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t� <br />EXTENSION OF THE INFORMATION PAGE - ITEM 3.A - STATES COVERED <br />Policy Number: 46 WEC PI6280 Endorsement Number: <br />Effective Date: 07/20/21 Effective hour is the same as stated on the Information Page of the policy. <br />Named Insured and Address: PLANETBIDS INC <br />13263 VENTURA BLVD STE 101 <br />STUDIO CITY CA 91604 <br />Item 3.A. of the Information Page is completed to include the following states: <br />Indiana IN <br />Missouri MO <br />California CA <br />Form WC 99 03 67 Printed in U.S.A. <br />Process Date: 06/10/21 <br />Rlek Mwvgm etdDiwlmt <br />Rene &APPR,aVem BY: <br />C <br />Policy E Risk Management Analyst <br />