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r <br /> r <br /> Workers'Compensation and Employers' Liability Policy ' <br /> Named Insured Endorsement Number <br /> BARRETT BUSINESS SERVICES, INC. <br /> 8100 NE PARKWAY DRIVE, STE. 200 Policy Number <br /> VANCOUVER WA 98662 Symbol: WLR Number: C58906347 <br /> Policy Period Effective Date of Endorsement <br /> 06-01-2025 TO 06-01-2026 06-01-2025 <br /> Issued By(Name of Insurance Company) <br /> ACE AMERICAN INSURANCE COMPANY <br /> Insert the policy number.The remainder of the information is to be completed only when this endorsement Is issued subsequent to the preparation of the policy. <br /> This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. <br /> EARLIER NOTICE OF CANCELLATION OR <br /> NONRENEWAL PROVIDED BY US -CALIFORNIA <br /> A. Under Condition D. Cancellation of Part Six, the time period is amended as follows: <br /> We may cancel this policy by mailing or delivering to you written notice of cancellation at least: <br /> 1. 90 days before the effective date of cancellation if we cancel for non-payment <br /> of premium (in no event less than 10 days); or <br /> 2. 90 days before the effective date of cancellation if we cancel for any other reason permitted under <br /> applicable law(in no event less than 30 days). <br /> B. Under Part Six- Conditions of the policy, the following is added: <br /> Notice of Nonrenewal <br /> When we do not renew this policy, we will mail or deliver to you written notice of the <br /> nonrenewal at least 90 days before the expiration date (in no event less than 30 days). <br /> Mailing that notice to you at your mailing address shown in Item 9 of the Information Page <br /> will be sufficient to prove notice. <br /> This form provides notice in excess of the notification requirements of CIC Section 676.8. <br /> Authorized Agent <br /> WC 90 04 09(05/20) <br />