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F 0 Such assignment may be conditional upon consent of the insurer,provided that such consent is not unreasonably refused. The insurer further certMes that it will not cancel,terminate,or fall to renew this policy except for failure to pay the premium,and that the automatic renewal of the policy provides the Insured with the option of renewal at the face amount of the expiring policy. If there is a failure to pay the premium and the insurer elects to cancel,terminate or not renew the policy,the insurer will send notice by either registered or certified mail to the operator and the CiWMB. Cancellation,termination, or failure to renew may not occur,however, during the one hundred twenty(120)days beginning with the date of receipt of the notice by the operator and the CIWMB, as evidenced by the return receipts. Cancellation,termination,or failure to renew will not occur and the policy will remain in full force and effect in the event that on or before the date of expiration; (1) The CIWMB or local enforcement agency deems the facility abandoned;or (2) The permit Is terminated or revolted or a new permit is denied by the CiWMB or local enforcement agency; or (3) Closure is ordered by the CIWMB; or any other State or Federal agency, or a court of competent jurisdiction; or (4) The operator Is named as a debtor In a voluntary or involuntary proceeding under Title 11 (Bankruptcy)U.S, Code; or (5) All delinquent premium payments have been brought current if this policy is used In combination with another mechanism,this policy shall be considered primary coverage, Whenever requested by the California integrated Waste Management Board of the State of California, the Insurer agrees to fumish to the CIW`MB a certified copy of the original policy listed above, including all endorsements thereon. The party below certifies and signs under penalty of perjury that the information in this document Is true and correct to the best of his or her knowledge, and satisfies the requirements of Title do CaliforniaaIsCade of Regulations, Divisio 2,Subdivision 1, Chapter 6. r. Notaft%eat (Authorized afore of Insurer Vcla u.Edwards, Notary Public (Title) Uwchlan lWp, Chester County My Corr mimlon Expires June 21,2004 Britt Member,PennsyrNaftAssodationofNolaNs (Typg4or Printed Name of Person igning) (W' ess of 7wry- nature) Uate PRIVACY STATEMENT The Information Practices Act(California Civil Code Section 1798.17)and the Federal Privacy Act(5 U.S.C.552a(e)(3))require that this notice be provided when collecting personal information from individuals. AGENCY REQUESTING INFORMATION: California Integrated Waste Management Board. x UNIT RESPONSIBLE FOR MAINTENANCE OF FORM: Financial Assurances Section, California Integrated Waste Management Board, 81300 Cal Center Drive, Sacramento, CA 95826. Contact the I? Manager, Financial Assurances Section, at(9 16)255-2200. ) I CA-SOLID WASTE-CPC(1/00) Page CIWMB 106(4/96)