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WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 04 00 01 B <br /> (Ed. 10-14) <br /> INFORMATION PAGE <br /> National Specialty Insurance Company Policy No. NXT7CLDW3F-01-WC <br /> Insurer ID No(s). 16447 Prior Policy No. <br /> 1. Named Insured: Paramount Education LLC DBA ❑ Individual © LLC <br /> Mailing Address: Paramount Education LLC DBA ❑ Corporation ❑ LLP <br /> MyCodingClasses ❑ Partnership ❑ Other: <br /> 4661 Rimini Ct <br /> Dublin, CA 94568 <br /> Email Address: Jack@mycodingclasses.com <br /> FEIN: XX-XXX1604 <br /> Intra/Interstate Risk ID No. <br /> Other workplaces not shown above: <br /> 2. The policy period is from 03/14/2026 to 03/14/2027 12:01 A.M. standard time at the <br /> insured's mailing address. <br /> 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed <br /> here: <br /> CA <br /> B. Employers Liability Insurance: Part Two of the policy applies to work in each state listed in Item 3A. The limits of our <br /> liability under Part Two are: <br /> Bodily Injury by Accident $1,000,000.00 each accident <br /> Bodily Injury by Disease $1,000,000.00 policy limit <br /> Bodily Injury by Disease $1,000,000.00 each employee <br /> C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: <br /> All States Except Ohio, North Dakota,Washington,Wyoming, Michigan, Pennsylvania, Delaware,Wisconsin, <br /> Minnesota, Massachusetts and Washington D.C. <br /> D. This policy includes these endorsements and schedules: <br /> 4. The premium for this policy will be determined by our Manual of Rules, Classifications, Rates and Rating Plans.All <br /> information required below is subject to verification and change by audit. <br /> Premium Basis Rate Per Estimated <br /> Code Estimated Annual $100 of Annual <br /> No. Classifications Remuneration Remuneration Premium <br /> Refer to Form WC 04 00 05-Classifications for more information. <br /> Experience Modification n/a Total Estimated Annual Premium $$1,430.00 <br /> Minimum Premium$ $500.00 Deposit Premium $$238.34 <br /> Premium Adjustment Period: Annually Countersigned By <br /> Producer Information: <br /> Servicing/Issuing Office Palo Alto Date 12/18/2025 <br /> WC040001 B <br /> (Ed. 10-14) <br />