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THIS ENDORSEMENT CHANGES THE POLICY.PLEASE READ IT CAREFULLY. <br />AMENDMENT TO WORKERS’ COMPENSATION BROAD FORM <br />ENDORSEMENT- EMPLOYERS’ LIABILITY STOP GAP COVERAGE <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 />ThisendorsementchangestheWorkers’A.ThiscoverageonlyappliesinNorthDakota, <br />CompensationBroadFormEndorsement–Ohio, Washington, and Wyoming <br />Employers’LiabilityStopGapCoverage <br />E.This paragraph is removed. <br />6.Employers’LiabilityStopGapCoverage <br />Form WC 99 03 58 BPrinted in U.S.A (Ed. 7/08) <br />Process Date:08/17/24Policy Expiration Date:09/26/25 <br /> <br />