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CC PACKET 05231989
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CC PACKET 05231989
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Last modified
12/30/2015 4:36:50 PM
Creation date
12/30/2015 4:36:27 PM
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SP Box #
18
SP Folder Name
CC PACKETS 1987-1989
SP Name
CC PACKET 05231989
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f <br /> League of Minnesota Cities Insurance Trust ' <br /> Group Self-insured Workers'Compensation Plan <br /> ADMINISTRATOR <br /> EMPLOYEE BENEFIT ADMINISTRATION CO. <br /> 8441 Wayzata Blvd. Suite 200 P.O. Box 59143 Minneapolis, Minnesota 55459-0143 Phone(612)544-0311 • <br /> Self-Insured Workers' Compensation Quotation <br /> (RENE4IAL of A4reement No. 02--000468-3) <br /> Name of City: CITY OF ST ANTHONY <br /> Policy Period: From: 0 To �.,6/01/199-. <br /> /01/1989 <br /> Estimated Annual Premium: <br /> ESTIMATED DEPOSIT <br /> CODE RATE PAYROLL PREMIUM <br /> STREET CONSTRUCTION & MAINTENANCE 5506 8. 10 145000. 11745. <br /> WATERWORK'S 7520 3.23 80000. 2584. <br /> FIREFIGHTERS (NOT VOLUNTEER) 7706 9.41 210000. 19761. <br /> POLICE ;7,2-0 4.54 420 )00. 19068. <br /> OFF SALE LIQUOR STORE 5017 2.46 20"0000. 5412. <br /> CITY SHOP & YARD 8227 3.88 25000. 070. <br /> CLERICAL 8810 0.39 220000. <br /> BUILDING MAINTENANCE & REPAIR 9015 9.95 5000. 499. <br /> ON SALE LIQUOR STORE 91)79 3.70 18500 6845. <br /> PARKS 9102 5.02 35000. 1757. <br /> STREET CLEAN/SEWER CLEAN.'SNOW REMOVAL 9402 6.08 36000. 2169. <br /> 1UNICIPAL EMPLOYEES 5410 2.91 3000. 873. <br /> SKATING RINK, OPERATION 9016 3.15 10000. 315. <br /> Manual Premium 72875. <br /> Experience Modification 0.95 <br /> Standard Premium 69231. <br /> Premium Discount 6102. <br /> Discounted Standard Premium 63129. <br /> LMC Insurance Trust Discount 0" 0. <br /> Net Deposit Premium 63129. <br /> The foregoing quotation is for a deposit premium based on your <br /> estimate of payroll . Your final actual premium will be computed after <br /> an audit of payroll subsequent to the close of your policy year and <br /> will be subject to revisions in rate or experience modification. <br /> While you are a member of the LMCIT Workers' Compensation Plan, you <br /> will be eligible to participate in distributions from the Trust based <br /> upon cls'ims experience and earnings of the Trust. • <br /> Employee Benefit Administration Co. <br /> EBA 44.1 CG 111/871 , <br />
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