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~~~~~~~ <br />N.v <br />p.t <br />~`~~~ H01~ OFFICE,aAN FRA19C25W ANNIUAI iiATNYG ENDORSEMENT <br />CoMPENSAT'10l1 ~ Ig AGREED 'T'itAT THE GLASSIFICAT101yS AID RATE'S PER 5140 OF REIAt1NERAT1pN APPEARING <br />lfV5UFtANCB <br />~~~ D IN THE: CaNTiNUOUS PC-L.tCY Isauao TO THIS ~MP40YER ASE a~nE~ECi AS s~lOYrN BEl.~UY~[. <br />uec ~~4 ut ~iu_u_ta iea r7oicomuv., ...........,....„' <br />H~tE ARE Ydt1R NEW RATES FOR THE P~i1QD INDIC/ITED. F YOUR NAME OR Al7dRF,.SS SHOULB <br />BE CORRECTED OR iF INSUIiAMCE YS 1VOT 1~ FtfA NEXT YEAR, P1.6ASE TELL tlS, <br />~MFORTaNT Txls Is IudT A .~ ~rm^nlnus ~~~ 1848138-07 <br />SENO !W MD11EY UNLESS 5TATI=ME?iT IS EMCLASEQ <br />THE RATIi16 i~ER[OD 11E:NINS AA1D ENDS AT 12:OtAN ~T+j~ 2~IdD x-•01-07 'I'C 4"01-~$ <br />PACIFIC S'f11NDAtitz TI#~ <br />3i0RTH I~MERICBN AMtrSBMEIfTS, IItC 2]iEPaSIt' PRIO[IOIt $4!,649.00 <br />Zi101 CALABPiSR 1~iYS MINIP[I!!t PREIEItIt~! $354.00 <br />FORTA2!tA, CALIF 92337 FRI3t~lIQi4 A2~JIISTN[EI~i'P PERIOD 24~R1'PHLY <br />REP 31 R SD <br />NAISE OF EMPLOYER- 1~OA?H AHERICI-N AHUSElsErtTS, Il~C <br />Ui CORPORATION) <br />CODE [JO. FiiICtCYPAL WORb aNn RATES E1=FECTIYE FROM 06-01-07 TO 0 4-O1-t}8 <br /> IIGTER I?S <br /> 1'RE;KIUM St~SE 6z].,L2[NG <br /> HASIS RATE RATE* <br />902.6-1 aattaS23HENT PARxs alt E#IrBITIONS 383573 la. O1 8.55 <br />8810-1 CLERICAL OFFICE EIfPLOYEES--Ii.O. C. 2+287 1_ 1$ .99 <br />9'180-1 AMUSEMENT PA2IKS aR EXHI23FTIOIgS 122392 7.~7 6.63 <br />EaCPERIl~2CE P'la23IFICATIaK <br />4-O1-fl7 20 4-01-08 - 326 x <br />**'~*=*BUREAII IYd3'E INFOAMATIOI~I*~=~`=~'* <br />FEIN 330704455 <br />FEIN 33744085 <br />_ l~v~c ~ ~s. is ~~ rti /J <br />TGTAL ESTI2~THD AITl~tUAL FREb[IUM $134, 285 <br />I[tliT$RS I G3JED i~iltD I S SUSD AT SAK FRANC ~ ~2FR I L 12 , 200 7 PClLI CY L FAGS 1 OF 3 <br />SCtF FOR41 'IOBB]rL tP1EV. 70-O~i PLEAS <br />25B-19 <br />