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<br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br /> <br />IN REPL Y REFER TO: <br /> <br />1801464-07 <br /> <br />WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY <br />I NSURANCE POll CY <br />STATE COMPENSATION INSURANCE FUND <br />Forms and Endorsements Applicable List Policy <br /> <br />FORM NUMBER <br /> <br />FORM DESCRIPTION <br /> <br />10963A <br />10217 <br />10217 <br />10217 <br />10217 <br />10610 <br /> <br />ANNUAL RATING ENDORSEMENT <br />2089 -ENDORSEMENT AGREEMENT- <br />STATUTORY ACCOUNTING PRINCIPLES - BILL RECEIVABLE <br />2437 -ENDORSEMENT AGREEMENT- <br />MEDICAL PROVIDER NETWORK ENDORSEMENT <br />2558 -ENDORSEMENT AGREEMENT- <br />TERRORISM RISK INSURANCE EXTENSION ACT WC 00 01 13 <br />3015 -ENDORSEMENT AGREEMENT- <br />EXECUTIVE OFFICERS - MINIMUM/MAXIMUM LIMITS <br />POLICY HOLDER NOTICE <br /> <br />- <br /> <br />1275 Market Street. San Francisco, CA 94103-1410 <br />Mailing Address: P.O. Box 420807. San Francisco. CA 94142-0807 <br />