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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> EXPERIENCE RATING MODIFICATION FACTOR ENDORSEMENT <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 /> The premium for the policy will be adjusted by an experience rating modification factor. The Factor was not available when <br /> the policy was issued. The factor, if any, shown on the Information Page is an estimate. We will issue an endorsement to <br /> show the proper factor, if different from the factor shown, when it is calculated. <br /> Countersigned by <br /> Authorized Representative <br /> Form WC 00 04 03 Printed in U.S.A. <br /> Process Date: 11/04/25 Policy Expiration Date: 11/04/26 <br />