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EXTENSION OF THE INFORMATION PAGE - ITEM 3.A - STATES COVERED <br />Policy Number:76WEGAZ6AMUEndorsement Number: <br />Effective Date:09/26/24Effective 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 />SCOTTSDALEAZ85260 <br />Item 3.A. of the Information Page is completed to include the following states: <br />CaliforniaCA <br />TexasTX <br />ArizonaAZ <br />Form WC 99 03 67Printed in U.S.A. <br />Process Date:08/17/24Policy Expiration Date:09/26/25 <br /> <br />