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HomeMy WebLinkAboutCC RESO 2914. s£ SO STI . '2914 by e Cit-.Council of e City of Yetignal City that the 3500.00 deposit to the Stete 0 2e=ration Insurance Fund £or the renewal of the Do icy be, E the same is hereby, aut prized. PASSED AND ADOPTED by the City Council of the City of National City, California, this 17th day of July 1 9 45 AYES: Councilmen , by the following vote, to -wit: Christman, Cordingl_y, Newberry,___Tha _ab r_,___k'rttz NAYS: Councilmen None ABSENT: Noxie e ayor of the Cit, of National City, iP ornia. ATTEST: City Clerk. I hereby approve the foregoing Resolution Wafillet }this17th day of July , 19 45 Mayor of the City of National City, C•rnia. I hereby certify that the above and foregoing is a full and true copy of of the { Resolutions Ordinances Resolution Ordinance i No of the City of National City, California, as adopted by the City Council of said City, and approved by the Mayor of said City, on the day of 19 City Clerk of the City of National City, California. Deputy 4 0297 g ty3‘,. RESOLUTION- NO . , e, %/L3 RESOLUTION OF THE CITY COUNCIL OF THE CITY OF O ADOPTING BUDGET AND APPROVING ,kL MEMORANDUM R ` +" TXPENDITURE OF 1/4 CENT GAS TAX ALLOCATED FOR STREETS OF MAJOR IMPORTANCE **wand OnwpnenWHEREAS, a emoo n um poi agreement has been presented to be entered into with the State of California in accord- ance with a project statement for expenditure of the 1/4 cent gas tax for the fiscal year 1945 allocated for streets of major importance other than State highways in the City of Nations, City ; and WHEREAS, the city council has heard read said agree- ment in full and is familiar with the contents thereof; THEREFORE, be it resolved by the city council of the City of National City that said project statement be and it is hereby adopted as the budget of proposed ex- penditures of the 1/4 cent gas tax allocated for streets of major importance other than State highways, and said agreement be and the same is hereby approved and the mayor and the city clerk are directed to sign the same on behalf of said City, said agreement to be binding upon the City upon its execution by the authorized officials of the State. ADOPTED this day of , 1 Attest: City C erk of the City of I hereby certify that the foregoing resolution was duly and regularly passed by the city council of the City °f0ational 0` at a regular meeting thereof held , 1 'Clerk of he City of MC-10 STATE COMPENSATION INSURANCE FUND. EXECUTIVE OFFICES SAN FRANCISCO J. J. GALLAGHER R. S. DAVIS MANAGER L. I. NEWMAN, COMPTROLLER M.D. MEDICAL DIRECTOR DONALD GALLAGHER COUNSEL IN REPLY PLEASE MENTION 450 McALLISTER ST. File No. 10429-45 City of National City National City, California Attention: City Clerk Gentlemen: SAN FRANCISCO, 1 LOS ANGELES OAKLAND SACRAMENTO FRESNO SAN DIEGO STOCKTON SAN JOSE LONG BEACH SANTA BARBARA dune 1, 1945 We are enclosing your renewal policy and initial premium invoice. If it is necessary that a "demand" be presented before the initial premium can be approved for payment, will you please send us a blank for that purpose so we may execute it and return it to you in time? Continued coverage without lapse ie important, and for this reason the initial pre- mium should be paid on or before Jay , 1945 It is our aim to give the highest type of service, and you are invited to call upon lie with any problems relating to your workmen's compensation insurance. JJG;LH U-60 CREATED BY THE STATE OF CALIFORNIA TO FURNISH PROTECTION TO EMPLOYERS AT THE LOWEST POSSIBLE COST AND TO GUARANTEE TO THEIR EMPLOYEES ALL THE BENEFITS TO WHICH THEY ARE ENTITLED AS A CONDITION PRECEDENT, THIS POLICY IS NULL AND VOID UNLESS THE TOTAL INITIAL PREMIUM is PAID ON OR BEFORE THE STIPULATED DATE. READ CAREFULLY. State Compensation 3nsuronce Vital OF THE State of California (HEREIN CALLED THE FUND) In consideration of the total initial premium stated in the Schedule of this Policy, the payment of which as herein pro- vided is a condition precedent, and of the full premium to be adjusted hereafter upon the earnings of employees during the Policy Period at the rate or rates per $100 of earnings as herein provided, DOES HEREBY AGREE with the employer named in this Policy, herein called the Insured, with respect to personal injuries sustained by employees of the Insured within the Policy Period herein stated, including death resulting from such injuries, (1) TO PAY PROMPTLY AND DIRECTLY to any person entitled thereto under the Workmen's Compensation Laws of the State of California, and as therein provided, any