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<br />STATE <br />COMPENSATION <br />INSURANCE <br />I=UND <br />HOME OFFICE <br />SAN FRANCISCO <br />ALL EFFECTIVE DATES ARE <br />AT 12:01 AM PACIFIC <br />STANDARD TIME OR THE <br />TIME INDICATED AT <br />PACIFIC STANDARD TIME <br /> <br />. INTERIM BILLING RATE MODIFICATION <br /> <br />..,..,. <br /> <br />- <br /> <br />REP 01 <br />682897-02 <br />RENEWAL <br />SP <br />2-36-51-65 <br />PAGE 3 <br /> <br />AT 12.01 A.M. <br /> <br />- <br /> <br />ENDORSEMENT AGREEMENT <br />EFFECTIVE APRIL 1, 2002 <br /> <br />DAYLE MC INTOSH CENTER <br />FOR THE DISABLED, INC <br />13272 GARDEN GROVE BLVD <br />GARDEN GROVE, CA 92843 <br /> <br />CONTINUED <br /> <br />IT IS FURTHER AGREED THAT THE FOLLOWING STANDARD CLASS CODE, <br />BASE RATE AND INTERIM BILLING RATE SHALL APPLY FROM <br />4/01/02 TO 4/01/03 <br /> <br />STANDARD INTERIM <br />CLASS BASE BILLING <br />CODE RATE* RATE* <br />8742 2.08 1.50 <br />8810 1. 70 1.23 <br />8804 9.59 6.92 <br /> <br />- <br /> <br />* THE BASE RATE IS PROVIDED FOR YOUR INFORMATION. IT IS THE <br />RATE WHICH STATE FUND HAS FILED WITH THE DEPARTMENT OF <br />INSURANCE. THE INTERIM BILLING RATE WILL BE USED ON PAYROLL <br />REPORTS. IT TAKES INTO ACCOUNT RATING PLAN CREDITS (OR <br />DEBITS) WHICH WILL APPLY AT FINAL BILLING. <br /> <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIOl'IS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE <br />HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR <br />LIMITATIONS OF THIS ENDORSEMENT. <br /> <br />COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: <br /> <br />~~~" <br /> <br />- <br /> <br />APRIL 4, 2002 2900F <br /> <br />~~ <br /> <br />PRESIDENT <br /> <br />AUTHORIZED REPRESENTATIVE <br />