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TRAVELERS ONE TOWER SQUARE HARTFORD CT 06183 WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY ENDORSEMENT WC 99 03 99 (00) POLICY NUMBER: U13-OR34080A-20-42-G CALIFORNIA WORKERS' COMPENSATION NOTICE OF NON -RENEWAL Section 11664 of the California Insurance Code which becomes operative November 30, 1994 requires us in most instances to provide you with a notice of non -renewal. Except as specified in paragraphs 1 through 6 below, if we elect to non -renew your policy, we are required to deliver or mail to you a written notice stating the reason or reasons for the non -renewal of the policy. The notice is required to be sent to you no earlier than 120 days before the end of the policy period and no later than 30 days before the end of the policy period. If we fail to provide you the required notice, we are required to continue the coverage under the policy with no change in the premium rate until 60 days after we provide you with the required notice. We are not required to provide you with a notice of non -renewal in any of the following situations: 1. Your policy was transferred or renewed without a change in its terms or conditions or the rate on which the premium is based to another insurer or other insurers who are members of the same insurance group as us. 2. The policy was extended for 90 days or less and the required notice was given prior to the extension. 3. You obtained replacement coverage or agreed, in writing, within 60 days of the termination of the policy, to obtain that coverage. 4. The policy is for a period of no more than 60 days and you were notified at the time of issuance that it may not be renewed. 5. You requested a change in the terms or conditions or risks covered by the policy within 60 days prior to the end of the policy period. 6. We made a written offer to you at least 30 days, but not more than 120 days, prior to the end of the policy period to renew the policy at a changed premium rate. DATE OF ISSUE: 05-11-20 STASSIGN: el RiekM�agnurtfDtxaiun RREviEvrEo &pAPFR vim Sr} t\o� f�M1�GN.t ram, V�t.IFA(K �k Risk Management Matyst