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Endorsement Endorsement Effective: Policy No.: Named Insured: L. This Policy covers you for all Employees employed during the Policy Period provided the compensable injury or death happened during the Policy Period and subject to all other terms and conditions of this Policy. M. This Policy does not cover any obligation imposed upon you by Article 9 of the Workers’ Compensation Law of New York or by any provision amending or supplementing Article 9. Countersigned MIDWEST EMPLOYERS CASUALTY COMPANY Authorized Representative Secretary President This endorsement forms part of the Policy to which attached, effective on the inception date of the Policy unless otherwise stated herein. All other terms and conditions of the Policy remain unchanged. CMB-NY (8-13) Page 4 of 4 Date Printed: Page 49 of 201