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it <br /> THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br /> OPTIONAL PREMIUM INCREASE ENDORSEMENT - CALIFORNIA <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 /> You must provide us, or our authorized representative, We will notify you of your failure to provide access by <br /> access to records necessary to perform a payroll mailing a certified, return-receipt document stating the <br /> verification audit. If you fail to provide access within 90 increased premium and the total amount of our costs <br /> days after expiration of the policy, you are liable to pay a incurred in our attempt(s)to perform an audit. In addition <br /> total premium equal to 3 times our current estimate of to any other obligations under this contract, 30 days <br /> the annual premium for your policy. In addition, if you fail after you receive the notification, you will be obligated to <br /> to provide access after our third request within a 90 day pay the total premium and costs referenced above. If, <br /> or longer period, you are also liable for our costs in thereafter, you provide access to your records within <br /> attempting to perform the audit unless you provide a three years after the policy expires, or within another <br /> compelling business reason for your failure. mutually agreed upon time, and we succeed in <br /> performing the audit to our satisfaction, we will revise <br /> We will contact you to schedule appointments during your total premium and the costs due to reflect the <br /> normal business hours. <br /> results of the audit. <br /> Form WC 04 04 21 Printed in U.S.A. Page 1 of 1 <br /> Process Date: 11/04/26 Policy Expiration Date: 11/04/26 <br />