CRASIF - Premium Statement
July 1,
2023 to June 30, 2024
MEMBER Date Billed: 11/10/2023
Third Quarter Premium Statement No: CRA0000000
Loc# |
Code |
Classification |
Payroll Estimate |
Rate per $100 of Payroll |
Manual Premium |
Experience Modification Factor |
Standard
Premium |
5506 |
Heavy Maintenance |
$ - |
14.43 |
$ - $ - |
|||
5509 |
Street Maintenance |
$ - |
3.46 |
$ - $ - |
|||
8227 |
Contractors Yard |
$ - |
2.02 |
$ - $ - |
|||
8810 |
Clerical |
$ - |
0.60 |
$ - $ - |
|||
9410 |
Municipal Employees |
$ - |
0.76 |
$ - $ - |
TOTAL $ - $ - $ -
2023 Dividend Premium Discount
Net Annual Discounted Premium $ -
Less: Payments to Date $ -
Balance Owed through June 30, 2024 $ -
NOTE:
1.
The 3rd quarterly
deposit is due by December
10, 2023 for January 1, 2024 to March 31, 2024.
2.
Please forward only your check to the lockbox.
Do not send a check stub or copy of invoice with the
payment.
3. Please
make check payable and return to: