Laserfiche WebLink
Tait & Associates, Inc. <br />Tait Environmental Services, Inc. <br />TRAVELERSJ� <br />WORKERS COMPENSATION <br />AND <br />EMPLOYERS LIABILITY POLICY <br />ENDORSEMENT WC 04 06 01 (A) <br />POLICY NUMBER: UB-4J588939-21-43-G <br />CALIFORNIA CANCELATION ENDORSEMENT <br />This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. <br />of the information page. <br />The cancelation condition in Part Six (Conditions) of the policy is replaced by these conditions: <br />CANCELATION <br />1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the <br />cancelation is to take effect. <br />2. We may cancel this policy for one or more of the following reasons: <br />a. Non-payment of premium; <br />b. Failure to report payroll; <br />c. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued <br />by us; <br />d. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this <br />policy or any previous policy issued by us; <br />e. Material misrepresentation made by you or your agent; <br />f. Failure to cooperate with us in the investigation of a claim; <br />g. Failure to comply with Federal or State safety orders; <br />h. Failure to comply with written recommendations of our designated loss control representatives; <br />L The occurrence of a material change in the ownership of your business; <br />j. The occurrence of any change in your business or operations that materially increases the hazard for <br />frequency or severity of loss; <br />k. The occurrence of any change in your business or operation that requires additional or different <br />classification for premium calculation; <br />I. The occurrence of any change in your business or operation which contemplates an activity excluded <br />by our reinsurance treaties. <br />3. If we cancel your policy for any of the reasons listed in (a) through (f), we will give you 10 days advance <br />written notice, stating when the cancelation is to take effect. Mailing that notice to you at your mailing <br />address shown in Item 1 of the Information Page will be sufficient to prove notice. If we cancel your policy <br />for any of the reasons listed in Items (g) through (1), we will give you 30 days advance written notice; <br />however, we agree that in the event of cancelation and reissuance of a policy effective upon a material <br />change in ownership or operations, notice will not be provided. <br />4. The policy period will end on the day and hour stated in the cancelation notice. <br />DATE OF ISSUE: <br />ST ASSIGN: <br />63540930 121-22 Auto/WC I Izabela Stachura 18/25/2021 9:11:48 AM (PDT) I Page 8 of 8 <br />