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<br />. ,.nv,L... I""llnrH..C r~lVt1Ic. .U'i lU~~V~-Ot'lb-I44( <br />. ",~Y'::'(l:'1W' H.1:l 1('06 15:47 No.003 P.02 <br />, ' ," '~';~;~~T& HCIMi llma; SAIl FIlANCXSCll' ANNUAL RATING ENDORSEMlWT <br />, . \ ~~T10N <br />"'li1'!A~CI IT IS AGllUll T1lAT T"" CLA$$I/'1CATlONll AND RATlIIl PER $'00 OF llllMUI\IIlIIATlON Al*PIAlIING <br />. .' N D IN TIIlI CONTlNUOUS POUCY ISSUED TO TIllS EMPLOVER ARE AMENDED AS lIHOWH BELOW, <br /> <br />IIllAIl Me YOUR NEW RA1I!S tIOIl THE PliRIOD INllICATED. If YOUR HAMIl OFI ADDlISN SIlOUI.D <br />811 COFIFllill'\'Bl OFI If IN8I.IlIANCll IS NOT NIEJlEl) FOR NEXT YIWl, PWO TELl. us. <br />IMPORTANT CON1'lNlJOl.ii POLICY ' 380-06 <br />T1111118 NOT A alU. CALIJ'OIUUA ASSOCIATION or LICBHSBD <br />SItlD NO IIlNBY _IISS STATIIlINI' IS rNCl.\ISeD INVESTIGATORS IHC. ,'".' :' " <br />RAftNl '1111100 G1NI 101M ", <br />'ACxnc ITAIlOARD TIIII <br /> <br />PAUL CliAHCI PRIVATIC ItmSS'l'IGATIONS RA'l'IHG PUIOD <br />PO BOX 8565 . <br />aIVBRSIDB, CALI' 92515 <br /> <br />1-01-06 '1'0 <br />UHI' <br />nlPOIIT PUKU1K <br />KIHIMIK PUKIUM <br />PBlKIUM I.IlJU$TKIIH'I' P8RIOD <br /> <br />1-01-07 <br /> <br />'6 <br />$1,325.00 <br />U60.00 <br />MONTHLY <br />R IK <br /> <br />lIA111 Ol" EKl"LOYSll- CHANCE. PAUL AJlP <br />CJlAlICE. SUSAN <br />(HUSBAND AN!) WIFE) <br /> <br />CODE NO. <br /> <br />P1INCIPAL WORK AND RAT~ EFFECTIVE 'RaK 01-01-06 TO 01-01-07 <br /> <br />nltlllUH <br />PRMIlll'l wa .lILl.INC <br />WIS RAft IlA'l'!* <br /> <br />8810-1 <br /> <br />INBPJl;CTIOK POll INSUaAHCE OR VALUATI01i <br />rURPOSBS--H.O.C.--lIiClUDING OUTSIDE <br />$ALI!.SPIIlSotf <br /> <br />C~llICAL OFFICI aKPLOYBES--N.O.C. <br /> <br />1644Z5 <br /> <br />7.38 <br /> <br />5.79 <br /> <br />8720-1 <br /> <br />3179:1 <br /> <br />1.47 <br /> <br />1.15 <br /> <br />BXPKRIEHCE MODIFICATION <br />1-01-06 TO 1-01-07 <br /> <br />89 'I <br /> <br />********BUR5AV NOTt IHFoaHATIOR******** <br /> <br />nm ~86S61258 <br /> <br /> <br /> <br />TOTAL ISTINA'l'BD ANNUAL PRBKIUK <br /> <br />$8,807 <br /> <br />couwrsa$lGRr:D AXI) ISSuaD AT $AN YRANCIllCO .TAllttARY 18, 2006 POLICY L PAGI 1. 01 <br />ICI' """" ,l)I4IA mEV. 10-otll lOVI!II PLIlAlfIlr- <br />