sums due for compensation for injuries (except the increase in any award by reason of serious and wilful misconduct, insurance against which is prohibited by law), and for the reasonable cost of medical, surgical and hospital treatment, including nursing, medicines, medical and surgical supplies, crutches and apparatus, including artificial members, and to be directly and primarily liable to employees covered by this Policy, or in the event of their death, to their dependents, to pay the compensation, if any, for which the insured employer is liable; and, as between the employees and the Fund, the notice to or knowledge of the occurrence of an injury on the part of the employer shall be deemed notice or knowledge, as the case may be, on the part of the Fund; and jurisdiction of the employer shall, for the purpose of the law, be jurisdiction of the Fund; and the Fund shall in all things be bound by and subject to the orders, findings, decisions or awards rendered against the employer under the provisions of the Workmen's Compensation Laws of the State of California, (2) TO INDEMNIFY the Insured against loss by reason of liability for damages imposed upon the Insured, as an employer, under any other law of the State of California, for injuries sustained by employees covered by this Policy, including death resulting from such injuries, (3) TO SERVE the Insured (a) by the inspection of work places covered by the Policy when and as deemed desirable by the Fund and thereupon to suggest to this Insured such changes or improvements as may operate to reduce the number or severity of injuries during work, and, (b) upon notice of such injuries, by investigation thereof and by settlement of any resulting claims in accordance with the law, (4) TO DEFEND, in the name and on behalf of the Insured, claims or suits against the Insured for compensation or for damages, whether groundless or otherwise, which may be instituted against the Insured by or on behalf of employees covered by this Policy or their dependents, and to pay all costs ofsuch defense, including all costs taxed against the Insured and all interest accruing after entry of judgment, SUBJECT TO THE FOLLOWING CONDITIONS: BASIS OF PREMIUM EXECUTIVE OFFICERS PAYROLL REPORTS EARNINGS INCLUDE ALL ALLOWANCES RATE CHANGES PLANT INSPECTION PAYROLL AUDIT PREMIUM ADJUSTMENT STATUTORY REQUIREMENT OF POLICY EMPLOYEES LIEN 1 The premium is to be based upon the entire remuneration earned during the Policy Period by all officials and employees 2 except those specifically excluded from coverage under this Policy. The Insured shall keep complete and accurate records 3 of the remuneration earned by all officials and employees classified according to the kind of work performed; such records 4 to be kept for examination by the Fund. Failure to keep such records on the part of the Insured shall entitle the Fund to 5 apply, to the entire remuneration earned, the premium rate applicable to the most hazardous work performed. 6 The entire remuneration earned by each executive officer provided by the by-laws of the insured corporation and 7 covered by this Policy shall be subject to premium charge at the rate applicable to the highest rated hazard to which each 8 such executive officer is exposed. 9 At the request of the Fund, at any time, the Insured shall immediately furnish to the Fund a statement of all earnings 10 of every kind of all employees during any period during which this Policy is effective, and shall immediately pay to 11 the Fund the premium computed upon such earnings. Any earnings of employees represented by board and/or lodging 12 furnished by the employer shall be included for computation of premium for this Policy at no less than the following 13 amounts per month per person to whom such board and/or lodging is furnished: Where board only is furnished, $30.00; 14 where lodging only is, furnished, $6.00; where both board and lodging are furnished, $36.00. 15 When gratuities or tips are received in any employment or occupation from persons other than the Insured, the basis 16 for calculating the remuneration earned by such employee within the meaning of this Policy shall be the actual earnings of 17 the employee including tips. The amount of such tips shall in no event be less than $6 per week, per employee. 