{\rtf1\adeflang1025\ansi\ansicpg1252\uc1\adeff0\deff0\stshfdbch0\stshfloch0\stshfhich0\stshfbi0\deflang1033\deflangfe1033\themelang1033\themelangfe0\themelangcs0{\fonttbl{\f0\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f34\fbidi \froman\fcharset0\fprq2{\*\panose 02040503050406030204}Cambria Math;}
{\f40\fbidi \fswiss\fcharset0\fprq2{\*\panose 00000000000000000000}Tahoma;}{\f41\fbidi \fswiss\fcharset0\fprq2{\*\panose 020b0a04020102020204}Arial Black;}{\flomajor\f31500\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}
{\fdbmajor\f31501\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\fhimajor\f31502\fbidi \froman\fcharset0\fprq2{\*\panose 00000000000000000000}Cambria;}
{\fbimajor\f31503\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\flominor\f31504\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}
{\fdbminor\f31505\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\fhiminor\f31506\fbidi \fswiss\fcharset0\fprq2{\*\panose 020f0502020204030204}Calibri;}
{\fbiminor\f31507\fbidi \froman\fcharset0\fprq2{\*\panose 02020603050405020304}Times New Roman;}{\f42\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\f43\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
{\f45\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\f46\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\f47\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\f48\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}
{\f49\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\f50\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\f382\fbidi \froman\fcharset238\fprq2 Cambria Math CE;}{\f383\fbidi \froman\fcharset204\fprq2 Cambria Math Cyr;}
{\f385\fbidi \froman\fcharset161\fprq2 Cambria Math Greek;}{\f386\fbidi \froman\fcharset162\fprq2 Cambria Math Tur;}{\f389\fbidi \froman\fcharset186\fprq2 Cambria Math Baltic;}{\f390\fbidi \froman\fcharset163\fprq2 Cambria Math (Vietnamese);}
{\f442\fbidi \fswiss\fcharset238\fprq2 Tahoma CE;}{\f443\fbidi \fswiss\fcharset204\fprq2 Tahoma Cyr;}{\f445\fbidi \fswiss\fcharset161\fprq2 Tahoma Greek;}{\f446\fbidi \fswiss\fcharset162\fprq2 Tahoma Tur;}
{\f447\fbidi \fswiss\fcharset177\fprq2 Tahoma (Hebrew);}{\f448\fbidi \fswiss\fcharset178\fprq2 Tahoma (Arabic);}{\f449\fbidi \fswiss\fcharset186\fprq2 Tahoma Baltic;}{\f450\fbidi \fswiss\fcharset163\fprq2 Tahoma (Vietnamese);}
{\f451\fbidi \fswiss\fcharset222\fprq2 Tahoma (Thai);}{\f452\fbidi \fswiss\fcharset238\fprq2 Arial Black CE;}{\f453\fbidi \fswiss\fcharset204\fprq2 Arial Black Cyr;}{\f455\fbidi \fswiss\fcharset161\fprq2 Arial Black Greek;}
{\f456\fbidi \fswiss\fcharset162\fprq2 Arial Black Tur;}{\f459\fbidi \fswiss\fcharset186\fprq2 Arial Black Baltic;}{\flomajor\f31508\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}
{\flomajor\f31509\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}{\flomajor\f31511\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\flomajor\f31512\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}
{\flomajor\f31513\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\flomajor\f31514\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\flomajor\f31515\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}
{\flomajor\f31516\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\fdbmajor\f31518\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\fdbmajor\f31519\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
{\fdbmajor\f31521\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fdbmajor\f31522\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fdbmajor\f31523\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}
{\fdbmajor\f31524\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\fdbmajor\f31525\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\fdbmajor\f31526\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}
{\fhimajor\f31528\fbidi \froman\fcharset238\fprq2 Cambria CE;}{\fhimajor\f31529\fbidi \froman\fcharset204\fprq2 Cambria Cyr;}{\fhimajor\f31531\fbidi \froman\fcharset161\fprq2 Cambria Greek;}{\fhimajor\f31532\fbidi \froman\fcharset162\fprq2 Cambria Tur;}
{\fhimajor\f31535\fbidi \froman\fcharset186\fprq2 Cambria Baltic;}{\fhimajor\f31536\fbidi \froman\fcharset163\fprq2 Cambria (Vietnamese);}{\fbimajor\f31538\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}
{\fbimajor\f31539\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}{\fbimajor\f31541\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fbimajor\f31542\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}
{\fbimajor\f31543\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\fbimajor\f31544\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\fbimajor\f31545\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}
{\fbimajor\f31546\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\flominor\f31548\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\flominor\f31549\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}
{\flominor\f31551\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\flominor\f31552\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\flominor\f31553\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}
{\flominor\f31554\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\flominor\f31555\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\flominor\f31556\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}
{\fdbminor\f31558\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}{\fdbminor\f31559\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}{\fdbminor\f31561\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}
{\fdbminor\f31562\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}{\fdbminor\f31563\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\fdbminor\f31564\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}
{\fdbminor\f31565\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}{\fdbminor\f31566\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}{\fhiminor\f31568\fbidi \fswiss\fcharset238\fprq2 Calibri CE;}
{\fhiminor\f31569\fbidi \fswiss\fcharset204\fprq2 Calibri Cyr;}{\fhiminor\f31571\fbidi \fswiss\fcharset161\fprq2 Calibri Greek;}{\fhiminor\f31572\fbidi \fswiss\fcharset162\fprq2 Calibri Tur;}
{\fhiminor\f31575\fbidi \fswiss\fcharset186\fprq2 Calibri Baltic;}{\fhiminor\f31576\fbidi \fswiss\fcharset163\fprq2 Calibri (Vietnamese);}{\fbiminor\f31578\fbidi \froman\fcharset238\fprq2 Times New Roman CE;}
{\fbiminor\f31579\fbidi \froman\fcharset204\fprq2 Times New Roman Cyr;}{\fbiminor\f31581\fbidi \froman\fcharset161\fprq2 Times New Roman Greek;}{\fbiminor\f31582\fbidi \froman\fcharset162\fprq2 Times New Roman Tur;}
{\fbiminor\f31583\fbidi \froman\fcharset177\fprq2 Times New Roman (Hebrew);}{\fbiminor\f31584\fbidi \froman\fcharset178\fprq2 Times New Roman (Arabic);}{\fbiminor\f31585\fbidi \froman\fcharset186\fprq2 Times New Roman Baltic;}
{\fbiminor\f31586\fbidi \froman\fcharset163\fprq2 Times New Roman (Vietnamese);}}{\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;
\red255\green255\blue255;\red0\green0\blue128;\red0\green128\blue128;\red0\green128\blue0;\red128\green0\blue128;\red128\green0\blue0;\red128\green128\blue0;\red128\green128\blue128;\red192\green192\blue192;\red255\green255\blue255;}{\*\defchp }
{\*\defpap \ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 }\noqfpromote {\stylesheet{\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \snext0 \sqformat \spriority0 \styrsid16211270 Normal;}{\s2\ql \li0\ri0\keepn\widctlpar\tx360\tx2160\tx3060\wrapdefault\aspalpha\aspnum\faauto\outlinelevel1\adjustright\rin0\lin0\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs16\ul\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext0 \slink15 \sqformat \spriority9 \styrsid12868681 heading 2;}{\*\cs10 \additive \ssemihidden \sunhideused \spriority1 Default Paragraph Font;}{\*
\ts11\tsrowd\trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind0\tblindtype3\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv 
\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \snext11 \ssemihidden \sunhideused Normal Table;}{\*\cs15 \additive 
\rtlch\fcs1 \ab\ai\af0\afs28 \ltrch\fcs0 \b\i\fs28\loch\f31502\hich\af31502\dbch\af31501 \sbasedon10 \slink2 \slocked \ssemihidden \spriority9 \styrsid332849 Heading 2 Char;}{
\s16\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 
\sbasedon0 \snext16 \slink17 \sqformat \spriority10 \styrsid16211270 Title;}{\*\cs17 \additive \rtlch\fcs1 \ab\af0\afs32 \ltrch\fcs0 \b\fs32\kerning28\loch\f31502\hich\af31502\dbch\af31501 \sbasedon10 \slink16 \slocked \spriority10 \styrsid332849 
Title Char;}{\s18\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs18\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext18 \slink19 \styrsid16211270 
Body Text;}{\*\cs19 \additive \rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \fs24 \sbasedon10 \slink18 \slocked \ssemihidden \styrsid332849 Body Text Char;}{\*\ts20\tsrowd\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidthB3\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind0\tblindtype3\tsvertalt\tsbrdrt\tsbrdrl\tsbrdrb\tsbrdrr\tsbrdrdgl\tsbrdrdgr\tsbrdrh\tsbrdrv 
\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs20\alang1025 \ltrch\fcs0 \fs20\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon11 \snext20 \spriority59 \styrsid13572198 Table Grid;}{
\s21\ql \li0\ri0\widctlpar\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 
\sbasedon0 \snext21 \slink22 \styrsid7930344 header;}{\*\cs22 \additive \rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \fs24 \sbasedon10 \slink21 \slocked \ssemihidden \styrsid332849 Header Char;}{\s23\ql \li0\ri0\widctlpar
\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext23 \slink24 \styrsid7930344 footer;}{\*\cs24 
\additive \rtlch\fcs1 \af0\afs24 \ltrch\fcs0 \fs24 \sbasedon10 \slink23 \slocked \ssemihidden \styrsid332849 Footer Char;}{\s25\qj \li720\ri720\widctlpar\tx2880\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin720\lin720\itap0 \rtlch\fcs1 
\af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext25 \styrsid12868681 Block Text;}{\s26\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 
\af40\afs16\alang1025 \ltrch\fcs0 \f40\fs16\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 \sbasedon0 \snext26 \slink27 \ssemihidden \styrsid16742526 Balloon Text;}{\*\cs27 \additive \rtlch\fcs1 \af40\afs16 \ltrch\fcs0 \f40\fs16 
\sbasedon10 \slink26 \slocked \ssemihidden \styrsid332849 Balloon Text Char;}{\*\cs28 \additive \rtlch\fcs1 \af0 \ltrch\fcs0 \sbasedon10 \styrsid11014981 page number;}}{\*\rsidtbl \rsid132918\rsid226211\rsid285584\rsid330445\rsid332849\rsid474937
\rsid603419\rsid685910\rsid739280\rsid749545\rsid818476\rsid872514\rsid877836\rsid932004\rsid1002363\rsid1054820\rsid1128179\rsid1206445\rsid1253583\rsid1261693\rsid1266608\rsid1324768\rsid1340174\rsid1462802\rsid1593936\rsid1639486\rsid1865667
\rsid1910654\rsid2032721\rsid2361921\rsid2372871\rsid2381697\rsid2492620\rsid2501028\rsid2510068\rsid2621551\rsid2761060\rsid2831321\rsid2950492\rsid3027969\rsid3029616\rsid3032379\rsid3038418\rsid3091063\rsid3099455\rsid3103797\rsid3348989\rsid3491188
\rsid3505871\rsid3611253\rsid3700452\rsid3874121\rsid3889369\rsid4073677\rsid4091936\rsid4141281\rsid4224024\rsid4291995\rsid4401434\rsid4464067\rsid4606902\rsid4749582\rsid4871891\rsid4877350\rsid4931412\rsid4985709\rsid5071625\rsid5130914\rsid5177491
\rsid5191079\rsid5248832\rsid5337860\rsid5458700\rsid5467581\rsid5505869\rsid5657542\rsid5663054\rsid5839530\rsid5982675\rsid6035974\rsid6094998\rsid6101645\rsid6123726\rsid6243269\rsid6429324\rsid6519921\rsid6570022\rsid6620299\rsid6700977\rsid6777393
\rsid6818022\rsid6908736\rsid6974152\rsid7230380\rsid7237605\rsid7285567\rsid7288257\rsid7412528\rsid7617877\rsid7622482\rsid7743395\rsid7930344\rsid8024144\rsid8084306\rsid8152306\rsid8195789\rsid8339108\rsid8420329\rsid8457432\rsid8595965\rsid8667207
\rsid8803392\rsid8855350\rsid8860350\rsid8861186\rsid8926215\rsid8979773\rsid9009846\rsid9112476\rsid9325396\rsid9797572\rsid9860729\rsid9913430\rsid9966873\rsid10054492\rsid10054949\rsid10099644\rsid10111872\rsid10238163\rsid10252242\rsid10313964
\rsid10369440\rsid10447248\rsid10637964\rsid10777804\rsid10911545\rsid10966568\rsid11014981\rsid11152034\rsid11206879\rsid11279515\rsid11413414\rsid11484474\rsid11543694\rsid11600093\rsid11684128\rsid11739488\rsid11821258\rsid12000672\rsid12214971
\rsid12220285\rsid12269519\rsid12462020\rsid12464152\rsid12657798\rsid12666139\rsid12716801\rsid12735305\rsid12792744\rsid12868681\rsid12916933\rsid12934455\rsid12987191\rsid12995669\rsid13179980\rsid13310430\rsid13452365\rsid13572198\rsid13644678
\rsid13852638\rsid13894282\rsid13960794\rsid14033439\rsid14037758\rsid14121014\rsid14121993\rsid14158317\rsid14247912\rsid14305086\rsid14497034\rsid14498625\rsid14504261\rsid14507127\rsid14554322\rsid14559226\rsid14703997\rsid14953038\rsid15289393
\rsid15296695\rsid15365222\rsid15807361\rsid15824971\rsid15861288\rsid15935419\rsid15937808\rsid15953426\rsid16022120\rsid16073618\rsid16153626\rsid16211270\rsid16272621\rsid16322573\rsid16333697\rsid16453334\rsid16582651\rsid16676819\rsid16742526}
{\mmathPr\mmathFont34\mbrkBin0\mbrkBinSub0\msmallFrac0\mdispDef1\mlMargin0\mrMargin0\mdefJc1\mwrapIndent1440\mintLim0\mnaryLim1}{\info{\title N}{\author Sean Sheehy}{\operator Viernes Jr, Quintin}{\creatim\yr2016\mo8\dy24\hr15\min35}
{\revtim\yr2016\mo8\dy24\hr15\min35}{\printim\yr2008\mo9\dy25\hr11\min10}{\version2}{\edmins0}{\nofpages2}{\nofwords1085}{\nofchars6188}{\*\company NJDOT}{\nofcharsws7259}{\vern57437}}{\*\xmlnstbl {\xmlns1 http://schemas.microsoft.com/office/word/2003/wor
dml}}\paperw12240\paperh15840\margl720\margr720\margt536\margb4\gutter0\ltrsect 
\widowctrl\ftnbj\aenddoc\trackmoves0\trackformatting1\donotembedsysfont1\relyonvml0\donotembedlingdata0\grfdocevents0\validatexml1\showplaceholdtext0\ignoremixedcontent0\saveinvalidxml0\showxmlerrors1\noxlattoyen
\expshrtn\noultrlspc\dntblnsbdb\nospaceforul\formshade\horzdoc\dgmargin\dghspace180\dgvspace180\dghorigin720\dgvorigin536\dghshow1\dgvshow1
\jexpand\viewkind1\viewscale160\pgbrdrhead\pgbrdrfoot\splytwnine\ftnlytwnine\htmautsp\nolnhtadjtbl\useltbaln\alntblind\lytcalctblwd\lyttblrtgr\lnbrkrule\nobrkwrptbl\snaptogridincell\allowfieldendsel\wrppunct
\asianbrkrule\rsidroot16211270\stylelock\newtblstyruls\nogrowautofit\usenormstyforlist\noindnmbrts\felnbrelev\nocxsptable\indrlsweleven\noafcnsttbl\afelev\utinl\hwelev\spltpgpar\notcvasp\notbrkcnstfrctbl\notvatxbx\krnprsnet\cachedcolbal \nouicompat \fet0
{\*\wgrffmtfilter 013f}\nofeaturethrottle1\ilfomacatclnup0\enforceprot1\protlevel2{\*\ftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid9966873 \chftnsep 
\par }}{\*\ftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid9966873 \chftnsepc 
\par }}{\*\aftnsep \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid9966873 \chftnsep 
\par }}{\*\aftnsepc \ltrpar \pard\plain \ltrpar\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \insrsid9966873 \chftnsepc 
\par }}\ltrpar \sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\headerr \ltrpar \pard\plain \ltrpar\s21\ql \li0\ri0\widctlpar
\tqc\tx4320\tqr\tx8640\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid11014981 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid6101645\charrsid7930344 Form DC-175}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid6101645   (}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15296695 06}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid872514 /1}{\rtlch\fcs1 \af0\afs18 
\ltrch\fcs0 \fs18\insrsid11543694 6}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid9797572 )}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid6101645 \tab \tab   \tab             }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid15296695\charrsid15296695 Page }{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 \b\fs18\insrsid15296695\charrsid15296695  PAGE  \\* Arabic  \\* MERGEFORMAT }}{\fldrslt {\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 
\b\fs18\lang1024\langfe1024\noproof\insrsid4985709 1}}}\sectd \ltrsect\linex0\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15296695\charrsid15296695  of }{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 
\b\fs18\insrsid15296695\charrsid15296695  NUMPAGES  \\* Arabic  \\* MERGEFORMAT }}{\fldrslt {\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 \b\fs18\lang1024\langfe1024\noproof\insrsid4985709 2}}}\sectd \ltrsect\linex0\endnhere\sectdefaultcl\sftnbj {\rtlch\fcs1 
\af0\afs18 \ltrch\fcs0 \fs18\insrsid6101645\charrsid11014981 
\par }}{\*\pnseclvl1\pnucrm\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl2\pnucltr\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl3\pndec\pnstart1\pnindent720\pnhang {\pntxta .}}{\*\pnseclvl4\pnlcltr\pnstart1\pnindent720\pnhang {\pntxta )}}
