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r <br /> CHUBS® <br /> ISSUING COMPANY EXTENSION OF INFORMATION <br /> ACE AMERICAN INSURANCE COMPANY <br /> NCCI CARRIER CODE PAG E-C LASS I FICATI O N <br /> 12165 <br /> POLICY NUMBER New Fx] Renewal ❑ Rewrite <br /> Symbol: WLR Number: C6 60 38 62 2 <br /> PREVIOUS POLICY NO. ❑ Individual El Partnership <br /> Symbol: WLR Number: C65224987 �X Corporation <br /> CALIFORNIA <br /> Complete Item 4.of the Information Page <br /> Premium Basis Rate <br /> Classifications Code Estimated Total Per$100 of Estimated <br /> No. Premium <br /> Remuneration Remuneration <br /> AEGION CORP <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> BRINDERSON <br /> OIL OR GAS REFINING, DISTILLING OR COMMPRESSING *3719 1.64 <br /> UNITS-ERECTION OR REPAIR-ALL OPERATIONS <br /> MILLWRIGHT WORK NOC 3724 4.01 <br /> PLUMBING-LOW WAGE 5183 5.63 <br /> PLUMBING-HIGH WAGE 5187 3.38 <br /> CONCRETE CONSTRUCTION NOC-INCL. FOUNDATIONS 5213 5.89 <br /> CONTRACTOR-EXECUTIVE SUPERVISOR 5606 .72 <br /> ENGINEERS- INCLUDING OUTSIDE SALESPERSONS AND 8601 .29 <br /> CLERICAL OFFICE EMPLOYEES <br /> SALESPERSONS-OUTSIDE 8742 .36 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> CORRPRO <br /> ELECTRICAL WIRING-LOW WAGE 5190 4.53 <br /> CONTRACTOR-EXECUTIVE SUPERVISOR 5606 .72 <br /> DRILLING-NOT GEOTHERMAL,OIL OR GAS, MINING, 6204 9.65 <br /> QUARRYING <br /> SALESPERSONS-OUTSIDE 8742 .36 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> FYFE <br /> ANALYTICAL OR TESTING LABORATORIES 4511 .59 <br /> PAINTING-HIGH WAGE 5482 4.35 <br /> CLERICAL OFFICE EMPLOYEES NOC 8810 .28 <br /> ITI <br /> Minimum, Estimated and Deposit Premiums are shown on the Information Page. Total State Premium <br /> THIS EXTENSION OF INFORMATION PAGE IS EFFECTIVE FOR THE POLICY PERIOD INDICATED ON THE POLICY <br /> INFORMATION PAGE UNLESS OTHERWISE STATED. <br /> ISSUE DATE: 06/26/2019 (PAGE 1 CONTINUED) <br /> WC 99 04 18(12/05) Copyright 1987 National Council on Compensation Insurance <br /> INSURED COPY <br />