18 The Fund agrees to allow any reduction in the rate or rates per $100 of earnings which may be promulgated under 19 any rating plan approved by the Insurance Commissioner of California; and the Insured agrees to accept any increase 20 in such rates which may be so promulgated and approved. The effective date of any such reduction or increase shall be 21 the effective date thereof fixed by the Insurance Commissioner. It is further understood and agreed that (subject to the 22 approval of the Insurance Commissioner) the rates per $100 of earningsare subject to change, if during the term of 23 this Policy any amendments affecting the benefits provided by the Workmen's Compensation Laws become effective; such 24 change, if any, to be expressed by an endorsement naming the effective date thereof. 25 Any authorized representative of the Fund shall have the right and opportunity at all reasonable times during 26 the Policy Period to inspect the operations, work places, machinery and appliances of the Insured, and at any time to 27 examine and audit the Insured's books and records so far as they relate to remuneration earned by employees. If it shall 28 be ascertained by the Fund after the expiration or other termination of this Policy, that the total premium paid by the 29 Insured is less in amount than is properly chargeable to the Insured, under the terms of this Policy, the Insured shall immedi- 30 ately pay to the Fund at its office in San Francisco the difference between the total premium paid and the ascertained premium; 31 if the total premium paid by the Insured is in excess of the ascertained premium, the Fund shall immediately pay the amount 32 of such excess to the Insured, except that the Fund shall be entitled to retain the Minimum Premium for this Policy. 33 The initial premium shall be held by the Fund until the expiration or other termination of this Policy, when it shall be 34 applied in final adjustment of premium as herein provided. No return premium shall be payable until the actual remunera- 35 tion earned by all employees of the Insured during the Policy Period shall have been furnished to and audited by the Fund. 36 The employees covered by this Policy shall have a first lien upon any amount which shall become owing on account of 37 this Policy to the insured employer from the Fund, and in case of the legal incapacity or inability of the employer to receive 38 the said amount and pay it over to the employee or his (or her) dependents„the Fund may and shall pay the same directly to 39 the said employee or his (or her) dependents, thereby discharging to the extent of such payment the obligations of the 40 employer to the employee. NOTICE OF INJURY AND CLAIM MEDICAL TREATMENT SUBROGATION CANCELLATION POLICY NOT ASSIGNABLE CHANGE IN POLICY OTHER INSURANCE DIVIDENDS EMPLOYMENTS LEGALLY EXCLUDED AUTOMATIC EXTENSION RISKS NOT COVERED THE CONTRACT POLICY PERIOD PREMIUM PAYMENT REQUIRED 112 108 rendered null and void as herein provided, shall be from 109 to a't1y 1;y 1946 41 Written notice of any injury, with the fullest information available, and of any claim resulting therefrom, and every 42 notice and process served upon the Insured, must be forwarded immediately to the San Francisco office of the Fund by the 43 Insured. 44 The Fund shall not be liable for any settlements made or expenses incurred by the Insured, except that the Insured 45 may provide, at the expense of the Fund, reasonable medical, surgical and hospital treatment required by law for injured 46 employees covered by this Policy, subject to the right of the Fund to control, direct, change and modify such treatment; if the 47 Fund shall notify the Insured of the names and addresses of physicians, surgeons or hospitals required by the Fund to be used, 48 the Insured shall not incur expense for treatment by any others, unless the physicians, surgeons or hospitals named by the Fund 49 shall not be available, in which case such immediate medical or surgical relief as is necessary may be elsewhere provided. 50 In case of any payment for compensation or medical services under this Policy by the Fund or assumption of liability 51 therefor, the Fund shall be subrogated to all rights of the Insured against any person, firm or corporation to the amount 52 of such payment or liability. 53. This Policy may be cancelled by the Insured at any time upon surrender of the Policy to the Fund. This Policy may 54 •also be cancelled by the Fund at any time upon written notice to the Insured, stating when, not less than ten (10) days after 55 date of such notice, cancellation shall be effective. The effective date of such cancellation shall then be the end of the 56 Policy Period. If cancelled by the Insured, the Fund shall be entitled to the earned premium calculated at short rates in 57 accordance with the table printed hereon, and computed upon the entire earnings of all employees for the full original 58 Policy Period, as indicated by the actual earnings of all employees during the time the Policy shall have been in force. 