{\*\pnseclvl5\pndec\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl6\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl7\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl8
\pnlcltr\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}{\*\pnseclvl9\pnlcrm\pnstart1\pnindent720\pnhang {\pntxtb (}{\pntxta )}}\pard\plain \ltrpar
\s16\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16211270 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 
\scaps\fs28\insrsid16211270\charrsid7622482 N}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \scaps\fs28\insrsid7622482\charrsid7622482 ew Jersey Department of Transportation 
\par }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \scaps\fs28\insrsid16211270\charrsid7622482 I}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \scaps\fs28\insrsid7622482\charrsid7622482 nsurance Certificate}{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 
\scaps\fs28\insrsid16211270\charrsid7622482 
\par }\pard\plain \ltrpar\qr \li0\ri0\widctlpar\brdrb\brdrs\brdrw45 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16211270 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \b\fs15\insrsid16211270\charrsid10111872 
\par }\pard\plain \ltrpar\s18\ql \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16211270 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs18\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs20 
\ltrch\fcs0 \fs20\insrsid16211270\charrsid2510068 
This certifies that for the policies indicated below have been issued to the insured for the subject Contract for the policy period indicated, that the policies comply with the requirements of Section 152 of the Ó£»¨ÊÓƵ Department of Transportation Sta
ndard Specifications for Road and Bridge Construction as amended by the Special Provisions, and that all information contained herein is true and accurate.
\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh193\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb
\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\pard\plain \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs17\insrsid16211270 CONTRACTOR:\cell {\*\bkmkstart Contractor}}{\field{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694  FORMTEXT }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694 {\*\datafield 
00000000140000000a436f6e74726163746f7200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Contractor}}}}}{\fldrslt {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\lang1024\langfe1024\noproof\insrsid11543694 \u8194\'20\u8194\'20\u8194\'20
\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid16211270 {\*\bkmkend Contractor}\cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16211270 \trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh193\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\row \ltrrow}\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh224\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrs\brdrw5 \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid16211270 PROJECT NAME :\cell {\*\bkmkstart Project}}{\field{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs19\insrsid11543694  FORMTEXT }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694 {\*\datafield 00000000140000000750726f6a65637400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Project}}}}}{\fldrslt {\rtlch\fcs1 \af0 
\ltrch\fcs0 \fs19\lang1024\langfe1024\noproof\insrsid11543694 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs19\insrsid16211270 {\*\bkmkend Project}\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16211270 \trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh224\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrs\brdrw5 \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\row \ltrrow}\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh242\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid16211270 LOCATION:\cell {\*\bkmkstart Text1}}{\field{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs19\insrsid11543694  FORMTEXT }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694 {\*\datafield 000000001400000005546578743100000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text1}}}}}{\fldrslt {\rtlch\fcs1 \af0 
\ltrch\fcs0 \fs19\lang1024\langfe1024\noproof\insrsid11543694 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs19\insrsid16211270 {\*\bkmkend Text1}\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16211270 \trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh242\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth8946\clshdrawnil \cellx10746\row \ltrrow}\trowd \irow3\irowband3\lastrow \ltrrow
\ts11\trgaph108\trrh269\trleft90\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA5939\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr
\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth3007\clshdrawnil \cellx4807\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid16211270 DP FILE NO:\cell }{\field{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694  FORMTEXT }
{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694 {\*\datafield 00000000140000000000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20}}}}{\fldrslt {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\lang1024\langfe1024\noproof\insrsid11543694 \u8194
\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid16211270 \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16211270 \trowd \irow3\irowband3\lastrow \ltrrow
\ts11\trgaph108\trrh269\trleft90\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA5939\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr
\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth3007\clshdrawnil \cellx4807\row }\pard \ltrpar\ql \li0\ri0\widctlpar\brdrb
\brdrs\brdrw45\brsp20 \wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid16211270 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs15\insrsid16211270 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid10099644 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid1324768\charrsid7930344 A}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid1324768    }{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid1324768\charrsid7930344 COMPREHENSIVE GENERAL LIABILITY INSURANCE \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1324768\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\lastrow \ltrrow
\ts11\trgaph108\trrh344\trleft1\trkeep\trftsWidth3\trwWidth10811\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind1\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth10811\clshdrawnil \cellx10812\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 Company Providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text2}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
000000001400000005546578743200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text2}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid685910\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Text2}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid685910\charrsid2831321        }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid685910\charrsid2831321 ENDORSEMENTS       
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  PERSONAL INJURY
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 01000000140000000000000000000000000000000000}
{\*\formfield{\fftype1\fftypetxt0\ffhps20\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  }{\rtlch\fcs1 
\af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 CONTRACTUAL LIABILITY 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  PREMISES & OPERATIONS
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
010000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 
\af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  PRODUCTS & COMPLETED OPERATIONS
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
010000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 
\af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 INDEPENDENT CONTRACTORS
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  WAIVER OF SUBROGATION 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  SEVERABILITY OF INTEREST/}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 SEPARATION}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 
 OF }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 INSURED}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
010000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 
\af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321  PER PROJECT AGGREGATE
\par {\*\bkmkstart Check30}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b333000000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check30}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Check30}  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 EXPLOSIONS
\par {\*\bkmkstart Check31}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
650000001400000007436865636b333100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check31}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Check31} }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 DAMAGE TO UNDERGROUND UTILITIES
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\*\bkmkstart Check32}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid685910\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 650000001400000007436865636b333200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20
{\*\ffname Check32}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Check32} }{\rtlch\fcs1 
\af0\afs14 \ltrch\fcs0 \fs14\insrsid685910\charrsid2831321 COLLAPSE OF  FOUNDATIONS}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh264\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2287\clshdrawnil \cellx2287\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3201\clshdrawnil \cellx5488\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1299\clshdrawnil \cellx6787
\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text3}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
000000001400000005546578743300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text3}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid685910\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Text3}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid685910\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1927\clshdrawnil \cellx3367\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text4}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
000000001400000005546578743400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text4}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid685910\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Text4}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid685910\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1927\clshdrawnil \cellx3367\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text5}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\datafield 
000000001400000005546578743500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text5}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid685910\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 {\*\bkmkend Text5}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid685910\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1927\clshdrawnil \cellx3367\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 Limit of Liability: $\nestcell{\nonesttables
\par }{\*\bkmkstart Text6}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 {\*\datafield 
000000001400000005546578743600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text6}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid330445\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 {\*\bkmkend Text6}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0\afs15 \ltrch\fcs0 \fs15\insrsid330445\charrsid2831321 per occurrence Combined Single Limit (B.I & P.D.)\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid330445\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid330445\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt101\clpadr14\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1927\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx3367\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb
\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3420\clpadt115\clpadr115\clpadft3\clpadfr3\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 Deductible: $\nestcell{\nonesttables
\par }{\*\bkmkstart Text7}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 {\*\datafield 
000000001400000005546578743700000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text7}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid330445\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid330445\charrsid2831321 {\*\bkmkend Text7}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid330445\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid330445\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx1260\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1747\clshdrawnil \cellx3007\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3780\clshdrawnil \cellx6787
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid685910\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid685910\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid685910\charrsid7930344 {\*\nesttableprops\trowd \irow6\irowband6\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx1620\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5167\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil 
\cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 
This policy names the State, its officers, employees and agents\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid5177491\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5177491\charrsid7930344 {\*\nesttableprops\trowd \irow7\irowband7\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6787\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 As additional insured {\*\bkmkstart Check35}}
{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 {\*\datafield 
650000001400000007436865636b333500000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check35}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 {\*\bkmkend Check35} Yes   {\*\bkmkstart Check36}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 
\af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 {\*\datafield 650000001400000007436865636b333600000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check36}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid5177491\charrsid2831321 {\*\bkmkend Check36} No\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid5177491\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid5177491\charrsid7930344 {\*\nesttableprops\trowd \irow8\irowband8\lastrow \ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphpg\tposx4212\tposy77\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth11055\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6787\clshdrawnil \cellx6787\clvmrg\clvertalt\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4268\clshdrawnil \cellx11055\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh2748\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid685910 {\rtlch\fcs1 
\af0\afs16 \ltrch\fcs0 \fs16\insrsid474937\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7930344\charrsid7930344 
\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh2748\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2361\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb
\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \f41\insrsid1340174\charrsid2831321 B   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid1340174\charrsid2831321 COMPREH}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid12214971\charrsid2831321 ENS}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\b\fs18\insrsid1340174\charrsid2831321 IVE AUTOMOBILE LIABILITY INSURANCE
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 
\par Company Providing Coverage:\nestcell{\nonesttables
\par }{\*\bkmkstart Text8}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
000000001400000005546578743800000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text8}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid10911545\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\bkmkend Text8}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid10911545\charrsid2831321      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid10911545\charrsid2831321 ENDORSEMENTS  
