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upr000218-236
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I agree.Pacific Employers Insurance Company Auditor’s Summary Form Assured______MC NEIL CONSTRUCTION COMPANY_____________ Address 5860 Avalon Blvd.,Los Angeles, Calif. Broker______ EMETT & CHANDLER__________________________ Agency METRO. Audit N o. PAYROLL STATEMENT Policy N o.___ 0-93291 From ----------3-1-4-6-- T o_.____ 12-1-4-6 I f cancelled, date C O D E N O . T R A D E , B U S IN E S S . P R O F E S S IO N O R O C C U P A T IO N ( M A N U A L CLASSIFICATION) JOB #9 CONSTRUCTION OF RESERVOIR, LAS T O T A L R E M U N E R A TIO N P A ID O R A L L O W E D E M P LO Y E E S ______ R A T E E A R N E D PR EM IU M VE ?AS, NEVADA, COVERING CALIFORNIA EMPLOYEES. 5403 Carpentry 1,460 88 35 63 55 MC NEIL HOUSING CO. JOB NO. H-723 MC NEIL CONST. CO. JOB NO. C- 8 5 F O R M •aoa U N L I N E D