59 In any event the Fund shall be entitled to retain the entire Minimum Premium. If the Insured has actually retired from 60 the work covered hereby or if the Policy is cancelled by the Fund, the Fund shall be entitled to the earned premium 61 calculated upon the earnings of all employees during the period the Policy shall have been in force, but such premium shall 62 not be less than the pro-rata portion of the Minimum Premium. If cancelled by the Fund due to the Insured's failure to 63 comply with the provisions of the Policy as to payroll reports, payroll records or premium payment, cancellation shall be on 64 the short rate basis. In any event the Fund shall be entitled to retain the entire Minimum Premium. 65 Deposit by the Fund in the United States mails of any cancellation notice addressed to the last known address of the 66 Insured as shown by the records of the Fund, and registered at any United States postal station, shall constitute actual 67 delivery of such notice to the Insured. 68 The interest of the Insured in this Policy cannot be assigned to any other person or organization. 69 No condition or provision of this Policy shall be waived or altered except by endorsement attached hereto signed 70 by the. Manager or Secretary and countersigned by a duly authorized representative of the Fund; nor shall notice to any 71 representative, nor shall knowledge possessed by any representative, or by any other person, be held to effect a waiver or 72 change in any part of this Policy. 73 The Fund shall not be liable for a larger proportion of any claim covered by this Policy than the insurance hereunder 74 bears to the 'whole amount of valid and collectible insurance carried by the Insured. 75 Upon expiration of this Policy and after adjustment of premium as herein stipulated, the Insured shall be entitled to a 76 dividend which shall represent such proportion of any divisible surplus of the Fund as may be provided in the authorized 77 dividend plan in effect and applicable to this Policy, provided, that no dividend shall accrue or become payable hereunder:- 78 If any part of the premium for this Policy shall remain unpaid after written demand therefor, or in any event 79 for a continuous period of ninety days following date of the Fund's statement therefor mailed to the address of the Insured- 80 appearing on the records of the Fund, or 81 "- If the payroll records of the Insured are not available for •audit or not in such condition that the actual premium 82 for the Policy Period can be ascertained by payroll audit, or 83 If suit is brought by the Fund for an accounting or to enforce collection of any part of the premium for this Policy, 84 and provided that 85 In no event shall that part of any dividend accrue or become payable which would operate to reduce the total 86 net premium to be retained by the Fund for this Policy to an amount less than the Minimum Premium. 87 This Policy shall not operate as an election on the part of the Insured to come under the compensation provisions 88 of the Workmen's Compensation Laws of the State of California for employees who are excluded by said laws, unless the 89 employments engaged in are specifically described in the Schedule of this Policy or covered by endorsement hereon. 90 If the Insured shall, during the period covered by this Policy, employ any person or persons to whom the Insured 91 would be liable for compensation in, case of injury, in connection with work not specifically mentioned in the Schedule, 92 this Policy shall cover such work and the Insuredshall keep an accurate record of the total earnings of all employees 93 engaged in each class of such work, premium to be computed at the rate or rates which would apply had such work been 94 mentioned in the Schedule of the Policy; except that, unless specifically stated in the Schedule or covered 95 by endorsement hereon, this Policy does not cover the following risks, persons, operations, work or 96 employments : 97 If the Insured be an individual, any liability as a member of a copartnership or any other 98 organization; 99 If the Insured be a firm, association or copartnership, any member of such firm, association Imo or copartnership; l01 If the Insured be a corporation, any work or duties performed by any person having the 102 103 title of NO or a combination of any such titles with or without other titles. 