DAYLE MCINTOSH CENTER 4 -2002 - Laserfiche WebLink

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'. STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO ALL EFFECTIVE DATES ARE AT 12:01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME INTERUlBILLING I , '-' RATE MODIFICATION ~. ( . ...., REP 01 682897-02 RENEWAL SP 2-36-51-65 PAGE 2 AT 12.01 A.M. ENDORSEMENT AGREEMENT EFFECTIVE APRIL 1, 2002 ~fiAYL~ MC INTOSH CENTER FOR THE DISABLED, INC 13272 GARDEN GROVE BLVD GARDEN GROVE, CA 92843 CONTINUED **************************************************************** * * PREMIUM DISCOUNT SCHEDULE EFFECTIVE * * * * ~{ 4/01/02 TO 4/01/03 'k ESTIMATED MODIFIED PREMIUM IS DISCOUNTED ACCORDING TO THE FOLLOWING SCHEDULE: ~', 'k ok * FIRST $2,500 0.0% ABOVE $2,500 17 .5% ~~ " 1, * * * * ***********************r**************************************** THE ESTIMATED PREMIUM DISCOUNT IS BASED ON AN ESTIMATE OF YOUR PAYROLL. ACTUAL PREMIUM DISCOUNT APPLIED AT FINAL BILLING WILL BE BASED ON THE ACTUAL PAYROLL REPORTED ON YOUR POLICY AND SUBJECT TO AUDIT. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR L1MITATIO!lS, OF THIS POLICY OTHER THAN AS STATED. NOTHING" ELSEWHERE IN THIS POLICY SHALL BE HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR LIMITATIONS OF THIS ENDORSEMENT. COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: 77~~-- AUTHORIZED REPRESENTATIVE APRIL 4, 2002 2900F ~~ PRESIDENT .