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League of Minnesota Cities Insurance Trust <br /> Group Self-Insured Workers' Compensation Plan <br /> Workers' Compensation and Employers' Liability Agreement <br /> Administrator <br /> Berkley"Administrators <br /> a member of the Berkley Risk Management Services Group <br /> P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 <br /> The 'City' Agreement No. _r2- !!-;(-14 <br /> ST PONTHONY AGREEMENT PERIOD FF:0;•1: u6/01/19c 3 <br /> TO: C16! ?1/17'94 <br /> 3'r I SILVER LAk:E ;:0+°,D <br /> M,I NNEAPOL I S t•iN 1541''•-tj(?(`,;) <br /> C�NT I NL iAT I ON SCHEDULE FOR QUOTATION PAGE <br /> REMUNERATION RATE CODE DESCR I PT I ON EST. PREM. <br /> 21040-9. -1 .47 JJ:fib STREET CONSTRUCT I Ot•J & MAINTENANCE 15719. <br /> 92803. 4.; 'S,^^_(: bJATER$JOF;k::S 44E, . <br /> 284074. 8.G3 ;' 'iii• F I FIEF i GHTERS ft-.40T VOLUNTEEF;) i-A.04. <br /> 4342 ;:3. 6.54 7;2i:i POL i E E 316S'7. <br /> 30;56 i1 . 2.81 201 17 OFF SALE LlQUOR STORE 9567. <br /> CGO�-}!1, 1. i� �t=� CITY SHOI & YARD 1650. <br /> iJJ4 8 t. :>.54 <br /> 163iC CLERICAL <br /> 10.72 4()15 BUILDIt G MAINTENAt10E « REPAIR 629. <br /> 216315. 4.61 9i;;4 ON SALE LIQUOR STORE 9-' --. <br /> 40685. 4.1- 1 f.)2 PARKS 1697. <br /> 34814. 2 331 941f) MUNICIPAL EMPLU EES >4. <br /> 19200. 2.31 01411 ELECTED OR 1PPOINTED OFFICIALS 420. <br /> '25480. 2.31 9411 BOARDS AND COMMISSIONS,* 589. <br /> 11536. 4.36 17016 SKATING RINK OPERATION 563. <br /> Manual Premium 1G314 0. <br /> F-411518;14 <br /> BER!•':.L.EY INS SERVICES <br /> 920 '2ND AVE SO 41700 <br /> t1I NIJE.AF'OL I'S. MN 55j402--4023 <br /> r, <br /> C%4/2' /i f 9'3 <br /> BA 468 (3/92) Date: <br />