104 This Policy, including all endorsements or riders hereon, constitutes the entire contract of insur- 105 ance. No condition, provision, agreement, or understanding not set forth in the Policy or in such 106 endorsement or rider shall affect such contract or any rights, duties, or privileges arising therefrom. 107 The period, herein called the Policy Period, during which this Policy shall remain in force, unless cancelled or 4'u1y 1. 1945 , at 12.01 A.M., standard time as to each of said dates. , at 12.01 A.M., 1lo As a condition precedent, this Policy is null and void unless the total initial premium stated 111 herein is paid tothe,State Compensation Insurance Fund at its office in San Francisco on or before uly, 21. 1945 , at noon, standard time. Policy No. • - S 1O440-45 Name of Employer Address City or Town CITY 9F NATIONAL CITY NATIONAL CITY County of SCHEDULE SAN b1 00 State of California EXTENSION OF SCHEDULE FORM 504 3M-12-44 Classifica- tion No. DESCRIPTION OF PRINCIPAL WORK Estimated Rate or Rates Earnings of per $100 of Employees Earnings Initial Premium 8810 7380 8601 7706 7707 9403 '7590 9060 9043 8838 413d-243- Employees engaged exclusively in clerical office work. (Basic Rate $0.07) Chauffeurs and their helpers —commercial (not otherwise classified) —(No Payroll Division with 7219 Truckmen). (Basic rate $1.08) Engineers -Consulting, Mechanical, Civil, Electrical or Mining Engineers or Architects- 2'Zot engaged in actual construction or operation -- No Payroll Division. (Basic rate $0.70) Firemen (not volunteers), Including Drivers, Chaffeurs end all other employees of Fire Department. (Basic rate $4.01) TO REPO t' Q.WI TERL u0,uo D P©SI Firemen —Volunteers, serving with or with.ollt remuneration. Fate as 7706 "Firemen," but subject to a per capita charge of not less than $9.00 per annum Garbage, Ashes or Refuse Collecting —Including Drivers, Chauffeurs and their Helpers — (Reduction, rendering, disposal or fertilizer plants to be separately rated). (Basic rate $3.50) Garbage Works —reduction or incineration —(Drivers, Chauffeurs and their Helpers to be separately rated as 9403 "Garbage Collecting). (Basic rate $4.04) Golf Courses —Public —Ail employees, including clerical office employees. `(Basic Rate $0.92). The actual remuneration of caddies shall be included with the payroll of the regular employees in computing premium for this risk. Unless a complete and accurate record of all such remuneration is maintained, the payroll for caddies shall be taken at not less than $20,000 per season per course of eighteen holes • Hospitals — All employees — Including clerical office — (Drivers, Chauffeurs and their Helpers to be separately rated). (Basic rate $0.92) In determining the premium charge for student nurses, cadet nurses or internes, such . premiums shall be computed, on the basis of an average wage'of at least $15 pGrweek plus` board and lodging. -Librarians, Curators or Professional Assistants — Including Clerical Office Employees. (Basic rate $0.07) not performed under air pressure; Drivers, Chauffeurs and their Helpers. N.P.D. with. 7520 "Waterworks -Operation' (All other tunneling to be separately rated). (Basic rate $3.38) 0017 Weed or Pest Control -Not otherwise classified. (Basic rate $1.36) 8810 MAYOR AND 4 COUNCILMEN included at actual earnings y but subject to a per capita charge of no less than $2e00 per ann , Countersigned at San Francisco May 29 1945 Authorized Representative Manager FORM 004 SPA-12.44 Classifica- tion No. 8810 Employees engaged exclusively in clerical office work. (Basic Rate $0.07) roll Division Chauffeurs and their helpers —commercial (not otherwise classified) —(No Payroll ay 7380 with 7219 Truckmen). (Basic rate $1.08) 8601 Engineers —Consulting, Mechanical, Civil,rElectrical o, Mining Engineroll erss r Architects — Not engaged ... actual con...... --.tors ..-.-- 7706-- an• -1 e- Firemen (not volunteers), Including Drivers, Chaffewr< and all other employees of Fire Department. (Basic rate $4.01).