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<br />09/22/2008 12:54 <br /> <br />9093930943 <br /> <br />M SANCf-EZ <br /> <br />PAGE 14/14 <br /> <br />I <br />STATE HOME OFFICE SAN FRANeJ:SCO I ANNUA" RATING ENDORSEMENT <br />COM~II!!!"'SATldN IT IS AGREED THAT THE C~ASSIFICAnONS AND RATES PER $100 OF ReMUNERATION APPEARING <br />INSUFlANC" <br />FUNQ IN THE CONTINUOUS POLICY ISSUED TO THIS EMP~OYER ARE AM"NIJEIJ AS SHOWN EE"OW. <br /> - <br /> <br />CONTINUOUS PO"ICY 469 0003546-07 <br /> <br />IF YOU ~AVE ANY QUESTI.ONS, PLEASE CONT~T _YOUR LOCAL. STA!! FUND OFFICE BELOW: <br /> <br />LOS ANGELES <br />900 CORPORATE CENTER DR. <br />MONTEREY PARK , CA 91754 <br />(323) 266-5000 <br /> <br />- <br /> <br />I <br />, <br /> <br />Nhfuins hereIn eOl1tlllrnEld sh.11 be held to \lBry. ~Iter. wallJs or extend <br />8~reements or limitations. of the Policy other than as hMain 5tated. <br /> <br /> <br />0het1 COlJnt9fslgnad bv a duly authorized officer Of represl:!ntatlve of tl'le Statf!J Compensation Ins,l"Iranee <br />FLlnd, these declarations shall be vlllid and form part of the POliCY. <br /> <br />any of the term!>. ~ottditiol"ls <br /> <br />- <br /> <br />~~ <br /> <br />I AUTHO.'ZW .ePReSONTATlve <br />! <br /> <br />~~ <br /> <br />PRS51r>ENT <br /> <br />UNTERSIGNEO AJO ISSUEO AT SAN FRANCISCO MARCH 4. 2008 <br />selF FORM lOSGiA (REV. ~O-Oi) <br />I <br /> <br />POLICY L PAGS 3 OF 3 <br />