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SCHEDULE OF OPERATIONS <br />This Schedule of Operations forms a part of the policy effective on the inception date of the policy unless another date is <br />indicated below: <br />INSURER: TRUMBULL INSURANCE COMPANY <br />Company Code: H <br />Policy Number: 59 WEC AC9055 Schedule Number: 01-05-05 <br />Effective Date: 07/03/20 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Location Address of operations covered by this schedule: <br />BAY SPROUTS LLC <br />NO SPECIFIC LOCATION <br />IN STATE OF CO 00000 <br />FEIN: 46-2577161 <br />NAICS: 722110 <br />SIC: 5812 NO. OF EMPL: 0 <br />4. The premium for this policy will be determined by our Manuals of Rules, Classifications, Rates and Rating <br />Plans. All information required below is subject to verification and change by audit. <br />Premium Basis <br />Classifications Total Estimated Rates Per Estimated <br />Code Number and Annual $100 of Annual <br />Description Remuneration Remuneration Premium <br />8006 <br />STORE - DELICATESSEN - RETAIL <br />Countersigned by <br />Form WC 99 00 05 (1) Printed in U.S.A. <br />Process Date: 05/25/20 <br />100.00 1.930000 <br />2 <br />^ RAMmWmentDMsian <br />Aw F <br />REVIEWED & APPROVED BY.- <br />i vmwd <br />Policy E Wsk Pjanagement Analpt <br />