---- 7707 Firemer,—Volunteers, seving with or subject to a per capitar rcharge of nottless thane $9.00rper annum_ as 7706 `Firemen," but Garbage, Ashes or Refuse Collecting —Including Drivers, Chauffeurs and their Helpers- 9403t - - -- --- --- -- -- (F.eduction, rendering, disposal or fertilizer plants to be separately rated). (Basic rate $3.50)----------------' r,r very Chauffeurs and their Helpers to be 7590 Garbage Works —reduction or incineration —(Drivers, separately rated as 9403 "Garbage Collecting). (Blsiccrlrate ef$4e04mplcyees. .................................. Basic Rate 9060 Golf Courses — Public —All employees, including (Basic ll ofthe Computing premium for this risk. Unless a complete and accurate $0.92). The actual remuneration of caddies shall be included with the pay rregular ecord of all such remuneration imaintaied, the payroll for caddies shall be taken at not less than $20,000 per season per course of eighteen holvers, Chauffeurs and their 9043 Hospitals — All employees — Including clerical office — Helpers to be separately rated). (Basic rate $0.92)...... ....... ......... In premiums shallg beecopremium chrge f or mput d, ona athe basis of antave?aae vage,of caduateleast $1s or t5r_per week plus board and lodging. g Employees. - --------------------- -- 8838 Librarians, Curators or Professional Assistants — h.cludin Clerical Office (Basic rate $0.07)......... -` 9410 Municipal Employees Not Otherwise Classified —(Not laborers, workmen or mechanics) not engaged in manual labor.norin clerical office duties. (This classification includes employees engaged in laboratory work. inspectors of the Board of Health, electrical in, spectors, building inspectors, meter readers, and similar occupations). (Basic rate $059).... r ¢tOZ Parks —Not Otherwise Classified —Ail employees --Including Drivers, Chauffeurs and their eir Helpers — (Care, operation and maintenance of amusement devices to be separately rated). (Basic rate $1.65)............................. - 7720 fish wardens or jailers. Policemen, sheriffs, constables, marshals, pound keepers, game or (Basic rate$2.33)................................................... --.pound keepers, game or fish tables, marshals, 7722 Policedeputies Rate 7720e7 Policemen," but ubject o a per capita charge of not wardens or jailers. less than $9.00 per annum Buildings —Not erceio of 9015 • Publicpremises, operationthe of elevators atorheating, clighting ore power c,pparatvs,—(Optrat n or maintenance of amusement devices to be separately rated). (Basic rate $1.14) 7580 Sewage Disposal Plant Operation — Including Drivers, Chauffeurs and their Helpers (Basic rate$1.50)...................................... ............................... ----------- 9407 Sewer Cleaning —Including Drivers, Chauffeurs and their Helpers. (Basic rate $2.24). ing street s when not per, 6306 Sef ormednundertair prreessurerDrivers, ICh Chauffeurs and ncluding ltheir tHelpers. (All gother tunneling - to be separately rated). (Basic rate $5.87-------.------------•--' '-.............................................. . - --' "" - ---------------------------------- 9402 Street Cleaning —Including Drivers, Chauffeurs and their Helpers. (Basic rate $2.24).. STREET OR ROAD CONSTRUCTION: airport fenceanor guard-railsinc ud construction, Drivers, Paving or Repaving, surfacing or resurfacing, or scraping —all kinds —including 5506 runways, warming their Hel, incidental field Alai hto wa earth or rock excavation, filling orChauffeursgrading, and Hridge culvert itf g f' y. or tunneling, bridge or culvert building, quarrying, stone crushing, sandor gravel digging to be separately rated.) (Basic rate $2.48)" including clearing and grubbing 5507 Grading —All operations of bringing g: Drivero s, Chauffeurs and their Helpers —(Bridge rightlof•way and temporary surfacing: eet at anypoint or the entire distance orculvertbetween building abutments tsexceeds clearance is more than10 f tunneling, sewer construction, q g. stone crushing and sand ntd gravel 20 feet;(Basic rate $7.09).-.- stone and sand and gravel digging to be separately rated). Waterworks —Operation —All Employees —Including Drivers, Chauffeurs and their Helpers - -- ------ -- rate .-.- . I 7520 --(Construction of Aqueducts, Buildings, Dams or Reservoirs to be separately z (Basic rate $1.96)...----- - --•-•- -•----- - --- ing street c 6319 Water Mains or Connections not performed under air pr s ure; Drivers onstruction—inc eu suandl heirrtHelpers. N. P. Dw .with 7520 "Waterworks -Operation" (All other tunneling to•be separately rated). (Basic rate $3.38) •`----- ...... . 0017 Weed or Pest Control —Not otherwise classified. (Basic rate $1.36 8810 MAYOR AND 4 00101ICIDar included at actual earnings, but subject to a per capita. charge of no less than Sa.00 per anarcun. Estimated Earnings of Employees Rate or Rates per $100 of Earnings Initial Premium nit Irn PREMIUM ADJUSTMENT STATUTORY REQUIREMENT OF POLICY EMPLOYEES LIEN DESCRIPTION OF PRINCIPAL WORK ne4 heI ��� .-scw-mr etareetvt[ie iota premium pal andhe tascertained premium; 31 if oft total esstto the aid by the Inured, exceptnsuredis in that thecess of the Fund shallbeascertained entitled rto etainthe theFund Min mum Premium fopay the amount 3this Policy. 