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CNA (Ed. 10 93) <br /> (Ed. 10/93) <br /> WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY INSURANCE POLICY <br /> NOTICE OF CANCELLATION OR MATERIAL CHANGE ENDORSEMENT <br /> In the event of cancellation or other material change of the policy, we will mail advance notice to the person or <br /> organization named in the Schedule.The number of days advance notice is shown in the Schedule. <br /> This endorsement shall not operate directly or indirectly to benefit anyone not named in the Schedule. <br /> Schedule <br /> 1. Number of days advance notice: <br /> For non-payment of premium,the greater of: <br /> • the number of days required by state statute or <br /> • the number of days required by written contract <br /> For any other reason, the lesser of: <br /> • 60 days or <br /> • the number of days required in a written contract <br /> 2. Notice will be mailed to: <br /> Any person or organization you are required by written contract or agreement to mail prior written notice of <br /> cancellation or material change. <br /> Address: Per Certificates of Insurance on file with the broker <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated <br /> (The nformation below is required only when this endorsement is issued subsequent to preparation of the policy) <br /> Endorsement Effective 10-1-25 Policy No,WC274978630 Valley Forge Insurance Company <br /> WC274978644 Transportation insurance Company <br /> WC 99 06 06 <br /> G-20472-A Page 1 of 1 <br /> (Ed 10/93) <br />