management Analyst <br />