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<br />STATE <br />COMPENSATION <br />INSURANCE <br />FUND <br />HOME OFFICE <br />SAN FRANCISCO <br /> <br />ENDORSEMENT AGREEMENT <br />MEDICAL PROVIDER NETWORK <br /> <br />1801464-07 <br />RENEWAL <br />SG <br /> <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 />EFFECTIVE OCTOBER 1, 2007 AT 12.01 A.M. <br /> <br />PAGE <br /> <br />3 OF <br /> <br />3 <br /> <br />ADVANCED TRNSPRTTN CNCPTS GRP, INC <br />14 SORENSON <br />IRVINE, CA 92602 <br /> <br />CONTINUED. <br /> <br />EMPLOYEE AND RETAINS RECORDS OF THE TREATMENT AND MEDICAL <br />HISTORY. <br /> <br />THE EMPLOYER PROVIDES THE STAFF WITH NONOCCUPATIONAL GROUP <br />HEALTH COVERAGE IN A HEALTH-CARE SERVICE PLAN (SUCH AS AN <br />HMO/PPO PROGRAM) . <br />OR <br />THE EMPLOYER PROVIDES NONOCCUPATIONAL HEALTH COVERAGE IN A <br />GROUP HEALTH PLAN OR A GROUP HEALTH INSURANCE POLICY. PER <br />LABOR CODE 4616.7. <br /> <br />- <br /> <br />NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE <br />OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS 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 />Q:::::EPRESENTATIV <br />serF FORM 10217 (REV.3-07) <br /> <br /> <br />SEPTEMBER 14, 2007 <br /> <br />~(.~~- <br /> <br />PRESIDENT <br /> <br />2437 <br /> <br />OLD DP 217 <br />