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[C:\TEMP\~LF10001.BMP] <br /> <br />AGREEMENT <br /> <br /> This Agreement is entered into by and between EBI SERVICES, <br />INC., hereinafter called "Service Company", and <br /> <br />hereinafter called "Employer", this day of <br /> , 198 <br /> <br /> WITNESSETH <br /> <br /> WHEREAS, Service Company is in the business of providing <br />claims administrative assistance to California self-insured <br />employers subject to the California Workers' Compensation Laws; <br />and <br /> <br /> WHEREAS, Employer holds a Certificate of Consent~to Self- <br />insure issued by the California Director of Industrial Relations <br />and said Employer is subject to the California Workers' Compen- <br />sation Laws; <br /> <br /> WHEREAS, Employer desires to purchase Claims Administrative <br />Services from Service Company as hereinafter set forth below; <br /> <br /> NOW, THEREFORE, in consideration of the policies, covenants <br />and obligations of the parties hereinafter set forth, it is <br />agreed as follows: <br /> <br /> Service Company using individuals who in the opinion of <br /> <br />the Service Company are competent, capable and experienced agrees, <br />during the period of time this Agreement is in effect between <br />the parties: <br /> <br /> 1. To review on behalf of Employer all reports of injury <br /> as defined by California Labor Code Sections 3208 <br /> and 3208.1 that are reported by Employer to Service <br /> Company. <br /> <br />- 1 - <br /> <br />EBI SERVICES, INC. <br /> <br /> <br />