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HOME OFFICE SAN FRANCISCO <br />RATING ENDORSEMENT <br />IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING <br />IN THE CONTINUOUS POLICY ISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. <br />CONTINUOUS POLICY 9102788-15 <br />IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR LOCAL STATE FUND OFFICE BELOW: <br />CSC — POLICY AT MONTEREY PARK <br />900 CORPORATE CENTER DRIVE <br />MONTEREY PARK CA 91754 <br />(877) 405-4545 <br />Nothing herein contained shall be hold to very, alter, waive or extend any of the terms, conditions <br />agreements or limitations of the Policy other than as herein stated. <br />When countersigned by a duly authorized officer or representative of the State Compensation Insurance <br />Fund, these declarations shall be valid and form part of the Policy, <br />��el 4�01 <br />AUTHORIZED REPRESENTATIVE <br />PRESIDENT AND C50 <br />COUNTERSIGNED AND ISSUED AT SAN FRANCISCO MAY 6, 2015 <br />SCIF FORM 10963A IREM,2014) <br />POLICY L PAGE 3 OF <br />