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BITCD GENERAL INSURANCE CORPORATION <br /> BITCO NATIONAL INSURANCE COMPANY <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> CANC EJ-K ION PROVISION <br /> This endorsement modifies insurance provided under the following: <br /> WORKERS COMPENSATION AND EMPLOYERS LIABItJ1Y INSURANCE <br /> Part Six-Conditions,Item D. Cancellation, Number 2, is changed to read: <br /> 2. We may cancel this policy. 1Ne must mail or deliver to you not less than THIRTY (30) <br /> days advance written notice stating when the cancellation is to take effect, unless cancellation is for <br /> nonpayment of premium, in which event our obligation is mailing not less than TEN (10) <br /> days prior to the effective date of cancellation. Mailing notice to you at your mailing address sham in <br /> Item 1 on the Information Page will be sufficient to prove notice. <br /> Named Insured PALP, INC. DBA EXCEL PAVING COMPANY <br /> Policy Number WC 3758665 Endorsement No. <br /> Policy Period 06-01-25 to 06-01-26 Endorsement Effective Date: <br /> Producer's Name: THE BALDWIN GROUP SOUTHEAST LLC <br /> Producer Number: 0006686 <br /> AUTHORIZED REPRESENTATIVE DATE <br /> WC 99 0314(09/21) <br />