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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 32 d6 01 A <br />(Ed. 07-10} <br />CANCELLATION AND NON-RENEWAL ENDORSEMENT <br />This endorsement applies only to the insurance provided by the pol'~cy because North Carolina is shown in <br />item 3A. of the Information Page. <br />It is hereby understood and agreed that all. cancellatan provisions in the policy addressing the required <br />number of days notice for cancellation by us ornon-renewal by us are amended as follows: <br />a. 30 days notice will be given for notice of cancellation for non-payment of premium. <br />b. 30 days notice will be g'nrert for notice of cancellation for any other reason. <br />c. 4'S days notice will be given for non-renewal <br />Notwithstanding the provisions above, in no event will the number of days notice for cancellation or for non- <br />renewal befewer than the number of days required by North Carolina law. <br />In the event of cancellation or nonrenewal of tl~e policy, we will mail notice to the named insured, and io the <br />additional person(s) or organization(s) named in the Schedule below, as required by North Carolina law: <br />SCHEDULE <br />Orange County Government <br />200 S Cameron Street <br />Hillsborough NC 27278 <br />Re: Orange County Health Department Renovations <br />300 West Tryon St <br />Hillsborough NC <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 2/211 <br />Policy No. PW00000013 Endorsement No. 04 <br />insured H M KERN CORPORATION <br />insurance company Builders Premier <br />Policy Effective Date 07/01/10 <br />Countersigned by <br />WC 32 06 09 A <br />