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W <br />THE'd <br />HARTFORD <br />POLICY HOLDER NOTICE - PAYROLL BILLING <br />Thank you for choosing The Hartford. Your policy is on our payroll billing method. The payroll billing method uses actual <br />payrolls received throughout the policy period and a blended rate(s) to determine premiums due during the policy period. <br />To learn more about how your premium is calculated on the payroll billing method please visit: <br />https://www.thehartford.com/blended <br />Below are the blended rate(s) being used for each state and classification code on your policy: <br />State <br />Class Code <br />Blended Rate <br />Effective <br />1: 2022 BROADWAY ST, <br />9079 <br />1.290000 <br />06/07/2024 <br />REDWOOD CITY, CA <br />1: 2022 BROADWAY ST, <br />9079 <br />1.300000 <br />07/11/2024 <br />REDWOOD CITY, CA <br />1: 2022 BROADWAY ST, <br />9079 <br />1.330000 <br />07/18/2024 <br />REDWOOD CITY, CA <br />Form G-4119-0 Printed in U.S.A. <br />© 2017, The Hartford <br />ATTY/AGR.2024.136Nesta (2022 Broadway) (Page 28 of 31) <br />