33tion or The appliedtinlfinal adjustment of premiumthe Fund until the as herein provided. XNoareturn premium shall be payable unther termination of this il the actual a u, when it ne a- d during the Policy sur 35 tion earned by all oyees of the The employeespcovered by th snPolicyshall have a firstlienuponshallod furnished upon any amount which shall become owing on account of 36 37 this Policy to the insured employer from the Fund, and in case of the legal Incapacity or inability of the employer to receito ve 38 the said amount and er) 39 the said employee' orhis t(or eher) r to hdependents, e employee othereby dr his (or il.charrgngto the extent of suents„the Fund chanpaymend shall pay hehoblgations of e same the 40 employer to the employee. Chauffeurs and their helpers —commercial (Not otherwise 7380 dssified)—(No Payroll Division with 7219 Trackman) 8742 Salesmen (outside). messengers and collectors (not trans- porting or delivering merchandise) 8810 Employees engaged exclusively in clerical office work Casual employees —persons whose employment f is both casual and not in the course off the tradde, b` lies, o of work performed) e cludi gar casual Insured-(proper employees engaged in work in connection witht a private by nature WO AA sidence of the Insured - .i1.VV r1✓0 MINIMUM 113 The Minimum Premium for this Policy is $ 15 00 TOTAL INITIAL PREMIUM, IN WITNESS WHEREOF, THE STATE COMPENSATION INSURANCE FUND has caused this Policy to be signed by its Manager or PREMIUM Secretary, but the same shall not be binding upon the Fund unless countersigned by a duly authorized officer rrepresentative of the Fund. May 29t, 1945 Countersigned at San Francisco Authorized Representative SUBJECT TO THE FOLLOWING CONDITIONS: BASIS OF PREMIUM EXECUTIVE OFFICERS PAYROLL REPORTS EARNINGS INCLUDE ALL ALLOWANCES RATE CHANGES PLANT INSPECTION PAYROLL AUDIT PREMIUM ADJUSTMENT STATUTORY REQUIREMENT OF POLICY EMPLOYEES LIEN If any SME Manager -===ovrc�arla err lillerest 1 The premium is to be based upon the entire remuneration earned during the Policy Period by all officials and employees 2 except those specifically excluded from coverage under this Policy. The Insured shall keep complete and accurate records 3 of the remuneration earned by all officials and employees classified according to the kind of work performed; such records 4 to be kept for examination by the Fund. Failure to keep such records on the part of the Insured shall entitle the Fund to 5 apply, to the entire remuneration earned, the premium rate applicable to the most hazardous work performed. 6 The entire remuneration earned by each executive officer provided by the by-laws of the insured corporation and 7 covered by this Policy shall be subject to premium charge at the rate applicable to the highest rated hazard to which each 8 such executive officer is exposed. 9 At the request of the Fund, at any time, the Insured shall immediately furnish to the Fund a statement of all earnings 10 of every kind of all employees during any period during which this Policy is effective, and shall immediately pay to 11 the Fund the premium computed upon such earnings. Any earnings of employees represented by board and/or lodging 12 furnished by the employer shall be included for computation of premium for this Policy at no less than the following 13 amounts per month per person to whom such board and/or lodging is furnished: Where board only is furnished, $30.00; 14 where lodging only is furnished, $6.00; where both board and lodging are furnished, $36.00. 15 When gratuities or tips are received in any employment or occupation from persons other than the Insured, the basis 16 for calculating the remuneration earned by such employee within the meaning of this Policy shall be the actual earnings of 17 the employee including tips. The amount of such tips shall in no event be less than $6 per week, per employee. 18 The Fund agrees to allow any reduction in the rate or rates per $100 of earnings which may be promulgated under 19 any rating plan approved by the Insurance Commissioner of California; and the Insured agrees to accept any increase 20 in such rates which may be so promulgated and approved. The effective date of any such reduction or increase shall be 21 the effective date thereof fixed by the Insurance Commissioner. It is further understood and agreed that (subject to the 22 approval of the Insurance Commissioner) the rates per $100 of earningsare subject to change, if during the term of 23 this Policy any amendments affecting the benefits provided by the Workmen's Compensation Laws become effective; such 24 change, if any, to be expressed by an endorsement naming the effective date thereof. 