Certificate Of Excess Insurance {IC80}

IC80 - CERTIFICATE OF EXCESS INSURANCE. This certifies that a Workers’ Compensation and Workers’ Occupational Diseases Excess Insurance Policy has been issued and delivered to the Employer named below, and that by issuance and delivery of the said policy and the filing of the Certificate of Insurance, it is admitted that said excess policy was effective on the date stated below and that the coverage provided therein is applicable to benefits under the Workers’ Compensation and Workers’ Occupational Diseases Acts of the State of Illinois and that said policy shall remain in full force and effect until receipt by the Illinois Workers’ Compensation Commission of notice of its’ cancellation, expiration, or material alteration in accordance with the provisions of Chapter 820, Illinois Compiled Statutes. www.FormsWorkflow.com