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HOME OFFICE SANFRANCISGO ANNUAL RATING ENDORSEMENT <br />IT IS AGREED THAT THE CLASSIFICATIONS AND RATES PER $100 OF REMUNERATION APPEARING <br />IN THE CONTINUOUSPOLICYISSUED TO THIS EMPLOYER ARE AMENDED AS SHOWN BELOW. <br />HERE ARE YOUR NEW RATES FOR THE PERIOD INDICATED. IF YOUR NAME OR ADDRESS SHOULD <br />BE CORRECTED OR IF INSURANCE IS NOT NEEDED FOR NEXT YEAR, PLEASE TELL US. <br />IMPORTANT THIS IS NOT A BILL CONTINUOUS POLICY 9048876-18 <br />SEND NO MONEY UNLESS STATEMENT IS ENCLOSED <br />THE RATING PERIOD BEGINS AND ENDS AT 12:01AM RATING PERIOD 7-01-18 TO 7-01-19 <br />PACIFIC STANDARD TIME <br />FRIENDS OF SANTA ANA ZOO DEPOSIT PREMIUM $2,410.00 <br />1801 E CHESTNUT AVE MINIMUM PREMIUM $1,045.00 <br />SANTA ANA, CALIF 92701 PREMIUM ADJUSTMENT PERIOD MONTHLY <br />REP D1 R SP <br />NAME OF EMPLOYER- FRIENDS OF SANTA ANA ZOO <br />(A NON-PROFIT ORGANIZATION) <br />CODE N0, PRINCIPAL WORK AND RATES EFFECTIVE FROM 07-01-18 TO 07-01-19 <br />INTERIM <br />PREMIUM BASE BILLING <br />BASIS RATE RATE* <br />9180-1 AMUSEMENT OR RECREATIONAL FACILITIES-- 219000 7.30 7.22 <br />N.O.C.--OPERATION AND MAINTENANCE OF <br />AMUSEMENT DEVICES <br />8017-1 STORES--RETAIL--N.O.C. 116000 7.52 7.44 <br />8810-1 CLERICAL OFFICE EMPLOYEES--N.O.C. 280300 .70 .69 <br />9016-1 AMUSEMENT OR RECREATIONAL FACILITIES-- 80000 10.60 _ 10.48 <br />N.O.C.--ALL EMPLOYEES OTHER <br />EXPERIENCE MODIFICATION <br />07-01-18 TO 07-01-19 <br />*******BUREAU NOTE INFORMATION******** <br />FEIN 510160007 <br />77 <br />TOTAL ESTIMATED ANNUAL PREMIUM $26,771 <br />COUNTERSIGNED AND ISSUED AT SAN FRANC�SC,EO JULY 3, 2018 POLICY L PAGE 1 OF <br />SCIF, FORM 10963A (REV.7-2014) OV R PLEASE) <br />