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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 PolicylawofeachstateorterritorynamedinItem3.A.ofthe <br />InformationPage.Itincludesanyamendmentsto <br />Thispolicyincludesatitseffectivedatethe <br />thatlawwhichareineffectduringthepolicyperiod.It <br />InformationPageandallendorsementsandschedules <br />doesnotincludeanyfederalworkersorworkmen's <br />listedthere.Itisacontractofinsurancebetweenyou <br />compensationlaw,anyfederaloccupationaldisease <br />(theemployernamedinItem1oftheInformation <br />lawortheprovisionsofanylawthatprovide <br />Page)andus(theinsurernamedontheInformation <br />nonoccupational disability benefits. <br />Page).Theonlyagreementsrelatingtothisinsurance <br />arestatedinthispolicy.ThetermsofthispolicymayD.State <br />notbechangedorwaivedexceptbyendorsement <br />StatemeansanystateoftheUnitedStatesof <br />issued by us to be part of this policy. <br />America, and the District of Columbia. <br />B.Who Is Insured <br />E.Locations <br />YouareinsuredifyouareanemployernamedinItem <br />Thispolicycoversallofyourworkplaceslistedin <br />1oftheInformationPage.Ifthatemployerisa <br />Items1or4oftheInformationPage;anditcoversall <br />partnership,andifyouareoneofitspartners,youare <br />otherworkplacesinItem3.A.statesunlessyouhave <br />insured,butonlyinyourcapacityasanemployerof <br />otherinsuranceorareself-insuredforsuch <br />the partnership's employees. <br />workplaces. <br />C.Workers Compensation Law <br />WorkersCompensationLawmeanstheworkersor <br />workmen's compensation law and occupational disease <br />PART ONE - WORKERS COMPENSATION INSURANCE <br />A.How This Insurance AppliesC.We Will Defend <br />ThisworkerscompensationinsuranceappliestoWehavetherightanddutytodefendatourexpense <br />bodilyinjurybyaccidentorbodilyinjurybydisease.anyclaim,proceedingorsuitagainstyouforbenefits <br />Bodily injury includes resulting death.payablebythisinsurance.Wehavetherightto <br />investigateandsettletheseclaims,proceedingsor <br />1.Bodilyinjurybyaccidentmustoccurduringthe <br />suits. <br />policy period. <br />Wehavenodutytodefendaclaim,proceedingor <br />2.Bodilyinjurybydiseasemustbecausedor <br />suit that is not covered by this insurance. <br />aggravatedbytheconditionsofyouremployment. <br />Theemployee'slastdayoflastexposuretotheD.We Will Also Pay <br />conditionscausingoraggravatingsuchbodily <br />Wewillalsopaythesecosts,inadditiontoother <br />injurybydiseasemustoccurduringthepolicy <br />amountspayableunderthisinsurance,aspartofany <br />period. <br />claim, proceeding or suit we defend: <br />B.We Will Pay <br />1.reasonableexpensesincurredatourrequest,but <br />Wewillpaypromptlywhenduethebenefitsrequirednot loss of earnings; <br />of you by the workers compensation law. <br />Form WC 00 00 00 CPrinted in U.S.A.Page1 of6 <br />Process Date: 08/17/24Policy Expiration Date: 09/26/25 <br /> <br />