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid10911545\charrsid2831321  WAIVER OF SUBROGATION 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid10911545\charrsid2831321  SEVERABILITY OF INTEREST/}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 SEPARATION}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 
\fs14\insrsid10911545\charrsid2831321  OF }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 INSURED}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid10911545\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh182\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx2340\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx6660
\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text9}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
000000001400000005546578743900000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text9}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid10911545\charrsid2831321 \u8194\'20\u8194\'20\u8194
\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\bkmkend Text9}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid10911545\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6660
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text10}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
00000000140000000654657874313000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text10}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid10911545\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\bkmkend Text10}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid10911545\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt
\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6660\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821
\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text11}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
00000000140000000654657874313100000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text11}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid10911545\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\bkmkend Text11}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid10911545\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt
\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3420\clshdrawnil \cellx6660\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821
\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 Limit of Liability:}{\rtlch\fcs1 \af0\afs16 
\ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 $\nestcell{\nonesttables
\par }{\*\bkmkstart Text12}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\datafield 
00000000140000000654657874313200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text12}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid10911545\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10911545\charrsid2831321 {\*\bkmkend Text12}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0\afs15 \ltrch\fcs0 \fs15\insrsid10911545\charrsid2831321 per occurrence Combined Single Limit (B.I. & P.D.)\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid10911545\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10911545\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh260\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clpadt86\clpadr115\clpadft3\clpadfr3\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb
\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3420\clpadt72\clpadr0\clpadft3\clpadfr3\clshdrawnil \cellx6660\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid15953426\charrsid2831321 Type of Coverage: {\*\bkmkstart Check37}}
{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 {\*\datafield 
650000001400000007436865636b333700000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check37}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 {\*\bkmkend Check37} }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid15953426\charrsid2831321 ALL OWNED AUTOS}{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid15953426\charrsid2831321    {\*\bkmkstart Check38}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 
{\*\datafield 650000001400000007436865636b333800000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check38}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 {\*\bkmkend Check38} }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid15953426\charrsid2831321 
NON-OWNED AUTOS   {\*\bkmkstart Check39}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 {\*\datafield 
650000001400000007436865636b333900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check39}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid15953426\charrsid2831321 {\*\bkmkend Check39} HIRED AUTOS\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid15953426\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15953426\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\lastrow \ltrrow
\ts11\trgaph108\trrh353\trleft0\tpvpara\tphmrg\tposxr\tposy110\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6660\clshdrawnil \cellx6660\clvmrg\clvertalt\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4161\clpadt115\clpadr29\clpadft3\clpadfr3\clshdrawnil \cellx10821\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2361\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\sb120\widctlpar\intbl
\tx360\tx2160\tx3060\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs6 \ltrch\fcs0 \fs6\insrsid474937\charrsid2831321 \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid1340174\charrsid7930344 \trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2361\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh2022\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb
\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \f41\insrsid285584\charrsid2831321 C   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid285584\charrsid2831321 OWNER\rquote S AND CO}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid12868681\charrsid2831321 NTRACTOR\rquote 
S PROTECTIVE LIABILITY I}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid285584\charrsid2831321 NSURANCE
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid285584 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid285584\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 Company Providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text13}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\datafield 
00000000140000000654657874313300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text13}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid13310430\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\bkmkend Text13}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid13310430\charrsid2831321      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid13310430\charrsid2831321 ENDORSEMENTS  
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid13310430\charrsid2831321  SEVERABILITY OF INTEREST/}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 SEPARATION}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 
\fs14\insrsid13310430\charrsid2831321  OF }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 INSURED}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid13310430\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\*\bkmkstart Check62}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid2381697\charrsid2381697  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2381697\charrsid2381697 {\*\datafield 650000001400000007436865636b363200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20
{\*\ffname Check62}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2381697 {\*\bkmkend Check62} }{\rtlch\fcs1 \af0\afs14 
\ltrch\fcs0 \fs14\insrsid2381697\charrsid2381697 PER PROJECT AGGREGATE}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2381697 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13310430\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh360\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil 
\cellx2340\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx6840\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3980\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text14}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\datafield 
00000000140000000654657874313400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text14}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid13310430\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\bkmkend Text14}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid13310430\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13310430\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh258\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1850\clshdrawnil \cellx3290\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3550\clshdrawnil \cellx6840\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3980\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text15}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\datafield 
00000000140000000654657874313500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text15}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid13310430\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\bkmkend Text15}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid13310430\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13310430\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh256\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1850\clshdrawnil \cellx3290\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3550\clshdrawnil \cellx6840\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3980\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text16}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\datafield 
00000000140000000654657874313600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text16}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid13310430\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\bkmkend Text16}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid13310430\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13310430\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh256\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1850\clshdrawnil \cellx3290\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3550\clshdrawnil \cellx6840\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3980\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 Limit of Liability:}{\rtlch\fcs1 \af0\afs16 
\ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 $\nestcell{\nonesttables
\par }{\*\bkmkstart Text17}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid818476\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid818476\charrsid2831321 {\*\datafield 
00000000140000000654657874313700000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text17}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid818476\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 {\*\bkmkend Text17}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0\afs15 \ltrch\fcs0 \fs15\insrsid818476\charrsid2831321 per occurrence Combined Single Limit (B.I. & P.D.)}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid13310430\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid13310430\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid13310430\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr0\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1850\clshdrawnil \cellx3290\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3391\clpadt14\clpadr14\clpadft3\clpadfr3\clshdrawnil \cellx6681\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4240\clshdrawnil \cellx10921
\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321 
This policy names the State, its officers, employees and agents}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid818476\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid818476\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid818476\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trgaph108\trrh364\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6580\clshdrawnil 
\cellx6580\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4240\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321 As additional insured }{\field\fldpriv{\*\fldinst {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321 {\*\datafield 650000001400000007436865636b333500000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check35}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid9112476\charrsid2831321  Yes   }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321 {\*\datafield 
650000001400000007436865636b333600000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check36}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid9112476\charrsid2831321  No}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid818476\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid818476\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid818476\charrsid7930344 {\*\nesttableprops\trowd \irow6\irowband6\lastrow \ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA101\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3
\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6580\clshdrawnil 
\cellx6580\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4240\clshdrawnil \cellx10820\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh2022\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2492620 {\rtlch\fcs1 \af0 
\ltrch\fcs0 \fs16\insrsid2492620\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid285584\charrsid7930344 \trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh2022\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\row \ltrrow}\trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh2649\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 
\trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \f41\insrsid12214971\charrsid2831321 D   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid12214971\charrsid2831321 WORKERS\rquote  COMPENSATION AND EMPLOYER\rquote S LIABILITY INSURANCE
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid3029616 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid3029616\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Company providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text18}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 
00000000140000000654657874313800000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text18}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6620299\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text18}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 ENDORSEMENTS  
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid6620299\charrsid2831321 US LONGSHORE & HARBOR WORKERS COVERAGE
\par AND JONES ACT:}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321       }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0 \ltrch\fcs0 
\fs16\insrsid6620299\charrsid2831321 {\*\datafield 650000001400000007436865636b333300000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check33}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Yes      }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 
 FORMCHECKBOX }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 650000001400000007436865636b333400000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check34}\ffdefres0}}}}{\fldrslt }}
\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  No}{\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 
\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh360\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2282\clshdrawnil \cellx2282\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3118\clshdrawnil \cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1448\clshdrawnil \cellx6848
\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text19}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 
00000000140000000654657874313900000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text19}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6620299\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text19}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3433\clshdrawnil \cellx6848
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text20}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 
00000000140000000654657874323000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text20}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6620299\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text20}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt
\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3433\clshdrawnil \cellx6848\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text21}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 
