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Endorsement Endorsement Effective: Policy No.: Named Insured: In the event of your bankruptcy or insolvency or of your failure or default to comply with your obligations under the Workers’ Compensation Law, the Chair of the Workers’ Compensation Board will be subrogated to all of your rights under this Policy. Nothing in this Condition will be construed to give a claimant a direct right of action against us. V. Section I. Cancellation of Part Six of this Policy is amended to read as follows: I. Cancellation and Non-Renewal. 1. Cancellation. During the first sixty (60) days this Policy is initially in effect, except for the discovery of fraud or material misrepresentation in the obtaining of the Policy or in the presentation of a claim thereunder; no cancellation shall become effective until twenty (20) days after written notice is mailed or delivered to you at the mailing address shown in Item 2 of the Schedule Page and to your authorized agent or broker. In the event that the Policy is cancelled for nonpayment of premium, then notice of cancellation shall be sent informing you of the amount due and the cancellation shall not become effective until ten (10) days after the notice of cancellation is served on you and filed with the Office of the Chair. After this Policy has been in effect for sixty (60) days unless cancelled pursuant to the paragraph above, or on or after the effective date if this Policy is a renewal, no notice of cancellation shall become effective until fifteen (15) days after written notice is mailed or delivered to you and to your authorized agent or broker, and such cancellation is based on one or more of the following with respect to this Policy: a. Nonpayment of premium provided, however, that a notice of cancellation on this ground shall inform you of the amount due and the cancellation shall not become effective until ten (10) days after the notice of cancellation is served on you and filed with the Office of the Chair; b. Conviction of a crime arising out of acts increasing the hazard insured against; c. Discovery of fraud or material misrepresentation in the obtaining of the Policy or in the presentation of a claim thereunder; d. After issuance of the Policy or after the last renewal date, discovery of an act or omission, or a violation of any Policy condition, that substantially and materially increases the hazard insured against, and which occurred subsequent to inception of the current Policy Period; e. Material change in the nature or extent of the risk, occurring after issuance or last annual renewal anniversary date of the Policy, which causes the risk of loss to be substantially and materially increased beyond that contemplated at the time the Policy was issued or last renewed; f. A determination by the superintendent that continuation of our present premium volume would jeopardize our solvency or be hazardous to the interests of our policyholders, its creditors or the public; or g. A determination by the superintendent that the continuation of the Policy would violate, or would place us in violation of, any provision of this chapter. A notice of cancellation should be filed by certified or registered mail at least thirty (30) days prior to the effective date of cancellation with the Office of the Chair of the Workers’ Compensation Board, 328 State Street, Schenectady, New York 12305-2318. 2. Non-Renewal. This Policy shall remain in full force and effect pursuant to the same terms, conditions and rates unless written notice is mailed or delivered by us to you, at the address shown in Item 2 of the Schedule Page, and to your authorized agent or broker, indicating our intention: CMB-NY (8-13) Page 2 of 4 Date Printed: Page 47 of 201