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THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. <br />PART FIVE - PREMIUM AMENDATORY ENDORSEMENT <br />Policy Number: -6 WEG B❑3❑P❑ Endorsement Number: <br />Effective Date: 11/04/211 EffectiE0 iFO❑r is t-e same as stated on t❑e Information Page of t❑e policy. <br />Named Insured and Address: Beginners Edge Sports Training <br />F-432 E TIERRA B❑E❑A L❑ <br />SCOTTSDALE A❑ 8-160 <br />Ti❑is endorsement amends Part FiE0 - Premi::n of tip policy as follows❑ <br />Part FiEe - PremiiEn, Section A. i:Oj Manilals❑is replaced iy tip following proEJsion❑ <br />A. Our Manuals <br />All premiLin for tEJs policy will Da determined y oiEr manilals of rues, rates and loss costs :as applicaJeQ rating <br />plans, forms, endorsements, and classifications, and sib❑ mane-als are e:pressly incorporated y reference into, and <br />apply to, tits policy and any renewals i:oj manilals❑ As iced in tJs policy and any renewals, oLir manilals means <br />mantels tit EaCO ❑een❑ <br />1. DeEoloped in any format and filed ❑y tie state -designated worEors compensation rating or addsory organiE:8tion <br />on olir ❑eCialfwit❑t❑e appropriate state instance regdatory aEt❑ority❑or <br />2. DeEoloped in any format and filed y tip respectii-:0 state rating ❑lea❑ on oil :10❑alf wit❑ t0e appropriate state <br />instance regi-latory ai-t❑ority❑or <br />3. DeEoloped in any format and filed y ❑s witi❑ti0e appropriate state insiiance reg:1atory aiEtEorityiland <br />4. For eac❑ or any of tip tree scenarios a❑oil, tie manilals also mE8t :10 approiEed for ::8e y tip appropriate <br />state insi-irance regiJatory ai-t❑ority, or as ot:lerwise aEt❑ori!Eod y law as applicaiEle. <br />We may c!lange of manilals and apply t❑ e c!langes to toms policy and any renewals if s❑c❑ manlal clanges are <br />approiEed for Se y t❑e appropriate state ins❑rance reg:latory aAEority, or an otEierwise ai_t❑orii_:0d ❑y law as <br />applicaJe. <br />Part Fib - Premii-in, Section D. FPremi::rn Payments❑is replaced y t❑e following pro:lsion❑ <br />D. Premium Payments <br />Yo❑ will pay all premiiE n w0en d!-10. Yo❑ will pay tile premi!Ern e.on if part or all of a worEors compensation law is not <br />E8Iid. TOO d!-le date for a!llit and retrospectiE6 premiE ns is t0a dFle date specified in tFle !JIling for tFla policy. <br />Form WC 00 0419 A Printed in O.S.A. <br />Process Date: 11/04/202❑ Policy Expiration Date: 11/04/2026 <br />