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ATKINS NOR-l-H ANAERICA A-2010-005 REVIEWED BY� Z4, �A � EUNICE HEREDIA (PG 11 OF 13) <br />WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY we 99 of to <br />0 <br />This endorsement modifies insurance provided under the following: <br />(If no entry appears above, information required to complete this Schedule will be shown in the Declarations as <br />applicable 10 this endorsement) <br />For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of <br />oanceUoUon, as provided in PART SIX CONDITIONS, D. Cenoe}abon of the Workers' Compensation and <br />Employers' Liability Insurance Policy oroaamended by an applicable state cancellation endorsement, in increased to <br />the number of days shown in the Schedule above. <br />All other terms and conditions remain the same. <br />This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br />(The infonnaUon below is required only when this endorsement is issued subsequent to preparation cK the ponq^) <br />Endorsement Effective April 1'2O15 Policy No. CVV874OSO1504 Endorsement No. <br />Insured ATKINS NORTH AMERICA, INC. <br />Insurance CompanyGreemwkch Insurance CompW tersigned by <br />VVeY90Il0 <br />Ecl 1/08 Ocz00rxLAmerica, Inc, <br />