00000000140000000654657874323100000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text21}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6620299\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text21}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440\clvertalb\clbrdrt
\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3433\clshdrawnil \cellx6848\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 Limit}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6818022\charrsid2831321  }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 of Liability: }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 $}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text22}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\datafield 
00000000140000000654657874323200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text22}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6620299\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text22}\nestcell{\nonesttables
\par }Each accident\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt86\clpadr29\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3433\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx6848\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997
\nestrow}{\nonesttables
\par }}\pard \ltrpar\qr \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321        $}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\*\bkmkstart Text24}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321  FORMTEXT }{
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321 {\*\datafield 00000000140000000654657874323400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text24}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\lang1024\langfe1024\noproof\insrsid10313964\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6620299\charrsid2831321 {\*\bkmkend Text24}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321 Disease, each employee}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6620299\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6620299\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr58\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3433\clshdrawnil \cellx6848\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }}\pard \ltrpar\qr \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321 $\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\*\bkmkstart Text23}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321  FORMTEXT }{
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid10313964\charrsid2831321 {\*\datafield 00000000140000000654657874323300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text23}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\lang1024\langfe1024\noproof\insrsid10313964\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid10313964\charrsid2831321 {\*\bkmkend Text23}\nestcell{\nonesttables
\par }Disease, policy limit\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid10313964\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid10313964\charrsid7930344 {\*\nesttableprops\trowd \irow6\irowband6\lastrow \ltrrow
\ts11\trgaph108\trrh259\trleft0\tpvpara\tphmrg\tposxr\tposy42\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1
\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clpadt115\clpadr58\clpadft3\clpadfr3\clshdrawnil 
\cellx1440\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1975\clshdrawnil \cellx3415\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3433\clshdrawnil \cellx6848\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4149\clshdrawnil \cellx10997\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh2649\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \f41\insrsid12214971\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid12214971\charrsid7930344 
\trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh2649\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth3\trwWidth11101\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl
\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11101\clshdrawnil \cellx11163\row }\pard\plain \ltrpar\s16\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid2372871 
\rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 \b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7230380 
\par }\pard \ltrpar\s16\qc \li0\ri0\widctlpar\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid7622482 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7230380 \page }{\rtlch\fcs1 \af0\afs28 \ltrch\fcs0 \scaps\fs28\insrsid7622482\charrsid7622482 
Ó£»¨ÊÓƵ Department of Transportation 
\par Insurance Certificate
\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh263\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb
\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth9108\clshdrawnil \cellx10908\pard\plain \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 \fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid2372871 
CONTRACTOR:\cell }{\field{\*\fldinst {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid11543694  REF  Contractor }}{\fldrslt {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\lang1024\langfe1024\noproof\insrsid11543694      }}}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs19\insrsid2372871 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 
\af0 \ltrch\fcs0 \insrsid2372871 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh263\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl 
\clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth9108\clshdrawnil \cellx10908\row 
\ltrrow}\trowd \irow1\irowband1\lastrow \ltrrow\ts11\trgaph108\trrh263\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl 
\clbrdrb\brdrtbl \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrs\brdrw5 \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth9108\clshdrawnil \cellx10908\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid10099644 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid6035974 PROJECT NAME:}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs17\insrsid2372871 \cell }{\rtlch\fcs1 \af0 
\ltrch\fcs0 \fs19\insrsid2372871 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2372871 \trowd \irow1\irowband1\lastrow \ltrrow
\ts11\trgaph108\trrh263\trleft90\trkeep\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblind198\tblindtype3 \clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrtbl \clbrdrb\brdrtbl \clbrdrr\brdrtbl 
\cltxlrtb\clftsWidth3\clwWidth1710\clshdrawnil \cellx1800\clvertalb\clbrdrt\brdrs\brdrw5 \clbrdrl\brdrtbl \clbrdrb\brdrs\brdrw5 \clbrdrr\brdrtbl \cltxlrtb\clftsWidth3\clwWidth9108\clshdrawnil \cellx10908\row }\pard \ltrpar\ql \li0\ri0\sl360\slmult1
\widctlpar\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid13572198 {\rtlch\fcs1 \af0\afs12 \ltrch\fcs0 \fs12\insrsid16272621\charrsid4871891 
\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh2325\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\f41\insrsid16272621\charrsid2831321 E   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid16272621\charrsid2831321 EXCESS LIABILITY INSURANCE
\par }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\fs16\insrsid11484474\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 Company Providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text25}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 {\*\datafield 
00000000140000000654657874323500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text25}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid11484474\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 {\*\bkmkend Text25}
\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }Policy takes effect if the primary policy is impaired or exhausted}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321  and has }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 
\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11484474\charrsid2831321 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx2340\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil 
\cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 the same terms and conditions as the primary underlying coverage for the }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11484474\charrsid2831321 
\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11484474\charrsid2831321 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil 
\cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 Policy Number: \nestcell{\nonesttables
\par }{\*\bkmkstart Text26}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 {\*\datafield 
00000000140000000654657874323600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text26}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid3700452\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 {\*\bkmkend Text26}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }following:\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3700452\charrsid2831321 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA575\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt
\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx1260\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2014\clshdrawnil 
\cellx3274\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2486\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4459\clshdrawnil \cellx10219\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }  }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid14305086\charrsid2831321  {\*\bkmkstart Check42}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 
\ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 {\*\datafield 650000001400000007436865636b343200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check42}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 {\*\bkmkend Check42}  }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\b\fs16\insrsid3700452\charrsid2831321 A  }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3700452\charrsid2831321 COMPREHENSIVE GENERAL LIABILITY\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3700452\charrsid2831321 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh184\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx1260\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2014\clshdrawnil \cellx3274\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2486\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb
\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text32}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\datafield 
00000000140000000654657874333200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text32}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6818022\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\bkmkend Text32}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2831321   }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694 {\*\bkmkstart Check43} }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid11543694\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2831321 {\*\datafield 650000001400000007436865636b343300000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20
{\*\ffname Check43}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2831321 {\*\bkmkend Check43}  }{\rtlch\fcs1 
\ab\af0\afs16 \ltrch\fcs0 \b\fs16\insrsid11543694\charrsid2831321 B  }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2831321 COMPREHENSIVE AUTOMOBILE LIABILITY}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid2831321 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh184\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1269\clshdrawnil \cellx1269\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2005\clshdrawnil \cellx3274
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2495\clshdrawnil \cellx5769\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10794\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6101645\charrsid2831321 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trgaph108\trrh147\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx5760\clvmgf\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 Expiration Date: \nestcell{\nonesttables
\par }{\*\bkmkstart Text55}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 {\*\datafield 
00000000140000000654657874353500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text55}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6101645\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 {\*\bkmkend Text55}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6101645\charrsid2831321 {\*\nesttableprops\trowd \irow6\irowband6\ltrrow
\ts11\trgaph108\trrh184\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1350\clshdrawnil \cellx1350\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2070\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx5760\clvmrg\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone 
\clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6101645\charrsid2831321 {\*\nesttableprops\trowd \irow7\irowband7\ltrrow
\ts11\trgaph108\trrh184\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5760\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 Limit of Liability: $
\nestcell{\nonesttables
\par }{\*\bkmkstart Text56}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 {\*\datafield 
00000000140000000654657874353600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text56}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid6101645\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid6101645\charrsid2831321 {\*\bkmkend Text56}\nestcell{\nonesttables
\par }per occurrence\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6101645\charrsid2831321 {\*\nesttableprops\trowd \irow8\irowband8\lastrow \ltrrow
\ts11\trgaph108\trrh184\trleft0\trftsWidth1\trftsWidthB3\trftsWidthA3\trwWidthA9\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1530\clshdrawnil \cellx1530\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1890\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx5760\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb
\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth5025\clshdrawnil \cellx10785\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh2325\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0\afs6 \ltrch\fcs0 \fs6\insrsid15807361\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16272621 \trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh2325\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2100\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr
\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl
\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid8861186\charrsid2831321 F   }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid8861186\charrsid2831321 MARINE  LIABILITY INSURANCE}{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid11600093\charrsid2831321    }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \i\fs16\insrsid11600093\charrsid2831321 (required only if construction operations require marine operations}{\rtlch\fcs1 \ab\af0\afs16 
\ltrch\fcs0 \i\fs16\insrsid4749582\charrsid2831321 )}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \i\fs16\insrsid8861186\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid8861186 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid8861186\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 Company Providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text28}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 
00000000140000000654657874323800000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text28}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid3889369\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\bkmkend Text28}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid3889369\charrsid2831321      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid3889369\charrsid2831321 ENDORSEMENTS  
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid3889369\charrsid2831321  PERSONAL INJURY
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 01000000140000000000000000000000000000000000}
{\*\formfield{\fftype1\fftypetxt0\ffhps20\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  }{\rtlch\fcs1 
\af0\afs14 \ltrch\fcs0 \fs14\insrsid3889369\charrsid2831321 CONTRACTUAL LIABILITY 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid3889369\charrsid2831321  WAIVER OF SUBROGATION 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid6519921 {\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 
 FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}
