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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br />papers related to the injury, claim, proceeding <br />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 our <br />manuals of rules, rates, rating plans and <br />classifications. We may change our manuals and <br />apply the changes to this policy if authorized by law <br />or a governmental agency regulating this insurance. <br />B. Classifications <br />Item 4 of the Information Page shows the rate and <br />premium basis for certain business or work <br />classifications. These classifications were assigned <br />based on an estimate of the exposures you would <br />have during the policy period. If your actual <br />exposures are not properly described by those <br />classifications, we will assign proper classifications, <br />rates and premium basis by endorsement to this <br />policy. <br />C. Remuneration <br />Premium for each work classification is determined <br />by multiplying a rate times a premium basis. <br />Remuneration is the most common premium basis. <br />This premium basis includes payroll and all other <br />remuneration paid or payable during the policy <br />period for the services of: <br />1. all your officers and employees engaged in work <br />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 you <br />do not have payroll records for these persons, <br />the contract price for their services and materials <br />may be used as the premium basis. This <br />paragraph 2 will not apply if you give us proof <br />that the employers of these persons lawfully <br />secured their workers compensation obligations. <br />D. Premium Payments <br />WC 00 00 00 C <br />(Ed. 1-15) <br />You will pay all premium when due. You will pay the <br />premium even if part or all of a workers <br />compensation 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, <br />premium 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 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 to <br />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 />1. If we cancel, final premium will be calculated pro <br />rata based on the time this policy was in force. <br />Final premium will not be less than the pro rata <br />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 policy <br />was in force, and increased by our short -rate <br />cancelation table and procedure. Final premium <br />will not be less than the minimum premium. <br />F. Records <br />You will keep records of information needed to <br />compute premium. You will provide us with copies of <br />those records when we ask for them. <br />G. Audit <br />You will let us examine and audit all your records <br />that relate to this policy. These records include <br />ledgers, journals, registers, vouchers, contracts, tax <br />reports, payroll and disbursement records, and <br />programs for storing and retrieving data. We may <br />conduct the audits during regular business hours <br />during the policy period and within three years after <br />the policy period ends. Information developed by <br />audit will be used to determine final premium. <br />Insurance rate service organizations have the same <br />rights we have under this provision. <br />5 of 6 <br />© Copyright 2013 National Council on Compensation Insurance, Inc. All Rights Reserved. <br />�oRaN <br />} : <br />RiskMmRgemerdDivisiun <br />REVIEWED & APPROVED BY.- <br />cc <br />Risk Management Analyst <br />