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CALIFORNIA WORKERS' COMPENSATION INSURANCE NOTICE OF NONRENEWAL Section 11664 of to California Insiance Code re -Ares -IF,, in most instances, to proElde yo❑ wit-] a notice of nonrenewal. Eiuept as specified in paragrapu 1 tmo-g❑ 6 !ulow, if we elect to nonrenew yoj policy, we are re❑fired to deliur or mail to yo❑ a written notice stating t!u reason or reasons for to nonrenewal of to policy. T❑e notice is re❑cored to iu sent to yo❑ no earlier tun 120 days !ufore tiu end of tiu policy period and no later tun 30 days ufore t!u end of tiu policy period. If we fail to pro:Jde yo❑ to re -cored notice, we are re❑cored to continu to courage .nder to policy wit❑ no change in to premi::n rate iEntil 60 days after we pros-Ide yo❑wit❑tiu re❑cored notice. We are not re -]tired to pro!lde yo❑ wit❑ a notice of nonrenewal in any of t❑e following sit❑ations❑ YoLlr policy was transferred or renewed witium a ciunge in its terms or conditions or tiu rate on wimc❑ Lie premiErn is used to anotiur insider or otiur ins-irers w❑o are memijers of t-e same insilrance groDp as iu. 2. T❑e policy was emended for 90 days or less and tiu re -]fired notice was giun prior to ti❑e emension. Yo❑ oimained replacement courage or agreed, in writing, witmn 60 days of tiu termination of to policy, to oimain t❑at courage. 4. T❑e policy is for a period of no more titan 60 days and yo❑ were notified at tiu time of issiunce tut it may not !Da renewed. Yo❑ re❑Dusted a cunge in tiu terms or conditions or risiu coured i❑y t!u policy witimn 60 days prior to t!u end of t!u policy period. 6. We made a written offer to yo❑ to renew to policy at a premi::n rate increase of less tun 2❑ percent. -A❑If to premi::n rate in yo:lr gourning classification is to iu increased 2❑ percent or greater and we intend to renew t-e policy, we still proEJde a written notice of a renewal offer not less tiun 30 days prior to tiu policy renewal date. T❑e gourning classification si-all iu determined ❑y tEb rues and regimations estamisud in accordance wit❑ California Instance Code 11 ❑i❑D.3:0i❑ -B❑For p:lrposes of tms ❑otice, Cpremion rate❑ means tiu cost of ins:l-ance per Tlit of e:])osim-e prior to t❑e application of indi:ldi:al ris❑ iuriations used on loss or e--pense considerations si❑c❑ as scudmed rating and ei-lperience rating. Tms notice does not cunge tiu policy to wmc❑ it is attaciud. Form PN 04 99 02 B (Ed. 5-02) Printed in D.S.A. Page 2 of 2