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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 06 01 A <br /> EEC Environmental dba: Environmental Engineering & Contracting, Inc. (Ed. 12/93) <br /> WSD 5066761 03 <br /> CALIFORNIA CANCELATION ENDORSEMENT <br /> This endorsement applies only to the insurance provided by the policy because California is shown in Item 3.A. of the <br /> INFORMATION PAGE. <br /> The cancellation condition in Part Six (Conditions) of the policy is replaced by these conditions: <br /> CANCELATION <br /> 1. You may cancel this policy. You must mail or deliver advance written notice to us stating when the cancellation is <br /> to take effect. <br /> 2. We may cancel this policy for one or more of the following reasons: <br /> a. Non-payment of premium; <br /> b. Failure to report payroll; <br /> c. Failure to permit us to audit payroll as required by the terms of this policy or of a previous policy issued by us; <br /> d. Failure to pay any additional premium resulting from an audit of payroll required by the terms of this policy or <br /> any previous policy issued by us; <br /> e. Material misrepresentation made by you or your agent; <br /> f. Failure to cooperate with us in the investigation of a claim; <br /> g. Failure to comply with Federal or State safety orders; <br /> h. Failure to comply with written recommendations of our designated loss control representatives; <br /> i. The occurrence of a material change in the ownership of your business; <br /> j. The occurrence of any change in your business or operations that materially increases the hazard for <br /> frequency or severity of loss; <br /> k. The occurrence of any change in your business or operation that requires additional or different classification <br /> for premium calculation; <br /> Copyright 1998by The Workers'Compensation Insurance Rating Bureau of California. All rights reserved. Page 1 of 2 <br /> From the WCIRB's California Workers'Compensation Insurance Forms Manual Copyright 1M. <br /> INSURED <br /> 89056740 125-26 A/G/U/W/P011/E&0 I Dani Rembleski 11/28/2026 10:36:44 AM (PST) I Page 16 of 19 <br />