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EXTENSION OF THE INFORMATION PAGE - ITEM 3.D - ENDORSEMENTS <br />Policy Number: 46 WEC P16280 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.D. of the Information Page is completed to include the following endorsements: <br />WC240406D <br />MISSOURI EMPLOYER PAID MEDICAL ENDORSEMENT <br />WC240601B <br />MISSOURI CANCELLATION AND NON RENEWAL ENDORSEMENT <br />WC240602B <br />MISSOURI PROPERTY AND CASUALTY GUARANTY ASSOCIATION <br />ENDORSEMENT <br />WC240604C <br />MISSOURI AMENDATORY ENDORSEMENT <br />WC550011 D <br />Employees Claim for Workers compensation Benefits <br />WC8804001 <br />Notice to Employees - Injuries Caused By Work (TITLE IN SPANISH) <br />WC8804011 <br />Notice to Employees - Injuries Caused By Work <br />WC9900011 <br />Signature/ Copyright <br />WC990002 <br />WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY BUSINESS INSURANCE <br />POLICY <br />WC990005 <br />SCHEDULE OF OPERATIONS <br />WC990300B <br />WORKERS' COMPENSATION BROAD FORM ENDORSEMENT <br />WC990302B <br />WORKERS COMPENSATION BROAD FORM ENDORSEMENT <br />WC990303B <br />WORKERS COMPENSATION BROAD FORM ENDORSEMENT EXTENDED OPTIONS <br />WC990356A <br />AMENDMENT TO WORKERS COMPENSATION BROAD FORM ENDORSEMENT <br />EXTENDED OPTIONS - EMPLOYERS LIABILITY STOP GAP COVERAGE <br />WC990358B <br />AMENDMENT TO WORKERS COMPENSATION BROAD FORM ENDORSEMENT - <br />EMPLOYERS LIABILITY STOP GAP COVERAGE <br />WC990359B <br />AMENDMENT TO WORKERS COMPENSATION BROAD FORM ENDORSEMENT - <br />EMPLOYERS LIABILITY STOP GAP COVERAGE <br />WC990366 <br />EXTENSION OF THE INFORMATION PAGE - ITEM 1 - OTHER WORKPLACES <br />Form WC 99 03 68 Printed in U.S.A. <br />Process Date: 06/10/21 Polic <br />RIAMeagmtmtDivision <br />1' Rwn D & APPRDVM BY: <br />a f4A".�� P. V:IG V. d <br />Rak Management Analyst <br />