Laserfiche WebLink
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY <br /> Insured Name: KEEFE MCCULLOUGH & CO LLP <br /> Policy Number: 001-WC10A-39871 <br /> Agency Name: 320, Plastridge/Delray Beach <br /> PREMIUM CALCULATION <br /> Extension of Information Page WC 00 00 01 A Item 4: FLORIDA <br /> Estimated <br /> Classification Code Remuneration Rate Premium <br /> AUDIT, ACCT, COMP SYS PRG-TRVL 8803 2,310,761 $.18 $4,159 <br /> CLERICAL NO DUTIES OUT OF OFC 8810 $4 $.26 $0 <br /> Manual Premium $4,159 <br /> Premium Subject to Experience Modification $4,159 <br /> Experience Modification Factor 0.95 <br /> Standard Premium $3,951 <br /> Plus: Expense Constant $200 <br /> Plus: Terrorism $462 <br /> Estimated Annual Premium $4,613 <br /> • <br /> • WC000001A <br /> Copyright 1987 National Council on Compensation Insurance <br /> EZO1O2, 2/96 Page 2 <br />