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~Sti'~ul <br />nr.r,~~-•~rv nr it°^~ 1`1 is corn°~+.,,i *r, r°od• <br />flfri C` i" lull n° COQ1 C]'lhl"I°r, <br /> <br />Z <br />ri <br />0 <br />c_ <br />L <br />7 <br />~' If we issue this form after the date your policy Policy issued to <br />takes effect, we must complete these spaces and T ]or <br />our representative must sign below. °'~ ~ (']•`~I: Cn, <br />Authorized representative I;~nr~7 _ Agreement takes effect <br />.•r('9SLi 11 _1.'j n.. Tn 517„^nC° G~r1'i C° d-~~-~'3 <br />~7?r t..;~ ctl;ro r: Policy number <br />1'nlr~ra=r, r'~,1n~arln RRT~' ~~-'Cl L. ~` i4.i.1P,R(,;~ <br />Insuring Agreement , <br />Endorsement number to Insuring Agreement. <br />Endorsement number to <br />OSt. Paul Fire antl Marine Insu ra nc: Company, 1980. <br />