\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid3889369\charrsid2831321  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid6519921 PER PROJECT AGGREGATE}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx2340\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1003\clshdrawnil \cellx6403\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2134\clshdrawnil \cellx2134\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2134\clshdrawnil \cellx4268\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2135\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text29}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 
00000000140000000654657874323900000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text29}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid3889369\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\bkmkend Text29}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx1260\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3163\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text30}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\datafield 
00000000140000000654657874333000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text30}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid3889369\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\bkmkend Text30}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1260\clshdrawnil \cellx1260\clvertalb
\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3240\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth3163\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7412528\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text54}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7412528\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7412528\charrsid2831321 {\*\datafield 
00000000140000000654657874353400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text54}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid7412528\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid7412528\charrsid2831321 {\*\bkmkend Text54}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid7412528\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid7412528\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1260\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx1260\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3240\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3163\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 Limit of Liability: $\nestcell{\nonesttables
\par }{\*\bkmkstart Text31}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 {\*\datafield 
00000000140000000654657874333100000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text31}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8926215\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 {\*\bkmkend Text31}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 per occurrence}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid3889369\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid3889369\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1620\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx1620\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3420\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2983\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 
This policy names the State, its officers, employees and agents\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid8926215\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8926215\charrsid7930344 {\*\nesttableprops\trowd \irow6\irowband6\ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6403\clshdrawnil \cellx6403
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 as additional insured: {\*\bkmkstart Check44}}
{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 {\*\datafield 
650000001400000007436865636b343400000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check44}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 {\*\bkmkend Check44} Yes    {\*\bkmkstart Check45}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 
\af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 {\*\datafield 650000001400000007436865636b343500000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check45}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect
\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8926215\charrsid2831321 {\*\bkmkend Check45} No\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid8926215\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8926215\charrsid7930344 {\*\nesttableprops\trowd \irow7\irowband7\lastrow \ltrrow
\ts11\trgaph108\trrh225\trleft0\tpvpara\tphmrg\tposxr\tposnegy-91\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3
\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6403\clshdrawnil \cellx6403
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2100\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid11484474 {\rtlch\fcs1 \af0\afs6 \ltrch\fcs0 
\fs6\insrsid15807361\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid16272621 \trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh2100\trleft-108
\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh1929\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr
\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl
\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid13179980\charrsid2831321 G}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid5839530\charrsid2831321      RAILROAD PROTECTIVE L}{
\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid13179980\charrsid2831321 IABILITY INSURANCE}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid15807361\charrsid2831321   }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \i\fs16\insrsid15807361\charrsid2831321 
 (if required by Special Provisions)}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid13179980\charrsid2831321 
\par }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid5839530\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid13179980 {\rtlch\fcs1 \af0 \ltrch\fcs0 \fs16\insrsid13179980\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 Company Providing Coverage:}{\rtlch\fcs1 \af0\afs16 
\ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text33}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text33}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\bkmkend Text33}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid6818022\charrsid2831321      }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6818022\charrsid2831321 ENDORSEMENTS  }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid6818022 
\par }{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\ul\insrsid872514\charrsid2831321 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\datafield 
650000001400000007436865636b313900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check19}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid6818022\charrsid2831321  SEVERABILITY OF INTEREST/}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 SEPARATION}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 
\fs14\insrsid6818022\charrsid2831321  OF }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2831321 INSURED}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid6818022\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2381697\charrsid2381697 
 FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2381697\charrsid2381697 {\*\datafield 650000001400000007436865636b363200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check62}\ffdefres0}}}}{\fldrslt }}
\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid2381697  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid2381697\charrsid2381697 PER PROJECT AGGREGATE}{
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3
\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx2340
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx5400\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1003\clshdrawnil \cellx6403\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3
\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2134\clshdrawnil \cellx2134
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2134\clshdrawnil \cellx4268\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2135\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 Policy Number:}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text34}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text34}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\bkmkend Text34}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3
\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2983\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 Effective Date:}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text35}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text35}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\bkmkend Text35}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3
\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440
\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2983\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 Expiration Date:}{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 
\fs16\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text36}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text36}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid6818022\charrsid2831321 {\*\bkmkend Text36}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid6818022\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid6818022\charrsid7930344 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3
\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1440\clshdrawnil \cellx1440
\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1980\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth2983\clshdrawnil \cellx6403\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4423\clshdrawnil \cellx10826\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid2831321 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 Limit of Liability: $\nestcell{\nonesttables
\par }{\*\bkmkstart Text37}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333700000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text37}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\bkmkend Text37}\nestcell{\nonesttables
\par }per occurrence, $\nestcell{\nonesttables
\par }{\*\bkmkstart Text38}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\datafield 
00000000140000000654657874333800000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text38}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid8084306\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid8084306\charrsid2831321 {\*\bkmkend Text38}\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \af0 \ltrch\fcs0 \fs18\insrsid8084306\charrsid2831321 annual aggregate\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8084306\charrsid7930344 {\*\nesttableprops\trowd \irow5\irowband5\lastrow \ltrrow
\ts11\trgaph108\trrh198\trleft0\tpvpara\tphmrg\tposxr\tposnegy-267\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10826\trftsWidthB3\trftsWidthA3\trwWidthA885\trautofit1\trpaddl108\trpaddr108\trpaddfl3
\trpaddft3\trpaddfb3\trpaddfr3\tabsnoovrlp1\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1620\clshdrawnil \cellx1620\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb
\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1402\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx4822\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth1298\clshdrawnil \cellx6120\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3821\clshdrawnil \cellx9941\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh1929\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx360\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs6 \ltrch\fcs0 
\f41\fs6\insrsid474937\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid11684128 \trowd \irow2\irowband2\ltrrow
\ts11\trgaph108\trrh1929\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\row \ltrrow}\trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh3603\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 
\trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 \trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 
\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid5839530 {\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid5839530\charrsid2831321 H}{\rtlch\fcs1 \af0 \ltrch\fcs0 \f41\insrsid3348989\charrsid2831321  }{\rtlch\fcs1 
\af0\afs18 \ltrch\fcs0 \f41\fs18\insrsid3348989\charrsid2831321   }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \b\fs18\insrsid3348989\charrsid2831321 POLLUTION LIABILITY}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid3348989\charrsid2831321  INSURANCE
\par \tab \tab \tab \tab \tab \tab \tab \tab \tab      }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \fs18\ul\insrsid3348989\charrsid2831321 ENDORS}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \fs18\ul\insrsid1002363 E}{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\fs18\ul\insrsid3348989\charrsid2831321 MENTS}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid3348989\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Company Providing Coverage:
\nestcell{\nonesttables
\par }{\*\bkmkstart Text42}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text42}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194
\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 {\*\bkmkend Text42}
\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }{\*\bkmkstart Check50}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
650000001400000007436865636b353000000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check50}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid2361921\charrsid2831321 {\*\bkmkend Check50} BODILY INJURY AND PRO}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 PERTY DAMAGE}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 
\fs14\insrsid2361921\charrsid2831321 
\par {\*\bkmkstart Check51}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check51}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 {\*\bkmkend Check51} NATURAL RESOURCES DAMAGE
\par {\*\bkmkstart Check52}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check52}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check52} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 ENVIRONMENTAL CLEAN UP INCLUDING}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321  }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 RESTORATION
\par {\*\bkmkstart Check53}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353300000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check53}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check53} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 LEGAL DEFENSE}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check54}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353400000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check54}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid14033439 {\*\bkmkend Check54} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 TRANSPORTATION OF WASTE FROM THE PROJECT LIMITS}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check55}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353500000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check55}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check55} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid1002363 DISPOSAL LIABILITY}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check56}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353600000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check56}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check56} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid1002363 WAIVER OF SUBROGATION}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check57}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353700000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check57}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check57} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694 SEVERABILITY OF INTEREST/SEPARATION OF INSURED}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 
\fs14\insrsid12220285\charrsid2831321 
\par }{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2381697  FORMCHECKBOX }{\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694\charrsid2381697 {\*\datafield 
650000001400000007436865636b363200000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check62}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \fs16\insrsid11543694  }{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694\charrsid2381697 PER PROJECT AGGREGATE}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694 \line }{\rtlch\fcs1 \ab\af0\afs14 
\ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 
\par }{\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 \fs18\insrsid12220285\charrsid14033439 The policy does }{\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 \fs18\ul\insrsid12220285\charrsid14033439 not}{\rtlch\fcs1 \ab\af0\afs18 \ltrch\fcs0 
\fs18\insrsid12220285\charrsid14033439  contain exclusions or limitations for:
\par {\*\bkmkstart Check58}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353800000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check58}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check58} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 LIABILITIES ASSUMED}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check59}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b353900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check59}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check59} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 LEAD, SILICA, ASBESTOS
\par {\*\bkmkstart Check60}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b363000000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check60}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check60} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 UNDERGROUND STORAGE TANKS}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid12220285\charrsid2831321 
\par {\*\bkmkstart Check61}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\datafield 
650000001400000007436865636b363100000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check61}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 {\*\bkmkend Check61} }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 INSURED VS. INSURED EX}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 
\fs14\insrsid11543694 CL}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 USION THAT RESTRICTS}{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321 
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid11543694 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid12220285\charrsid2831321       }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 
\fs14\insrsid12220285\charrsid2831321 COVERAGE TO THE STATE }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid2381697 \line }{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \fs14\insrsid12220285\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trqr\trgaph108\trrh232\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid14033439\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2339\clshdrawnil \cellx2339\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3059\clshdrawnil \cellx5398
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1098\clshdrawnil \cellx6496\clvmgf\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clpadt115\clpadr43\clpadft3\clpadfr3\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow1\irowband1\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3246\clshdrawnil \cellx3246\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3250\clshdrawnil \cellx6496
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Policy Number:\nestcell{\nonesttables
\par }{\*\bkmkstart Text46}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343600000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text46}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Text46}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow2\irowband2\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1439\clshdrawnil \cellx1439\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1983\clshdrawnil \cellx3422
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3074\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Effective Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text45}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343500000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text45}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Text45}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow3\irowband3\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1439\clshdrawnil \cellx1439\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1983\clshdrawnil 
\cellx3422\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3074\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Expiration Date:\nestcell{\nonesttables
\par }{\*\bkmkstart Text44}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343400000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text44}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Text44}\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow4\irowband4\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1439\clshdrawnil \cellx1439\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1983\clshdrawnil 
\cellx3422\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3074\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Limit of Liability: $\nestcell{\nonesttables
\par }{\*\bkmkstart Text43}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text43}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Text43}\nestcell{\nonesttables
\par }per occurrence\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow5\irowband5\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1622\clshdrawnil \cellx1622\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil \cellx3422
\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3074\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321                                $
\nestcell{\nonesttables
\par }{\*\bkmkstart Text47}}{\field{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
00000000140000000654657874343700000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text47}}}}}{\fldrslt {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\lang1024\langfe1024\noproof\insrsid2361921\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Text47}\nestcell{\nonesttables
\par }aggregate\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow6\irowband6\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1622\clshdrawnil \cellx1622\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1800\clshdrawnil 
\cellx3422\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3074\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone 
\cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 Policy is written on the following basis:
\nestcell{\nonesttables
\par }\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow7\irowband7\ltrrow
\ts11\trqr\trgaph108\trrh226\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalb\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3246\clshdrawnil \cellx3246\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth3250\clshdrawnil \cellx6496
\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil \cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \b\fs16\insrsid2361921\charrsid2831321        {\*\bkmkstart Check46}}
{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
650000001400000007436865636b343600000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check46}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Check46} Occurrence form, and completed operations coverage to be provided for no less than\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow8\irowband8\ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321              2 years after Acceptance
\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow9\irowband9\ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321        {\*\bkmkstart Check47}}{\field\fldpriv{\*\fldinst 
{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 650000001400000007436865636b343700000000000000000000000000}
{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check47}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 
\fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Check47} Claims made, and Extended Reporting Provision coverage to be maintained for no\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow10\irowband10\ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321              less than 2 years after Acceptance
\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow11\irowband11\ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 
This policy names the State, its officers, employees and agents\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow12\irowband12\ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid5839530 {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 As additional insured:   {\*\bkmkstart Check48}}
{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMCHECKBOX }{\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 
650000001400000007436865636b343800000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check48}\ffdefres0}}}}{\fldrslt }}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Check48} Yes    {\*\bkmkstart Check49}}{\field\fldpriv{\*\fldinst {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321  FORMCHECKBOX }{
\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\datafield 650000001400000007436865636b343900000000000000000000000000}{\*\formfield{\fftype1\ffres25\fftypetxt0\ffhps20{\*\ffname Check49}\ffdefres0}}}}{\fldrslt }}
\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \ab\af0\afs16 \ltrch\fcs0 \fs16\insrsid2361921\charrsid2831321 {\*\bkmkend Check49} No\nestcell{\nonesttables
\par }}{\rtlch\fcs1 \ab\af0\afs14 \ltrch\fcs0 \b\fs14\insrsid2361921\charrsid2831321 \nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2361921\charrsid2831321 {\*\nesttableprops\trowd \irow13\irowband13\lastrow \ltrrow
\ts11\trqr\trgaph108\trrh130\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone 
\clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth6496\clshdrawnil \cellx6496\clvmrg\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth4304\clshdrawnil 
\cellx10800\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh3603\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2361921 {\rtlch\fcs1 \ab\af0 \ltrch\fcs0 
\b\fs18\insrsid3348989\charrsid2831321 \tab }{\rtlch\fcs1 \ab\af0 \ltrch\fcs0 \b\fs18\insrsid5839530\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 
\insrsid5839530 \trowd \irow3\irowband3\lastrow \ltrrow\ts11\trgaph108\trrh3603\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 \trbrdrh\brdrs\brdrw10 \trbrdrv\brdrs\brdrw10 
\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb
\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth11016\clshdrawnil \cellx10908\row }\pard \ltrpar\ql \li0\ri0\widctlpar\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid3099455 {\rtlch\fcs1 \af0\afs16 
\ltrch\fcs0 \fs16\insrsid2510068\charrsid7622482 
\par \ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh900\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmgf\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7380\clshdrawnil \cellx10800\pard \ltrpar\qc \li0\ri0\widctlpar\intbl
\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \b\fs22\ul\insrsid2501028\charrsid2831321 Certificate Holder
\par }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs6 \ltrch\fcs0 \fs6\insrsid2501028\charrsid2831321 
\par }\pard \ltrpar\qj \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 

\par }\pard\plain \ltrpar\s16\ql \li0\ri0\sl360\slmult1\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 \rtlch\fcs1 \ab\af0\afs24\alang1025 \ltrch\fcs0 
\b\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs16 \ltrch\fcs0 \b0\scaps\fs16\insrsid2501028\charrsid2831321 Ó£»¨ÊÓƵ Department of Transportation 
\par Regional Construction Engineer
\par }\pard\plain \ltrpar\ql \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid15296695 \rtlch\fcs1 \af0\afs24\alang1025 \ltrch\fcs0 
\fs24\lang1033\langfe1033\cgrid\langnp1033\langfenp1033 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 Address:\nestcell{\nonesttables
\par }{\*\bkmkstart Text39}}{\field\flddirty{\*\fldinst {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 {\*\datafield 
00000000140000000654657874333900000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text39}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang1024\langfe1024\noproof\insrsid2501028\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 {\*\bkmkend Text39}\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2501028\charrsid2831321 {\*\nesttableprops\trowd \irow0\irowband0\ltrrow
\ts11\trgaph108\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone 
\clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx1080\clvertalt\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2217\clshdrawnil \cellx3297
\nestrow}{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2\pararsid15296695 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 
\fs20\insrsid2501028\charrsid2831321 \nestcell{\nonesttables
\par }{\*\bkmkstart Text40}}{\field\flddirty{\*\fldinst {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 {\*\datafield 
00000000140000000654657874343000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text40}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\lang1024\langfe1024\noproof\insrsid2501028\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 {\*\bkmkend Text40}\nestcell{\nonesttables
\par }}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap2 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2501028\charrsid2831321 {\*\nesttableprops\trowd \irow1\irowband1\lastrow \ltrrow
\ts11\trgaph108\trrh452\trleft0\trftsWidth1\trftsWidthB3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol\tblind0\tblindtype3 \clvertalt\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx1080\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2217\clshdrawnil \cellx3297
\nestrow}{\nonesttables
\par }\ltrrow}\trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh900\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmgf\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7380\clshdrawnil \cellx10800\pard \ltrpar\ql \li0\ri0\sl360\slmult1\widctlpar\intbl
\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs20 \ltrch\fcs0 \fs20\insrsid2501028\charrsid2831321 \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 
I certify that I am an authorized representative for each of the above indicated insurance
\par Companies, and that all policies have been endorsed to require written notice of cancellation or non-renewal to the named Certificate Holder, 30 days prior to cancellation or expiration of the policy.\cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2501028\charrsid2831321 \trowd \irow0\irowband0\ltrrow\ts11\trgaph108\trrh900\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmgf\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalt\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl 
\clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth7380\clshdrawnil \cellx10800\row \ltrrow}\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh180\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx7920\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx10260\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx10800\pard \ltrpar\qc \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0\afs22 \ltrch\fcs0 \b\fs22\ul\insrsid8855350\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 
\af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321 Company:\cell {\*\bkmkstart Text48}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\datafield 00000000140000000654657874343800000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text48}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\lang1024\langfe1024\noproof\insrsid8855350\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\bkmkend Text48}\cell \cell \cell {\*\bkmkstart Text51}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\datafield 00000000140000000654657874353100000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text51}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\lang1024\langfe1024\noproof\insrsid8855350\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\bkmkend Text51}\cell \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8855350\charrsid2831321 
\trowd \irow1\irowband1\ltrrow\ts11\trgaph108\trrh180\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx7920\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2340\clshdrawnil \cellx10260\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx10800\row \ltrrow}\trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh153\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrtbl \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7740\clvertalt
