Multiple Security Endorsement {IC81}

IC81 - MULTIPLE SECURITY ENDORSEMENT. This form is used by employers who are authorized to self-insure their workers’ compensation liabilities in the State of Illinois. This form serves as a binding agreement among the employer and each listed surety, escrow agent, or bank providing a letter of credit to secure the employer’s obligations under the Illinois Workers’ Compensation Act and the Workers’ Occupational Diseases Act. The endorsement consolidates and formally links multiple forms of financial security—such as surety bonds, escrow deposits, or letters of credit—into one document. It specifies that all listed securities will share pro rata responsibility for the employer’s liabilities based on their individual amounts in proportion to the total security amount. This includes not only benefits owed under the Acts but also administrative and legal defense costs. Importantly, if any individual form of security becomes uncollectible, the others are not liable for the shortfall. The endorsement also designates the Illinois Self-Insurers Advisory Board or its representative to manage and defend claims in the event the employer becomes insolvent. www.FormsWorkflow.com