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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 04 19 <br /> (Ed. 1-01) <br /> PREMIUM DUE DATE ENDORSEMENT <br /> This endorsement is used to amend: <br /> Section D. of Part Five of the policy is replaced by this provision. <br /> PART FIVE <br /> PREMIUM <br /> D. Premium is amended to read: <br /> You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is <br /> not valid. The due date for audit and retrospective premiums is the date of the billing. <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) <br /> Endorsement Effective Policy No. Endorsement No. <br /> Insured Premium$ <br /> Insurance Company Countersigned by <br /> WC 00 04 19 <br /> (Ed. 1-01) <br /> ©2000 National Council on Compensation Insurance,Inc. <br />