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G2GJ <br />KeyRisk K <br />Expertise is no accident <br />REY RISK INSURANCE COMPANY <br />Renewal Quote Conditions <br />The following quote conditions are included as part of the attached quotation. Please review and <br />verify the accuracy of the estimated renewal payrolls. <br />Oar quote is valid until the proposed effective date of the policy. There maybe <br />minor premium variations between the quote and the fma] policy. <br />Workers compensation insurance is quoted for North Carolina only. Other States <br />Insurance will be provided for the District of Columbia and all states except <br />North Dakota, Ohio, Washington and Wyoming. <br />No other endorsements or changes to policy terms and conditions are being <br />provided unless specifically indicated in this quotation <br />• This quote is subject to and utilizes a Key Risk Insurance Company Consent to Rate <br />Filing. If the quotation is accepted, the Consent to Rate application must be signed by the <br />Client and returned to Key Risk Insurance Company at the time coverage is bound and <br />prior to policy issuance. <br />North Carolina law requires employers to report workplace injuries that involve more <br />than one day of disability no later than five days after knowledge of a workplace injury. <br />All workplace injuries involving medical cost or lost workdays should be reported to <br />Key Risk immediately. <br />Voluntary Compensation coverage is provided for Library and Senior Services only. <br />Coverage for acts of terrorism, as defined in the Terrorism Risk Insurance Act of <br />2002 (the "Act"), is included in this quote. The portion of your annual premium <br />that is attributed to coverage for acts of terrorism is displayed in our quotation. <br />Any losses caused by certified acts of terrorism, as defined in the Act would be <br />partially reimbursed by the United States Government under a formula <br />established by federal law. Under this formula, the United States pays 90% of <br />covered terrorism losses exceeding the statutorily established deductible paid by <br />an insurance company providing the coverage. <br />Key Risk Insurance Company has a Best's Rating of "A+" (Superior). Founded in 1899, A.M. <br />Best is the oldest and most widely recognized rating agency dedicated to the insurance industry. <br />SEND RENEWAL BINDING INSTRUCTIONS TO YOUR UNDERWR=R <br />• PRIOR TO THE POLMYEFFEC=DATE <br />