\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx10800\pard \ltrpar\qc \li0\ri0\widctlpar\intbl
\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \b\fs22\ul\insrsid2501028\charrsid2831321 \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 Address:\cell 
{\*\bkmkstart Text49}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 {\*\datafield 
00000000140000000654657874343900000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text49}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\lang1024\langfe1024\noproof\insrsid2501028\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 {\*\bkmkend Text49}\cell \cell \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid11543694 {\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid2501028\charrsid2831321                           
}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid11543694 S}{\rtlch\fcs1 \af0\afs14 \ltrch\fcs0 \fs14\insrsid2501028\charrsid2831321 ignature\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {
\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2501028\charrsid2831321 \trowd \irow2\irowband2\ltrrow\ts11\trgaph108\trrh153\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrtbl \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7740\clvertalt
\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3060\clshdrawnil \cellx10800\row \ltrrow}\trowd \irow3\irowband3\ltrrow\ts11\trgaph108\trrh117\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl
\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx8100\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2160\clshdrawnil \cellx10260\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx10800\pard \ltrpar\qc \li0\ri0\widctlpar\intbl\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 
\af0\afs22 \ltrch\fcs0 \b\fs22\ul\insrsid8855350\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 
\af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321 \cell {\*\bkmkstart Text50}}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\datafield 00000000140000000654657874353000000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text50}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\lang1024\langfe1024\noproof\insrsid8855350\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\bkmkend Text50}\cell \cell Name:\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\brdrb\brdrs\brdrw10 
\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\*\bkmkstart Text52}{\field{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321  FORMTEXT }{
\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321 {\*\datafield 00000000140000000654657874353200000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text52}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\lang1024\langfe1024\noproof\insrsid8855350\charrsid2831321 \u8194\'20\u8194\'20\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 
\fs18\insrsid8855350\charrsid2831321 {\*\bkmkend Text52}\cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 \af0\afs18 
\ltrch\fcs0 \fs18\insrsid8855350\charrsid2831321 \cell }\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid8855350\charrsid2831321 \trowd \irow3\irowband3\ltrrow
\ts11\trgaph108\trrh117\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid2831321\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrtbl \clbrdrr
\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrnone \clbrdrl
\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth360\clshdrawnil \cellx7380\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth720\clshdrawnil \cellx8100\clvertalb
\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrnone \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2160\clshdrawnil \cellx10260\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrtbl \clbrdrr\brdrs\brdrw10 
\cltxlrtb\clftsWidth3\clwWidth540\clshdrawnil \cellx10800\row \ltrrow}\trowd \irow4\irowband4\lastrow \ltrrow\ts11\trgaph108\trrh248\trleft-108\trbrdrt\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid15296695\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrtbl 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx7848\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1476\clshdrawnil 
\cellx9324\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1476\clshdrawnil \cellx10800\pard \ltrpar\qc \li0\ri0\widctlpar\intbl
\tx1080\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2831321 {\rtlch\fcs1 \af0\afs22 \ltrch\fcs0 \b\fs22\ul\insrsid2501028\charrsid2831321 \cell }\pard \ltrpar
\ql \li0\ri0\widctlpar\intbl\pvpara\phmrg\posy18\dxfrtext180\dfrmtxtx180\dfrmtxty0\wraparound\aspalpha\aspnum\faauto\adjustright\rin0\lin0\pararsid2501028 {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 Phone:\cell 
{\*\bkmkstart Text53}}{\field\flddirty{\*\fldinst {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321  FORMTEXT }{\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 {\*\datafield 
00000000140000000654657874353300000000000000000000000000}{\*\formfield{\fftype0\fftypetxt0\ffhps20{\*\ffname Text53}}}}}{\fldrslt {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\lang1024\langfe1024\noproof\insrsid2501028\charrsid2831321 \u8194\'20\u8194\'20
\u8194\'20\u8194\'20\u8194\'20}}}\sectd \ltrsect\linex0\headery360\endnhere\sectlinegrid360\sectdefaultcl\sectrsid9325396\sftnbj {\rtlch\fcs1 \af0\afs18 \ltrch\fcs0 \fs18\insrsid2501028\charrsid2831321 {\*\bkmkend Text53}\cell \cell \cell \cell 
}\pard \ltrpar\ql \li0\ri0\widctlpar\intbl\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid2501028\charrsid2831321 \trowd \irow4\irowband4\lastrow \ltrrow\ts11\trgaph108\trrh248\trleft-108\trbrdrt
\brdrs\brdrw10 \trbrdrl\brdrs\brdrw10 \trbrdrb\brdrs\brdrw10 \trbrdrr\brdrs\brdrw10 
\tpvpara\tphmrg\tposy18\tdfrmtxtLeft180\tdfrmtxtRight180\trftsWidth3\trwWidth10908\trftsWidthB3\trftsWidthA3\trautofit1\trpaddl108\trpaddr108\trpaddfl3\trpaddft3\trpaddfb3\trpaddfr3\tblrsid15296695\tbllkhdrrows\tbllklastrow\tbllkhdrcols\tbllklastcol
\tblind0\tblindtype3 \clvmrg\clvertalt\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth3528\clshdrawnil \cellx3420\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrs\brdrw10 \clbrdrb\brdrs\brdrw10 
\clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1080\clshdrawnil \cellx4500\clvertalb\clbrdrt\brdrs\brdrw10 \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth2520\clshdrawnil \cellx7020\clvertalb\clbrdrt\brdrtbl 
\clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth828\clshdrawnil \cellx7848\clvertalb\clbrdrt\brdrnone \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrnone \cltxlrtb\clftsWidth3\clwWidth1476\clshdrawnil 
\cellx9324\clvertalb\clbrdrt\brdrtbl \clbrdrl\brdrnone \clbrdrb\brdrs\brdrw10 \clbrdrr\brdrs\brdrw10 \cltxlrtb\clftsWidth3\clwWidth1476\clshdrawnil \cellx10800\row }\pard \ltrpar\ql \li0\ri0\widctlpar
\tx1080\wrapdefault\aspalpha\aspnum\faauto\adjustright\rin0\lin0\itap0\pararsid4871891 {\rtlch\fcs1 \af0 \ltrch\fcs0 \insrsid15935419\charrsid474937 
\par }{\*\themedata 504b030414000600080000002100e9de0fbfff0000001c020000130000005b436f6e74656e745f54797065735d2e786d6cac91cb4ec3301045f748fc83e52d4a
9cb2400825e982c78ec7a27cc0c8992416c9d8b2a755fbf74cd25442a820166c2cd933f79e3be372bd1f07b5c3989ca74aaff2422b24eb1b475da5df374fd9ad
5689811a183c61a50f98f4babebc2837878049899a52a57be670674cb23d8e90721f90a4d2fa3802cb35762680fd800ecd7551dc18eb899138e3c943d7e503b6
b01d583deee5f99824e290b4ba3f364eac4a430883b3c092d4eca8f946c916422ecab927f52ea42b89a1cd59c254f919b0e85e6535d135a8de20f20b8c12c3b0
0c895fcf6720192de6bf3b9e89ecdbd6596cbcdd8eb28e7c365ecc4ec1ff1460f53fe813d3cc7f5b7f020000ffff0300504b030414000600080000002100a5d6
a7e7c0000000360100000b0000005f72656c732f2e72656c73848fcf6ac3300c87ef85bd83d17d51d2c31825762fa590432fa37d00e1287f68221bdb1bebdb4f
c7060abb0884a4eff7a93dfeae8bf9e194e720169aaa06c3e2433fcb68e1763dbf7f82c985a4a725085b787086a37bdbb55fbc50d1a33ccd311ba548b6309512
0f88d94fbc52ae4264d1c910d24a45db3462247fa791715fd71f989e19e0364cd3f51652d73760ae8fa8c9ffb3c330cc9e4fc17faf2ce545046e37944c69e462
a1a82fe353bd90a865aad41ed0b5b8f9d6fd010000ffff0300504b0304140006000800000021006b799616830000008a0000001c0000007468656d652f746865
6d652f7468656d654d616e616765722e786d6c0ccc4d0ac3201040e17da17790d93763bb284562b2cbaebbf600439c1a41c7a0d29fdbd7e5e38337cedf14d59b
4b0d592c9c070d8a65cd2e88b7f07c2ca71ba8da481cc52c6ce1c715e6e97818c9b48d13df49c873517d23d59085adb5dd20d6b52bd521ef2cdd5eb9246a3d8b
4757e8d3f729e245eb2b260a0238fd010000ffff0300504b03041400060008000000210096b5ade296060000501b0000160000007468656d652f7468656d652f
7468656d65312e786d6cec594f6fdb3614bf0fd87720746f6327761a07758ad8b19b2d4d1bc46e871e698996d850a240d2497d1bdae38001c3ba618715d86d87
615b8116d8a5fb34d93a6c1dd0afb0475292c5585e9236d88aad3e2412f9e3fbff1e1fa9abd7eec70c1d1221294fda5efd72cd4324f1794093b0eddd1ef62fad
79482a9c0498f184b4bd2991deb58df7dfbb8ad755446282607d22d771db8b944ad79796a40fc3585ee62949606ecc458c15bc8a702910f808e8c66c69b9565b
5d8a314d3c94e018c8de1a8fa94fd05093f43672e23d06af89927ac06762a049136785c10607758d9053d965021d62d6f6804fc08f86e4bef210c352c144dbab
999fb7b4717509af678b985ab0b6b4ae6f7ed9ba6c4170b06c788a705430adf71bad2b5b057d03606a1ed7ebf5babd7a41cf00b0ef83a6569632cd467faddec9
699640f6719e76b7d6ac355c7c89feca9cccad4ea7d36c65b258a206641f1b73f8b5da6a6373d9c11b90c537e7f08dce66b7bbeae00dc8e257e7f0fd2badd586
8b37a088d1e4600ead1ddaef67d40bc898b3ed4af81ac0d76a197c86826828a24bb318f3442d8ab518dfe3a20f000d6458d104a9694ac6d88728eee2782428d6
0cf03ac1a5193be4cbb921cd0b495fd054b5bd0f530c1931a3f7eaf9f7af9e3f45c70f9e1d3ff8e9f8e1c3e3073f5a42ceaa6d9c84e5552fbffdeccfc71fa33f
9e7ef3f2d117d57859c6fffac327bffcfc793510d26726ce8b2f9ffcf6ecc98baf3efdfdbb4715f04d814765f890c644a29be408edf3181433567125272371be
15c308d3f28acd249438c19a4b05fd9e8a1cf4cd296699771c393ac4b5e01d01e5a30a787d72cf1178108989a2159c77a2d801ee72ce3a5c545a6147f32a9979
3849c26ae66252c6ed637c58c5bb8b13c7bfbd490a75330f4b47f16e441c31f7184e140e494214d273fc80900aedee52ead87597fa824b3e56e82e451d4c2b4d
32a423279a668bb6690c7e9956e90cfe766cb37b077538abd27a8b1cba48c80acc2a841f12e698f13a9e281c57911ce298950d7e03aba84ac8c154f8655c4f2a
f074481847bd804859b5e696007d4b4edfc150b12addbecba6b18b148a1e54d1bc81392f23b7f84137c2715a851dd0242a633f900710a218ed715505dfe56e86
e877f0034e16bafb0e258ebb4faf06b769e888340b103d3311da9750aa9d0a1cd3e4efca31a3508f6d0c5c5c398602f8e2ebc71591f5b616e24dd893aa3261fb
44f95d843b5974bb5c04f4edafb95b7892ec1108f3f98de75dc97d5772bdff7cc95d94cf672db4b3da0a6557f70db629362d72bcb0431e53c6066acac80d699a
6409fb44d08741bdce9c0e4971624a2378cceaba830b05366b90e0ea23aaa241845368b0eb9e2612ca8c742851ca251ceccc70256d8d87265dd96361531f186c
3d9058edf2c00eafe8e1fc5c509031bb4d680e9f39a3154de0accc56ae644441edd76156d7429d995bdd88664a9dc3ad50197c38af1a0c16d684060441db0256
5e85f3b9660d0713cc48a0ed6ef7dedc2dc60b17e92219e180643ed27acffba86e9c94c78ab90980d8a9f0913ee49d62b512b79626fb06dccee2a432bbc60276
b9f7dec44b7904cfbca4f3f6443ab2a49c9c2c41476dafd55c6e7ac8c769db1bc399161ee314bc2e75cf8759081743be1236ec4f4d6693e5336fb672c5dc24a8
c33585b5fb9cc24e1d4885545b58463634cc5416022cd19cacfccb4d30eb45296023fd35a458598360f8d7a4003bbaae25e331f155d9d9a5116d3bfb9a95523e
51440ca2e0088dd844ec6370bf0e55d027a012ae264c45d02f708fa6ad6da6dce29c255df9f6cae0ec38666984b372ab5334cf640b37795cc860de4ae2816e95
b21be5ceaf8a49f90b52a51cc6ff3355f47e0237052b81f6800fd7b802239daf6d8f0b1571a8426944fdbe80c6c1d40e8816b88b8569082ab84c36ff0539d4ff
6dce591a26ade1c0a7f669880485fd484582903d284b26fa4e2156cff62e4b9265844c4495c495a9157b440e091bea1ab8aaf7760f4510eaa69a6465c0e04ec6
9ffb9e65d028d44d4e39df9c1a52ecbd3607fee9cec7263328e5d661d3d0e4f62f44acd855ed7ab33cdf7bcb8ae889599bd5c8b3029895b6825696f6af29c239
b75a5bb1e6345e6ee6c28117e73586c1a2214ae1be07e93fb0ff51e133fb65426fa843be0fb515c187064d0cc206a2fa926d3c902e907670048d931db4c1a449
59d366ad93b65abe595f70a75bf03d616c2dd959fc7d4e6317cd99cbcec9c58b34766661c7d6766ca1a9c1b327531486c6f941c638c67cd22a7f75e2a37be0e8
2db8df9f30254d30c1372581a1f51c983c80e4b71ccdd28dbf000000ffff0300504b0304140006000800000021000dd1909fb60000001b010000270000007468
656d652f7468656d652f5f72656c732f7468656d654d616e616765722e786d6c2e72656c73848f4d0ac2301484f78277086f6fd3ba109126dd88d0add40384e4
350d363f2451eced0dae2c082e8761be9969bb979dc9136332de3168aa1a083ae995719ac16db8ec8e4052164e89d93b64b060828e6f37ed1567914b284d2624
52282e3198720e274a939cd08a54f980ae38a38f56e422a3a641c8bbd048f7757da0f19b017cc524bd62107bd5001996509affb3fd381a89672f1f165dfe5141
73d9850528a2c6cce0239baa4c04ca5bbabac4df000000ffff0300504b01022d0014000600080000002100e9de0fbfff0000001c020000130000000000000000
0000000000000000005b436f6e74656e745f54797065735d2e786d6c504b01022d0014000600080000002100a5d6a7e7c0000000360100000b00000000000000
000000000000300100005f72656c732f2e72656c73504b01022d00140006000800000021006b799616830000008a0000001c0000000000000000000000000019
0200007468656d652f7468656d652f7468656d654d616e616765722e786d6c504b01022d001400060008000000210096b5ade296060000501b00001600000000
000000000000000000d60200007468656d652f7468656d652f7468656d65312e786d6c504b01022d00140006000800000021000dd1909fb60000001b01000027
00000000000000000000000000a00900007468656d652f7468656d652f5f72656c732f7468656d654d616e616765722e786d6c2e72656c73504b050600000000050005005d0100009b0a00000000}
{\*\colorschememapping 3c3f786d6c2076657273696f6e3d22312e302220656e636f64696e673d225554462d3822207374616e64616c6f6e653d22796573223f3e0d0a3c613a636c724d
617020786d6c6e733a613d22687474703a2f2f736368656d61732e6f70656e786d6c666f726d6174732e6f72672f64726177696e676d6c2f323030362f6d6169
6e22206267313d226c743122207478313d22646b3122206267323d226c743222207478323d22646b322220616363656e74313d22616363656e74312220616363
656e74323d22616363656e74322220616363656e74333d22616363656e74332220616363656e74343d22616363656e74342220616363656e74353d22616363656e74352220616363656e74363d22616363656e74362220686c696e6b3d22686c696e6b2220666f6c486c696e6b3d22666f6c486c696e6b222f3e}
{\*\latentstyles\lsdstimax371\lsdlockeddef0\lsdsemihiddendef0\lsdunhideuseddef0\lsdqformatdef0\lsdprioritydef0{\lsdlockedexcept \lsdqformat1 \lsdlocked0 Normal;\lsdqformat1 \lsdlocked0 heading 1;\lsdqformat1 \lsdlocked0 heading 2;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 3;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 4;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 5;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 6;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 7;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 8;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 heading 9;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 6;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 7;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 8;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index 9;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 6;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 7;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 8;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toc 9;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal Indent;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footnote text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation text;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 header;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footer;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 index heading;\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdlocked0 caption;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 table of figures;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 envelope address;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 envelope return;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 footnote reference;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation reference;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 line number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 page number;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 endnote reference;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 endnote text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 table of authorities;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 macro;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 toa heading;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Bullet 5;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Number 5;
\lsdqformat1 \lsdlocked0 Title;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Closing;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Signature;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Default Paragraph Font;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 2;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 4;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 List Continue 5;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Message Header;
