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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY QUICK REFERENCE Beginning on Page Beginning on Page INFORMATION PAGE PART TWO - Continued 1 G. Limits of LiaE lity.............................................. 4 General Section.............................................................. 1 ❑. Recoery From Ot❑ers..................................... 4 A. T❑e Policy............................................................... 1 I. Actions Against❑s........................................... 4 B. W❑b Is Ins —red ....................................................... 1 C. Worers Compensation Law .................................. 1 PART THREE - OTHER STATES INSURANCE 4 D. State....................................................................... 1 A. ❑ow TEJs Ins—rance Applies............................. 4 E. Locations................................................................ 1 B. Elotice ............................................................... ❑ PARTONE- WORKERS COMPENSATION INSURANCE... 1 PART FOUR -YOUR DUTIES IF INJURY OCCURS..... ❑ A. —ow T::js Instance Applies ................................... 1 B. We Will Pay............................................................ 1 PART FIVE - PREMIUM ............................................... ❑ C. We Will Defend ....................................................... 1 A. O-r Man❑als..................................................... ❑ D. We Will Also Pay .................................................... 1 B. Classifications.................................................. ❑ E. Ot❑er Ins—rance...................................................... 2 C. RemAeration................................................... ❑ F. Payments Yo❑MC:8t Mae ...................................... 2 D. PremiEin Payments.......................................... ❑ G. Recoery From Ot❑ers........................................... 2 E. Final Premi-n.................................................. ❑ ❑. Stat tory Prolsions................................................ 2 F. Records............................................................ 6 G. A❑dit................................................................. 6 PART TWO - EMPLOYERS LIABILITY INSURANCE...... 2 A. —ow T::js Ins—rance Applies ................................... 2 PART SIX - CONDITIONS ....................................... 6 B. We will Pay............................................................. 3 A. Inspection......................................................... 6 C. Eeleions.............................................................. 3 B. Long Term Policy ............................................. 6 D. We Will Defend ....................................................... 3 C. Transfer of Yo—r RigEts and DEties.................. 6 E. We Will Also Pay .................................................... 4 D. Cancellation..................................................... 6 F. Ot er Ins—rance...................................................... 4 E. Sole Representatie......................................... 6 IMPORTANT: T❑is ❑❑ic❑Reference is not part of t❑e Worers Compensation and Employers LiaE lity Policy and does not prodde coerage. Refer to tie Wor ers Compensation and Employers LiaE lity Policy itself for act❑al contract❑al prorsions. PLEASE READ THE WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY CAREFULLY. Form WC 66 01 56 B Printed in O.S.A. Process Date: 11/04/211 Policy Expiration Date: 11/04/26