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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 />CONTINUOUS POLICY 9226837-19 <br />IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR LOCAL STATE FUND OFFICE BELOW: <br />CSC - POLICY AT VACAVILLE <br />1020 VAQUERO CIRCLE <br />VACAVILLE , CA 95688 <br />(877) 405-4545 <br />Nothing herein contained shall be held to vary, 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 />e-eew.601 <br />AUTHORIZED REPRESENTATIVE <br />PRESIDENT AND CEO <br />Qb'-ri <br />Iq-Z2-k <br />COUNTERSIGNED AND ISSUED AT SAN FRANCISCO MARCH 4, 2019 POLICY L PAG 3 OF 3 <br />SCIF FORM 10963A (REV.7-2014) <br />