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UIJT!FOEPSTFNFOU!DIBOHFT!UIF!QPMJDZ/QMFBTF!SFBE!JU!DBSFGVMMZ/ <br />QBSU!GJWF!.!QSFNJVN!BNFOEBUPSZ!FOEPSTFNFOU <br />Qpmjdz!Ovncfs;6WEGB3PFoepstfnfou!Ovncfs; <br />Fggfdujwf!Ebuf;11/04/2Effectie or is te same as stated on te Information Page of te policy. <br />Obnfe!Jotvsfe!boe!Beesftt;Beginners Edge Sports Training <br />432 E TIERRA BEA L <br />SCOTTSDALEA8260 <br />Tis endorsement amends Part Fie - Premim of te policy as follows <br />Part Fie - Premim, Section A. Or Manals is replaced y te following proision <br />B/Pvs!Nbovbmt <br />Allpremimfortispolicywilledeterminedyormanalsofrles,ratesandlosscostsasapplicale,rating <br />plans,forms,endorsements,andclassifications,andscmanalsareepresslyincorporatedyreferenceinto,and <br />applyto,tispolicyandanyrenewalsormanals.Assedintispolicyandanyrenewals,ormanalsmeans <br />manals tat ae een <br />1.Deelopedinanyformatandfiledytestate-designatedworerscompensationratingoradisoryorganiation <br />on or ealf wit te appropriate state insrance reglatory atority or <br />2.Deelopedinanyformatandfiledyterespectiestateratingreaonorealfwitteappropriatestate <br />insrance reglatory atority or <br />3.Deeloped in any format and filed y s wit te appropriate state insrance reglatory atority and <br />4.Foreacoranyoftetreescenariosaoe,temanalsalsomsteapproedforseyteappropriate <br />state insrance reglatory atority, or as oterwise atoried y law as applicale. <br />Wemaycangeormanalsandapplytecangestotispolicyandanyrenewalsifscmanalcangesare <br />approedforseyteappropriatestateinsrancereglatoryatority,oranoterwiseatoriedylawas <br />applicale. <br />Part Fie - Premim, Section D. Premim Payments is replaced y te following proision <br />E/Qsfnjvn!Qbznfout <br />Yowillpayallpremimwende.Yowillpaytepremimeenifpartorallofaworerscompensationlawisnot <br />alid. Te de date for adit and retrospectie premims is te de date specified in te illing for te policy. <br />Gpsn!XD!11!15!2:!B Printed in .S.A. <br />Qspdftt!Ebuf;11/04/202Qpmjdz!Fyqjsbujpo!Ebuf;11/04/2026 <br /> <br />