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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> PART FIVE - PREMIUM AMENDATORY 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 /> This endorsement amends Part Five-Premium of the policy as follows: <br /> Part Five- Premium, Section A. (Our Manuals) is replaced by the following provision: <br /> A. Our Manuals <br /> All premium for this policy will be determined by our manuals of rules, rates and loss costs (as applicable), rating <br /> plans, forms, endorsements, and classifications, and such manuals are expressly incorporated by reference into, and <br /> apply to, this policy and any renewals (our manuals). As used in this policy and any renewals, our manuals means <br /> manuals that have been: <br /> 1. Developed in any format and filed by the state-designated workers compensation rating or advisory organization <br /> on our behalf with the appropriate state insurance regulatory authority; or <br /> 2. Developed in any format and filed by the respective state rating bureau on our behalf with the appropriate state <br /> insurance regulatory authority, or <br /> 3. Developed in any format and filed by us with the appropriate state insurance regulatory authority; and <br /> 4. For each or any of the three scenarios above, the manuals also must be approved for use by the appropriate <br /> state insurance regulatory authority, or as otherwise authorized by law as applicable. <br /> We may change our manuals and apply the changes to this policy and any renewals if such manual changes are <br /> approved for use by the appropriate state insurance regulatory authority, or an otherwise authorized by law as <br /> applicable. <br /> Part Five- Premium, Section D. (Premium Payments) is replaced by the following provision: <br /> D. Premium Payments <br /> You will pay all premium when due. You will pay the premium even if part or all of a workers compensation law is not <br /> valid. The due date for audit and retrospective premiums is the due date specified in the billing for the policy. <br /> Form WC 00 04 19 A Printed in U.S.A. <br /> Process Date: 1 1/0412 02 5 Policy Expiration Date: 11/04/2026 <br />