BEGINNERS EDGE SPORTS TRAINING, LLC (3)

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PART FIVE - PREMIUM A. Our Manuals is amended Dy adding tiffs sentenceEl In tus part, "oil- manials" means mani=als approud or prescriiud ❑y tin Tei❑as Department of InsiFi-ance. C. Remuneration ❑i-irniur 2 is amended to read:] 2. All ot❑er persons engaged in wor❑tut word maize iu llaEle iEnder Part One iWorurs Compensation Ins0rance❑ of tits policy. Ti❑is paragrap❑ 2 will not apply if yo❑ giiu a proof tut tin employers of t❑ese persons IawfElly sec:1red woriurs compensation ins:lrance. D. Premium Payments is amended ❑y adding tiffs sentence❑ Tu JIling statement or iniuice for a::dit additional premiims and/or retrospectiu additional premi:Ins esta:lisius tin date t-e premiErn is die. E. Final Premium ❑inn❑er 2 is amended to read❑ 2. If yo❑ cancel, final premi::n will iu calcElated pro rata rased on tin time tiffs policy was in force. Final premi:]n will not iu less tiun tiie pro rata sure of tin minimErn premi::n. PART SIX - CONDITIONS A. Inspection is amended Dy adding tEJs sentence[] Yoor failore to comply wit❑t'ia safety recommendations made as a resElt of an inspection may case tEle policy to ❑e canceled ❑y u. C. Transfer of Your Rights and Duties is amended to read❑ Yoor rigEts and dries ❑ader tiEis policy may not u transferred witioEt OFT written consent. If yo❑ die, courage will u prodded for yoir sF]rddng spoClse or yob legal representatiu. TCJS applies only wit❑ respect to t❑eir acting in tie capacity as an employer and only for t❑e worEplaces listed in Items 1 and 4 on t❑e Information Page. D. Cancellation is amended to read[] 1. Yo❑ may cancel tEJs policy. Yo❑ mClst mail or deliur adiunce notice to C:8 stating w❑en to cancellation is to tau effect. 2. We may cancel tEJs policy. We may also decline to renew it. We mint gin yo❑written notice of cancellation or nonrenewal. T❑at notice will ❑e sent certified mail or deliured to yo❑ in person. A copy of to written notice will ❑e sent to the TeCLis Department of Instance-Didsion of WorursiCompensation. 3. ❑otice of cancellation or nonrenewal mint a sent to yo❑ not later tun t❑e 30t❑ day ❑efore to date on wEJc❑ t-e cancellation or nonrenewal ucomes effectiu, eE0ept that we may send t❑e notice not later titan t❑e 10t❑ day ❑efore to date on wCic❑ t❑e cancellation or nonrenewal ucomes effectiu if we cancel or do not renew ❑eca❑se Of Li a. Fra❑d in o❑taining courage❑ C.i Misrepresentation of t❑e amount of payroll for p0rposes of premiErn calcdation❑ c. Faille to pay a premiErn w❑en payment was dull d. An increase in to DaE:8rd for wEJc❑yo❑see❑courage ti at resdts from an action or omission and tut world prod❑ce an increase in to rate, incl❑ding an increase ucaise of faille to comply wit❑ reasonade recommendations for loss control or to comply wit::jn a reasonaiFle period wit❑ recommendations designed to rediue a uiurd tint is Ender yo:1- control❑ e. A determination Dy tin Commissioner of Ins:1rance tut tin continution of to policy word place iu in uolation of tin law, or world !u-ai:ardoiu to tin interests of s❑iucriiurs, creditors, or tin general p❑tic. 4. If anotiur ins:1rance company notifies tin Tei❑as Department of Ins:lrance-Di:lsion of Woriursi--ompensation t0at it is insFiring yo❑ as an employer, size❑ notice mint u a cancellation of tits policy effectiu wizen tin otiur policy starts. Add tin following to t❑e policy❑ PART SEVEN - OUR DUTY TO YOU FOR CLAIM NOTIFICATION A. Claims Notification We are re❑EJred to notify yo❑ of any claim tut is filed against yoir policy. T❑ereafter we mint notify yo❑ of any proposal to settle a claim or, on receipt of a written re❑zest from yoq of any administratiu or Hdicial proceeding relating to tie resol::tion of a claim, incliEding a ❑enefit renew conference conducted ❑y tiFe Tei❑as Department of Ins:lrance-Di:lsion of Worursi❑✓ompensation. Yo❑ may, in writing, elect to waiiu tAs notification re❑i-- Jrement. We mint, on tin written re❑E0st from yoq pro:Jde yo❑ wit❑ a list of claims curged against yoi-ir policy, payments made and reserius esta:1isi-ed on eac❑ claim, and a statement e:A)laining tin effect of claims on yo:1r premi::n rates. We mint fijnis❑ tie reiiiested information to you in writing no later tian tin 30t❑ day after tin date we receiu yos re❑lust. Tile information is considered to ie proEJded on tin date tin information is receiiud ❑y to ❑nited States Postal Ser:Jce or is personally deliured. Form WC 42 03 01 L Printed in O.S.A. Page 2 of 3