\lsdqformat1 \lsdlocked0 Subtitle;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text First Indent 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Note Heading;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text 2;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Body Text Indent 3;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Block Text;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Hyperlink;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 FollowedHyperlink;\lsdqformat1 \lsdlocked0 Strong;\lsdqformat1 \lsdlocked0 Emphasis;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Document Map;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Plain Text;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 E-mail Signature;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Top of Form;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Bottom of Form;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Normal (Web);\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Acronym;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Address;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Cite;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Code;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Definition;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Keyboard;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Preformatted;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Sample;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Typewriter;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 HTML Variable;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 annotation subject;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 No List;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 1;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 2;\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Outline List 3;
\lsdsemihidden1 \lsdunhideused1 \lsdlocked0 Balloon Text;\lsdsemihidden1 \lsdpriority99 \lsdlocked0 Placeholder Text;\lsdqformat1 \lsdpriority1 \lsdlocked0 No Spacing;\lsdpriority60 \lsdlocked0 Light Shading;\lsdpriority61 \lsdlocked0 Light List;
\lsdpriority62 \lsdlocked0 Light Grid;\lsdpriority63 \lsdlocked0 Medium Shading 1;\lsdpriority64 \lsdlocked0 Medium Shading 2;\lsdpriority65 \lsdlocked0 Medium List 1;\lsdpriority66 \lsdlocked0 Medium List 2;\lsdpriority67 \lsdlocked0 Medium Grid 1;
\lsdpriority68 \lsdlocked0 Medium Grid 2;\lsdpriority69 \lsdlocked0 Medium Grid 3;\lsdpriority70 \lsdlocked0 Dark List;\lsdpriority71 \lsdlocked0 Colorful Shading;\lsdpriority72 \lsdlocked0 Colorful List;\lsdpriority73 \lsdlocked0 Colorful Grid;
\lsdpriority60 \lsdlocked0 Light Shading Accent 1;\lsdpriority61 \lsdlocked0 Light List Accent 1;\lsdpriority62 \lsdlocked0 Light Grid Accent 1;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 1;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 1;
\lsdpriority65 \lsdlocked0 Medium List 1 Accent 1;\lsdsemihidden1 \lsdpriority99 \lsdlocked0 Revision;\lsdqformat1 \lsdpriority34 \lsdlocked0 List Paragraph;\lsdqformat1 \lsdpriority29 \lsdlocked0 Quote;
\lsdqformat1 \lsdpriority30 \lsdlocked0 Intense Quote;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 1;\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 1;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 1;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 1;
\lsdpriority70 \lsdlocked0 Dark List Accent 1;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 1;\lsdpriority72 \lsdlocked0 Colorful List Accent 1;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 1;\lsdpriority60 \lsdlocked0 Light Shading Accent 2;
\lsdpriority61 \lsdlocked0 Light List Accent 2;\lsdpriority62 \lsdlocked0 Light Grid Accent 2;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 2;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 2;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 2;
\lsdpriority66 \lsdlocked0 Medium List 2 Accent 2;\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 2;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 2;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 2;\lsdpriority70 \lsdlocked0 Dark List Accent 2;
\lsdpriority71 \lsdlocked0 Colorful Shading Accent 2;\lsdpriority72 \lsdlocked0 Colorful List Accent 2;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 2;\lsdpriority60 \lsdlocked0 Light Shading Accent 3;\lsdpriority61 \lsdlocked0 Light List Accent 3;
\lsdpriority62 \lsdlocked0 Light Grid Accent 3;\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 3;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 3;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 3;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 3;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 3;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 3;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 3;\lsdpriority70 \lsdlocked0 Dark List Accent 3;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 3;
\lsdpriority72 \lsdlocked0 Colorful List Accent 3;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 3;\lsdpriority60 \lsdlocked0 Light Shading Accent 4;\lsdpriority61 \lsdlocked0 Light List Accent 4;\lsdpriority62 \lsdlocked0 Light Grid Accent 4;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 4;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 4;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 4;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 4;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 4;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 4;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 4;\lsdpriority70 \lsdlocked0 Dark List Accent 4;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 4;
\lsdpriority72 \lsdlocked0 Colorful List Accent 4;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 4;\lsdpriority60 \lsdlocked0 Light Shading Accent 5;\lsdpriority61 \lsdlocked0 Light List Accent 5;\lsdpriority62 \lsdlocked0 Light Grid Accent 5;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 5;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 5;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 5;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 5;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 5;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 5;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 5;\lsdpriority70 \lsdlocked0 Dark List Accent 5;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 5;
\lsdpriority72 \lsdlocked0 Colorful List Accent 5;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 5;\lsdpriority60 \lsdlocked0 Light Shading Accent 6;\lsdpriority61 \lsdlocked0 Light List Accent 6;\lsdpriority62 \lsdlocked0 Light Grid Accent 6;
\lsdpriority63 \lsdlocked0 Medium Shading 1 Accent 6;\lsdpriority64 \lsdlocked0 Medium Shading 2 Accent 6;\lsdpriority65 \lsdlocked0 Medium List 1 Accent 6;\lsdpriority66 \lsdlocked0 Medium List 2 Accent 6;
\lsdpriority67 \lsdlocked0 Medium Grid 1 Accent 6;\lsdpriority68 \lsdlocked0 Medium Grid 2 Accent 6;\lsdpriority69 \lsdlocked0 Medium Grid 3 Accent 6;\lsdpriority70 \lsdlocked0 Dark List Accent 6;\lsdpriority71 \lsdlocked0 Colorful Shading Accent 6;
\lsdpriority72 \lsdlocked0 Colorful List Accent 6;\lsdpriority73 \lsdlocked0 Colorful Grid Accent 6;\lsdqformat1 \lsdpriority19 \lsdlocked0 Subtle Emphasis;\lsdqformat1 \lsdpriority21 \lsdlocked0 Intense Emphasis;
\lsdqformat1 \lsdpriority31 \lsdlocked0 Subtle Reference;\lsdqformat1 \lsdpriority32 \lsdlocked0 Intense Reference;\lsdqformat1 \lsdpriority33 \lsdlocked0 Book Title;\lsdsemihidden1 \lsdunhideused1 \lsdpriority37 \lsdlocked0 Bibliography;
\lsdsemihidden1 \lsdunhideused1 \lsdqformat1 \lsdpriority39 \lsdlocked0 TOC Heading;\lsdpriority41 \lsdlocked0 Plain Table 1;\lsdpriority42 \lsdlocked0 Plain Table 2;\lsdpriority43 \lsdlocked0 Plain Table 3;\lsdpriority44 \lsdlocked0 Plain Table 4;
\lsdpriority45 \lsdlocked0 Plain Table 5;\lsdpriority40 \lsdlocked0 Grid Table Light;\lsdpriority46 \lsdlocked0 Grid Table 1 Light;\lsdpriority47 \lsdlocked0 Grid Table 2;\lsdpriority48 \lsdlocked0 Grid Table 3;\lsdpriority49 \lsdlocked0 Grid Table 4;
\lsdpriority50 \lsdlocked0 Grid Table 5 Dark;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 1;
\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 1;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 1;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 1;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 1;
\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 1;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 2;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 2;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 2;
\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 2;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 2;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 2;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 2;
\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 3;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 3;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 3;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 3;
\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 3;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 3;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 3;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 4;
\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 4;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 4;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 4;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 4;
\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 4;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 4;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 5;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 5;
\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 5;\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 5;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 5;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 5;
\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 5;\lsdpriority46 \lsdlocked0 Grid Table 1 Light Accent 6;\lsdpriority47 \lsdlocked0 Grid Table 2 Accent 6;\lsdpriority48 \lsdlocked0 Grid Table 3 Accent 6;
\lsdpriority49 \lsdlocked0 Grid Table 4 Accent 6;\lsdpriority50 \lsdlocked0 Grid Table 5 Dark Accent 6;\lsdpriority51 \lsdlocked0 Grid Table 6 Colorful Accent 6;\lsdpriority52 \lsdlocked0 Grid Table 7 Colorful Accent 6;
\lsdpriority46 \lsdlocked0 List Table 1 Light;\lsdpriority47 \lsdlocked0 List Table 2;\lsdpriority48 \lsdlocked0 List Table 3;\lsdpriority49 \lsdlocked0 List Table 4;\lsdpriority50 \lsdlocked0 List Table 5 Dark;
\lsdpriority51 \lsdlocked0 List Table 6 Colorful;\lsdpriority52 \lsdlocked0 List Table 7 Colorful;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 1;\lsdpriority47 \lsdlocked0 List Table 2 Accent 1;\lsdpriority48 \lsdlocked0 List Table 3 Accent 1;
\lsdpriority49 \lsdlocked0 List Table 4 Accent 1;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 1;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 1;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 1;
\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 2;\lsdpriority47 \lsdlocked0 List Table 2 Accent 2;\lsdpriority48 \lsdlocked0 List Table 3 Accent 2;\lsdpriority49 \lsdlocked0 List Table 4 Accent 2;
\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 2;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 2;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 2;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 3;
\lsdpriority47 \lsdlocked0 List Table 2 Accent 3;\lsdpriority48 \lsdlocked0 List Table 3 Accent 3;\lsdpriority49 \lsdlocked0 List Table 4 Accent 3;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 3;
\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 3;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 3;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 4;\lsdpriority47 \lsdlocked0 List Table 2 Accent 4;
\lsdpriority48 \lsdlocked0 List Table 3 Accent 4;\lsdpriority49 \lsdlocked0 List Table 4 Accent 4;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 4;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 4;
\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 4;\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 5;\lsdpriority47 \lsdlocked0 List Table 2 Accent 5;\lsdpriority48 \lsdlocked0 List Table 3 Accent 5;
\lsdpriority49 \lsdlocked0 List Table 4 Accent 5;\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 5;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 5;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 5;
\lsdpriority46 \lsdlocked0 List Table 1 Light Accent 6;\lsdpriority47 \lsdlocked0 List Table 2 Accent 6;\lsdpriority48 \lsdlocked0 List Table 3 Accent 6;\lsdpriority49 \lsdlocked0 List Table 4 Accent 6;
\lsdpriority50 \lsdlocked0 List Table 5 Dark Accent 6;\lsdpriority51 \lsdlocked0 List Table 6 Colorful Accent 6;\lsdpriority52 \lsdlocked0 List Table 7 Colorful Accent 6;}}{\*\datastore 010500000200000018000000
4d73786d6c322e534158584d4c5265616465722e362e30000000000000000000000e0000
d0cf11e0a1b11ae1000000000000000000000000000000003e000300feff0900060000000000000000000000010000000100000000000000001000000200000001000000feffffff0000000000000000ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
fffffffffffffffffdffffff04000000feffffff05000000fefffffffeffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffff52006f006f007400200045006e00740072007900000000000000000000000000000000000000000000000000000000000000000000000000000000000000000016000500ffffffffffffffff010000000c6ad98892f1d411a65f0040963251e5000000000000000000000000d068
ffa23efed1010300000080020000000000004d0073006f004400610074006100530074006f0072006500000000000000000000000000000000000000000000000000000000000000000000000000000000001a000101ffffffffffffffff020000000000000000000000000000000000000000000000d068ffa23efed101
d068ffa23efed101000000000000000000000000320045004200340030003200dc00da0051005500ce00420041005100dd00cc0035004700c000c200dd0041003d003d000000000000000000000000000000000032000101ffffffffffffffff030000000000000000000000000000000000000000000000d068ffa23efe
d101d068ffa23efed1010000000000000000000000004900740065006d0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000a000201ffffffff04000000ffffffff000000000000000000000000000000000000000000000000
00000000000000000000000000000000d800000000000000010000000200000003000000feffffff0500000006000000070000000800000009000000feffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff
ffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffffff3c623a536f75726365732053656c65637465645374796c653d225c4150412e58534c22205374796c654e616d653d224150412220786d6c6e733a623d22687474703a2f2f736368656d61732e6f70656e786d6c666f726d6174732e6f7267
2f6f6666696365446f63756d656e742f323030362f6269626c696f6772617068792220786d6c6e733d22687474703a2f2f736368656d61732e6f70656e786d6c666f726d6174732e6f72672f6f6666696365446f63756d656e742f323030362f6269626c696f677261706879223e3c2f623a536f75726365733e00000000
0000000000000000000000000000000000000000000000000000000000000000000000003c3f786d6c2076657273696f6e3d22312e302220656e636f64696e673d225554462d3822207374616e64616c6f6e653d226e6f223f3e0d0a3c64733a6461746173746f72654974656d2064733a6974656d49443d227b36393545
343037302d334143462d344234312d383130312d3046364337433638323246347d2220786d6c6e733a64733d22687474703a2f2f736368656d61732e6f70656e786d6c666f726d6174732e6f72672f6f6666696365446f63756d656e742f323030362f637573746f6d586d6c223e3c64733a736368656d61526566733e3c
64733a736368656d615265662064733a7572693d22687474703a2f2f736368656d61732e6f70656e500072006f007000650072007400690065007300000000000000000000000000000000000000000000000000000000000000000000000000000000000000000016000200ffffffffffffffffffffffff000000000000
0000000000000000000000000000000000000000000000000000000000000400000055010000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000ffffffffffffffffffffffff00000000
00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000ffffffffffffffffffffffff0000
000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000ffffffffffffffffffffffff
000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000786d6c666f726d6174732e6f72672f6f6666696365446f63756d656e742f323030362f6269626c696f677261706879222f3e3c2f64733a736368656d61526566733e3c2f64733a6461746173746f
72654974656d3e0000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000
00000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000000105000000000000}}