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tuy <br /> EXTENSION OF THE INFORMATION PAGE - ITEM 3.D - ENDORSEMENTS <br /> Policy Number: 76 WEG BX3ZPJ Endorsement Number: <br /> Effective Date: 11/04/25 Effective hour is the same as stated on the Information Page of the policy. <br /> Named Insured and Address: Beginners Edge Sports Training <br /> 7432 E TIERRA BUENA LN <br /> SCOTTSDALE AZ 85260 <br /> Item 3.D. of the Information Page is completed to include the following endorsements: <br /> WC040306 WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT- <br /> CALIFORNIA <br /> WC0403606 EMPLOYERS LIABILITY COVERAGE AMENDATORY ENDORSEMENT-CALIFORNIA <br /> WC040421 OPTIONAL PREMIUM INCREASE ENDORSEMENT-CALIFORNIA <br /> WC040601 B CALIFORNIA CANCELATION ENDORSEMENT <br /> WC420301L TEXAS AMENDATORY ENDORSEMENT <br /> WC550011D Employees Claim for Workers compensation Benefits <br /> WC550022A NOTICE TO WORKERS' COMPENSATION POLICYHOLDERS IN TEXAS LETTER <br /> WC880400J Notice to Employees- Injuries Caused By Work(TITLE IN SPANISH) <br /> WC880401 J Notice to Employees- Injuries Caused By Work <br /> VVC990001 K Signature/Copyright <br /> WC990002 WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY BUSINESS INSURANCE <br /> POLICY <br /> WC990005 SCHEDULE OF OPERATIONS <br /> WC990302B WORKERS COMPENSATION BROAD FORM ENDORSEMENT <br /> WC990358B AMENDMENT TO WORKERS COMPENSATION BROAD FORM ENDORSEMENT- <br /> EMPLOYERS LIABILITY STOP GAP COVERAGE <br /> WC990366 EXTENSION OF THE INFORMATION PAGE - ITEM 1 - OTHER WORKPLACES <br /> WC990367 EXTENSION OF THE INFORMATION PAGE- ITEM 3.A-STATES COVERED <br /> WC990363 EXTENSION OF THE INFORMATION PAGE- ITEM 3.D. - ENDORSEMENTS <br /> Form WC 99 03 68 Printed in U.S.A. <br /> Process Date: 11/04/25 Policy Expiration Date: 11/04/26 <br />