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HOME OFFICE SAN FRANCISCO ANNUAL 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 />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 9226837-19 <br />SEND NO MONEY UNLESS STATEMENT IS ENCLOSED <br />THE RATING PERIOD BEGINS AND ENDS AT 12:01AM <br />PACIFIC STANDARD TIME RATING PERIOD 3-01-19 TO 3-01-20 <br />`SECOND CHANCE ORANGE COUNTY DEPOSIT PREMIUM $500.00 <br />307 PLACENTIA AVE STE 203 MINIMUM PREMIUM $500.00 <br />NEWPORT BEACH, CALIF 92663 PREMIUM ADJUSTMENT PERIOD QUARTERLY <br />R NA <br />NAME OF EMPLOYER- SECOND CHANCE ORANGE COUNTY <br />(A NON-PROFIT CORP.) <br />CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 03-01-19 TO 03-01-20 <br />INTERIM <br />PREMIUM BASE BILLING <br />BASIS RATE RATE* <br />8742-1 SALESPERSONS --OUTSIDE. 65327 .83 .91 <br />8810-1 CLERICAL OFFICE EMPLOYEES--N.O.C. 3158 .62 .68 <br />********BUREAU NOTE INFORMATION******** <br />FEIN 811224869 <br />z - @f <br />LA-Z2-1 9 <br />TOTAL ESTIMATED ANNUAL PREMIUM $618 <br />COUNSCIF,0,r SI G3NED ANDQIISSUED AT SAN FRANC(O EROPLEASEI MARCH 4, <br />2019 POLICY L PAGE CIO� <br />3/ <br />