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t <br /> � <br /> i <br /> � THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> I <br /> � This endorsement changes the policy to which it is attached effective on the inception date of the policy <br /> $ unless a different date is indicated below. <br /> � (The following "attaching ciause"need be completed only when this endorsement is issued subsequent to <br /> � preparation of the policy). <br /> This endorsement,effective 12:01 AM 1/1/2016 forms a part of Policy No. SEE ATTACHED ACORD 101 <br /> Issued to AECOM <br /> AECOM Techincal Services,Inc. <br /> URS Corporation <br /> By The Insurance Company of the State of Pennsylvania <br /> LIMITED ApVICE OF CANCELLATION TO SCHEDULED ENTITIES <br /> � (WORKERS'COMPENSATION ONLY) <br /> s <br /> � This policy is amended as follows: <br /> i <br /> i In the event that the Insurer cancels this policy for any reason other than non-payment of premium,and <br /> 1.the cancellation effective date is prior to this policy's expiration date; <br /> 2.the Named Insured or, if applicable,any othar employers named in Item 1 of the Information Page is under an <br /> existing contractual obligation ko notify a certificate holder(s)when this policy is canceled(hereinafter,the"Certificate <br /> Holder(s)")and the Named Insured has provided the Insurer,either directly or through its broker of record,either: <br /> ' (a)the name of the entity shown on the certificate,a contact name at such entity and the U.S.Postal Service mailing <br /> address of each such entity;or <br /> (b)the email address of a contact at each such entity;and <br /> 3.prior to the effective date of cancellation,the Named Insured confirms to the Insurer,either directly or through its <br /> broker of record,that the persons or organizations set forth in the Schedule below,as well as their respective <br /> addresses listed, should continue to be a part of the Schedule and,if not,the names of the persons or organizations <br /> that should be deleted, <br /> the Insurer will provide advice of cancellation(the"Advice")to each such Certificate Holder(s)confirmed by the <br /> Named Insured in writing to be correctly a part of the Schedule within 30 days after the Named Insured confirms the <br /> accuracy of the Schedule below with the Insurer; provided, however,that if a specific number of days is not stated <br /> above,then the Advice will be provided to such Certificate Holder(s)as soon as reasonably practicable after the <br /> Named Insured confirms the accuracy of the Schedule below with the Insurer. <br /> Proof of the Insurer emailing the Advice, using the information provided and subsequently confirmed by the Named <br /> Insured in writing,will serve as proof that the Insurer has fully satisfied its obligations under this endorsement. <br /> This endorsement does not affect,in any way,coverage provided under this policy or the cancellation of this policy or <br /> the effective date thereof,nor shall this endorsement invest any rights in any entity not insured under this policy. <br /> The following definitions apply to this endorsement: <br /> 1. Named Insured means the first named employer in Item 1 of the Information Page of this policy. <br /> 2. Insurer means the insurance company shown in the header on the Information Page of this policy. <br /> WC 99 00 58 <br /> (Ed.04/11) <br /> Attachment Code: D461827 <br /> Master ID: 1392522,Certificate ID: 14274123 <br />