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<br />. ." ~~- <br /> <br />STATE <br />"COMPENSATION <br />INSURANCE <br />FUND <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 />....... <br /> <br />i! <br />-- <br /> <br />REP 01 <br />682897-02 <br />RENEWAL <br />SP <br />2-36-51-65 <br />PAGE 1 <br /> <br />ENDORSEMENT AGREEMENT <br />EFFECTIVE APRIL 1, 2002 AT 12.01 A.M. <br /> <br />- . <br />'DAYLE'MC INTOSH CENTER <br />FOR THE DISABLED, INC <br />13272 GARDEN GROVE BLVD <br />GARDEN GROVE, CA 92843 <br /> <br />ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE <br />CONTROLLED BY THIS ENDORSEMENT. <br /> <br />IT IS AGREED THAT THE FOLLOWING CLASSIFICATION(S) IS (ARE) <br />HEREBY ADDED TO AND MADE A PART OF THIS POLICY. <br /> <br />RATE(S) EFFECTIVE UP TO 4/01/03 <br /> <br />STANDARD <br />CLASS DESCRIPTION OF WORK <br /> <br /> INTERIM <br />BASE BILLING <br />RATE" RATE* <br />2.08 1. 73 <br />1. 70 1.42 <br /> <br />8742 SALESPERSONS--OUTSIDE. <br /> <br />8810 CLERICAL OFFICE'BMPLOYEES--N.O.C. <br /> <br />IF THIS CLASSIFICATION CHANGE RESULTS IN INCREASED POLICY PREMIUM, <br />YOU ARE ENTITLED, AS PROVIDED BY INSURANCE CODE SECTION 11753.1, <br />TO REQUEST THAT THE CLASSIFICATION DECISION BE RECONSIDERED BY <br />THE WORKERS' COMPENSATION INSURANCE RATING BUREAU OF CALIFORNIA, <br />525 MARKET STREET, SUITE 800, SAN FRANCISCO, CALIFORNIA 94105-2716. <br /> <br />*THE BASE RATE IS PROVIDED FOR YOUR INFORMATION. IT IS THE RATE <br />WHICH STATE FUND HAS FILED WITH THE DEPARTMENT OF INSURANCE. <br />THE INTERIM BILLING RATE WILL BE USED ON PAYROLL REPORTS. IT <br />TAKES INTO ACCOUNT RATING PLAN CREDITS (OR DEBITS) WHICH WILL <br />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 L1MITATIQNS OF THIS <br />POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLlCy'"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 />AUTHORIZED REPRESENTATIVE <br /> <br />MARCH 28, 2002 9955 <br /> <br />~RE~ <br /> <br />77~ <br />