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WORKERS COMPENSATION AND EMPLOYERS <br />LIABILITY INSURANCE POLICY <br />In return for the payment of the premium and subject to all terms of this policy, we agree with you as follows: <br />GENERAL SECTION <br />A. The Policy <br />This policy includes at its effective date the <br />Information Page and all endorsements and schedules <br />listed there. It is a contract of insurance between you <br />(the employer named in Item 1 of the Information <br />Page) and us (the insurer named on the Information <br />Page). The only agreements relating to this insurance <br />are stated in this policy. The terms of this policy may <br />not be changed or waived except by endorsement <br />issued by us to be part of this policy. <br />B. Who Is Insured <br />You are insured if you are an employer named in Item <br />1 of the Information Page. If that employer is a <br />partnership, and if you are one of its partners, you are <br />insured, but only in your capacity as an employer of <br />the partnership's employees. <br />C. Workers Compensation Law <br />Workers Compensation Law means the workers or <br />workmen's compensation law and occupational disease <br />t� <br />law of each state or territory named in Item 3.A. of the <br />Information Page. It includes any amendments to <br />that law which are in effect during the policy period. It <br />does not include any federal workers or workmen's <br />compensation law, any federal occupational disease <br />law or the provisions of any law that provide <br />nonoccupational disability benefits. <br />D. State <br />State means any state of the United States of <br />America, and the District of Columbia. <br />E. Locations <br />This policy covers all of your workplaces listed in <br />Items 1 or 4 of the Information Page; and it covers all <br />other workplaces in Item 3.A. states unless you have <br />other insurance or are self -insured for such <br />workplaces. <br />PART ONE - WORKERS COMPENSATION INSURANCE <br />A. How This Insurance Applies <br />This workers compensation insurance applies to <br />bodily injury by accident or bodily injury by disease. <br />Bodily injury includes resulting death. <br />1. Bodily injury by accident must occur during the <br />policy period. <br />2. Bodily injury by disease must be caused or <br />aggravated by the conditions of your employment. <br />The employee's last day of last exposure to the <br />conditions causing or aggravating such bodily <br />injury by disease must occur during the policy <br />period. <br />B. We Will Pay <br />We will pay promptly when due the benefits required <br />of you by the workers compensation law. <br />C. We Will Defend <br />We have the right and duty to defend at our expense <br />any claim, proceeding or suit against you for benefits <br />payable by this insurance. We have the right to <br />investigate and settle these claims, proceedings or <br />suits. <br />We have no duty to defend a claim, proceeding or <br />suit that is not covered by this insurance. <br />D. We Will Also Pay <br />We will also pay these costs, in addition to other <br />amounts payable under this insurance, as part of any <br />claim, proceeding or suit we defend: <br />1. reasonable expenses incurred at our request, but <br />not loss of earnings; <br />Form WC 00 00 00 C Printed in U.S.A. <br />Process Date: 12/23/19 Polic'. <br />+s RhkMmrg`wdDWdmI <br />r/R�tviEwED & pA9 Rovm B <br />rMNY.N.I R. Rak Management Analys <br />