2017-413-E Aging - Senior Care of Orange County Inc. for adult day health care services

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DocuSign Envelope ID:30CFBA21-DC65-423A-A674-7D24A692C6ED WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 32 03 01 C (Ed. 01-14) (d) Cancellation for nonpayment of premium is not effective if the amount due is paid before the effective date stated in the notice of cancellation. 3. We may refuse to renew this policy: (a) If this policy is for a term of one year or less, we must provide you with notice of nonrenewal at least 45 days prior to the expiration date of the policy. (b) If this policy is for a term of more than one year or for an indefinite term, then to nonrenew the policy at the policy anniversary date we must provide you with notice of nonrenewal at least 45 days prior to the anniversary date of the policy we must provide you with notice of nonrenewal at least 45 days prior to the anniversary date of the policy, (c) The notice of nonrenewal must state the precise reason for nonrenewal. Failure to send this notice, as provided in paragraphs 3 and 5, to any other person designated in the policy to receive this notice invalidates the nonrenewal only as to that other person's interest. (d) Any nonrenewal attempted or made that is not in compliance with paragraphs(a), (b)and (c) is not effective. Paragraphs(a), (b)and (c)do not apply if you have obtained insurance elsewhere, have accepted replacement coverage, or have requested or agreed to nonrenewal. 4. Whenever we lower coverage limits, raise deductibles, or raise premium rates for reasons within our exclusive control and other than at your request,we will mail you written notice of the change at least 30 days in advance of the effective date of the change. As used in this paragraph, the phrase, "reasons within our exclusive control"does no mean experience modification changes, exposure changes, or loss cost rate changes. 5. We must provide the notice required by paragraphs 3 and 4 by mail to you and any other person designated in the policy to receive this notice at the addresses shown in the policy or, if not indicated in the policy, at the last known addresses. Mailing copies of the notice by regular first-class mail satisfies the notice requirements of paragraphs 3, 4 and 5. 6. We will also send copies of the notice required by this endorsement to the agent or broker of record,though failure to send copies of the notice to the agent or broker of record will not invalidate a cancellation or nonrenewal. Mailing copies of the notice by regular first-class mail to the agent or broker of record satisfies the requirements of this paragraph. Notice of nonrenewal may also be given by any method permitted for service of process pursuant to Rule 4 of the North Carolina Rule of Civil Procedure. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below Is required only when this endorsement Is Issued subsequent to preparation of the policy.) Endorsement Effective 02/08/2017 Policy No. MWCO106102-01 Endorsement No. Insured: Senior Care of Orange Premium (See Attached) County Inc Insurance Company: Markel Insurance Company Countersigned by (Ed.01-14) 02013 National Council on Compensation Insurance,Inc. 21 of 24