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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:HARTFORD CASUALTY INSURANCE COMPANY <br />Company Code:3 <br />Policy Number:76WEGAZ6AMUSchedule Number:01-04-03 <br />Effective Date:09/26/24Effective 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 />Beginners Edge Sports Training <br />LOCATION MAY VARY <br />COSTA MESA CA 92626 <br />NAICS: 713940 <br />FEIN:26-2932264SIC: 7991NO. OF EMPL: 2 <br />4.ThepremiumforthispolicywillbedeterminedbyourManualsofRules,Classifications,RatesandRating <br />Plans.All information required below is subject to verification and change by audit. <br />Premium Basis <br />ClassificationsTotal EstimatedRates PerEstimated <br />Code Number andAnnual$100 ofAnnual <br />DescriptionRemunerationRemunerationPremium <br />887052,400.001.570000823 <br />FITNESS INSTRUCTION PROGRAMS OR STUDIOS - ALL <br />EMPLOYEES - INCLUDING RECEPTIONISTS <br />Total State Summary <br />Total Class Premium823 <br />CA Territorial Differential1.03500029 <br />Waiver of Subrogation500 <br />Small Policy Credit25-338 <br />Total Estimated Annual Standard Premium1,014 <br />Expense constant200 <br />Terrorism Risk Insurance Program Reauthorization Act52,400.000.02000010 <br />Disclosure Endorsement <br />CA User Fund2.46040030 <br />CA Fraud0.4122005 <br />CA Uninsured Employers Benefit Trust Fund0.1505002 <br />CA Subsequent Injuries Benefit Trust Fund Assessments1.58910019 <br />CA Occupational Safety & Health Fund0.7266009 <br />CA Labor Enforcement & Compliance Fund0.7109009 <br />Total Estimated Annual Premium1,298 <br />Countersigned by <br />Authorized Representative <br />Form WC 99 00 05(1) Printed in U.S.A. <br />Process Date:08/17/24Policy Expiration Date:09/26/25 <br /> <br />