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<br />., <br />~OfC~ r <br /> <br />~, 1a11 i Oo, ~ 1LfR,, Ine. <br />~ COMPANIES AFFORDING COVERAGES <br />~rwd i~wt <br />_,.c.n, x.... 02110 ~°a~An. A ~. ~. c~.4 .~ acct ~irrlea <br /> [oypwr <br />u n(R <br /> ?~e1f1e <br />'~M( RND ;DDAI S: U IYSJRCD <br />[OMp;Nr <br />LL~~~ ft~ I~ <br />~"T~'V <br />Itlt~, a1.r.a. <br /> [d1p1NY D - <br /> L[TTFR <br /> CDyayLr E <br /> LLTT[R a. <br />•~n e m pMY TM pDLtlea a inwrenu IisteO DeY1w beve been issued tD 11M inwrW rymeD e1cYe en0 en'n 10[G ei inn tire. NDiN+fnfWg4n`` MY repu'aemMt. bLrm a LDMltgn <br />fen[ mrrDect or onw docVmeni +mm .npecl m which Inn certrliute met W issued Dr met pertsm, t)r Insirlerln efbrded M iM pDYCin deeCntLed herein h Hlaje(t ro an iM <br />erns e;clVS.Dns e1M corgncns DI such polies <br />VpLM. <br />!.1(q <br />1.{[!JI iNSUR1N:C <br />POIKY NUMBER pOLSr <br />[;pIR;TIDN D;T( O n OYM <br />L;[N e <br />;f:GALWT[ <br /> OCCURR[MC[ <br /> GENERAL l1ABILRY <br /> BDDIIY IIIIURY f 3 <br />• (~ <br />L! :iyppl rlLY:1JL iDRV -fie '/gyp <br />MY 209170 ~/~~~ <br /> ~ pa[y15[S-0p[RI1ipN5 PADp[PI•DNUGL / 7 <br /> [;RDSIOY AND CGLLIiPS[ <br /> Nr);RC. <br /> ^ UNL(~RpuND N;Z;aU <br /> Q pP'JD1Y_15n DMPLII(L . <br /> U°f AIT IGNS NQLRL BDDRrINIURr;MD <br /> e <br />L <br />I <br />, PRO <br />LGC 3 1 { l <br /> ~ . <br />PNGP(p <br />rGRV <br />BRGLf COMB~N(D ,VW ,WV <br /> O LIMO,I <br /> ^ °I °SV•s: iNJUPr p(R$ONAL IN JUAY / <br /> AUTOMOBLIE l1ABILITY BouiLr lnJUav ti <br /> LCKnPC RbON~ <br /> C~ _ioPPrrCN <br />~:[ (UPN• I~~~ L~~~•l <br />CAL NlvYel~7 •L~ <br />~~Y~ A\ t <br /> S <br />J Cw•,[_ BODIlYIN1U <br />IE;CR IICVDCNTI <br /> ,'~ <br />~•, R. PPppl Pir JLyL.L 1 <br /> <br />A <br />• <br />~ Boon. ~aJdA..ND <br />Y <br /> Ni' <br />' <br />h~- PRDP(Rlr J1N;,^rI 1 <br />~ <br /> CJV9 h[: , <br /> ELICESS LIABILRY <br /> BODIIr INJ-R~14D <br /> '1 <br />ilZ -VPRnI• rLmr ~ 1~ 6~1~a7 oabp[RTrDSy;G[ L 5000 ~ s,0~ <br /> L•~L= N;N Lr~b P[Lit COMBin[D <br /> r LPy <br /> 'WORKERS' COMPENSATION Si;rui DAr <br /> <br />tti and <br />~ $ <br />7~1~~3 <br /> fMPL0YER5'UABILITY '100,000, ,.r-.•.r... <br /> OTHER <br />;PF)4h Lr GL LNa;.Un.LV •i[N5':C~iC.fS <br />CaneNlation: Should any of the above described po1L..e5 be CanCelle4 bEto'F to reof. [he Issuing com~ <br />Gant' wii~-Tlad ~_ days watter~ nonce to the below named certifMate holdey <br />YI~M[1ONtL F.•~J 9I!yJ'~(PI~I~~;~(NLI DLP <br />t~a1 A <br />CM D•TL asu[D ~ ~ ~~ <br />ap <br />~--' ~ ~O~A YC1i~OYt~ i,l. 11 .11 i `r~. ~ ll~w., Zf1t. <br />>ata~d laoi i~elarttan MAlop~ESt ~ <br /> <br />1311 JAQrEL stsMt . <br /> eL., <br />~ <br />G11R~ ~W <br />•UiNORiI(D R[pALSL ;liv! <br /> . <br /> <br />;y~e¢ ivovember 30L :1982 30 . <br />- - --- - a '~ ~ rr =.eLe~.-~ - - <br />