25 Any authorized representative of the Fund shall have the right and opportunity at all reasonable times during 26 the Policy Period to inspect the operations, work places, machinery and appliances of the Insured, and at any time to 27 examine and audit the Insured's books and records so far as they relate to remuneration earned by employees. If it shall 28 be ascertained by the Fund after the expiration or other termination of this Policy, that the total premium paid by the 29 Insured is less in amount than is properly chargeable to the Insured, under the terms of this Policy, the Insured shall immedi- 30 ately pay to the Fund at its office in San Francisco the difference between the total premium paid and the ascertained premium; 31 if the total premium paid by the Insured is in excess of the ascertained premium, the Fund shall immediately pay the amount 32 of such excess to the Insured, except that the Fund shall be entitled to retain the Minimum Premium for this Policy. 33 The initial premium shall be held by the Fund until the expiration or other termination of this Policy, when it shall be 34 applied in final adjustment of premium as herein provided. No return premium shall be payable until the actual remunera- 35 tion earned by all employees of the Insured during the Policy Period shall have been furnished to and audited by the Fund. 36 The employees covered by this Policy shall have a first lien upon any amount which shall become owing on account of 37 this Policy to the insured employer from the Fund, and in case of the legal incapacity or inability of the employer to receive 38 the said amount and pay it over to the employee or his (or her) dependents„the Fund may and shall pay the same directly to 39 the said employee or his (or her) dependents, thereby discharging to the extent of such payment the obligations of the 40 employer to the employee. q THE STATE COMPENSATION INSURANCE FUND was created by the people of the State of California for the purpose of insuring employers against loss by reason of the liability imposed by law on account of injuries to employees. q A Policy in the State Compensation Insurance Fund guarantees complete pro- tection and at a minimum cost. It is expressly provided by law that the Fund should become neither more nor less than self-supporting and it is thus constituted as a cooperative association of employers for insurance at cost. Its policyholders are exempt from assessment liability. 41 Competitors are known to make false and misleading statements designed to influence patronage, but remember that since starting business in 1914 the Fund has furnished complete protection and has actually re- turned to policyholders over $45,000,000 IN DIVIDENDS. IMPORTANT Payment of premium on or before stipulated date is a condition precedent which must be complied with to validate this Policy. ,tate Tompen ation clinsurauce Fuu i OF THE *ale of California EXECUTIVE OFFICES: 450 MCALLISTER STREET SAN FRANCISCO OR E and become thoroughly familiar with its Provisions. A few moments' attention right now may save misunderstanding in the future. SHORT RATE CANCELLATION TABLE PER CENT PERIOD IN OF ANNUAL FORCE PREMIUM 1 day ............ ...... 2%n 2 days........................................--......-----..- 3 days.. .......................................................... . 5% 4 days. 5 days.............._...............................................------7 % a 8 6 days ................................................ 8% 7 days ..... _ 8 days ........ :9% 9 days10% 10 days 10% 11 days 11% 12 days ............................ ...............--r---------...................-11% 12% 13 days. ............................................. ............................... - 12% 14 days 15 days 13% 16 days 14% 17 days 15% 18 days .... 16% 19 days .... 16% 20 days 17% 25 days 19% 30 days-1 month 20% 35 days 23% 40 days 25% 45 days 27% 50 days 28% 55 days 29% 60 days-2 months 30% 65 days 33% 70 days 36% 75 days 37% 80 days 38% 85 days 39% 90 days-3 months 40% 105 days 46% 120 days-4 months 50% 135 days 56% 150 days-5 months 60% 165 days 66% 180 days-6 months 70% 195 days 73% 210 days-7 months 75% 225 days 78% 240 days-8 months 80% 255 days - 83% 270 days-9 months _ 85% 285 days 88% 300 days-10 months - 90% 315 days 93% 330 day,-11 months 95% 345 days 98% 360 days—I2 months 100% POLICY FORM NO. X-18 24920 6-49 6014