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Please provide information regarding any insurance policies and information regarding claims filed and paid,if any,in the designated <br /> spaces below. If no claim was filed under an insurance policy listed below,fill in the applicable blank with "None." <br /> Insurance Company Name Mutual of Enumclaw Insurance Co <br /> Policy Number BUP001912801 <br /> Type of Insurance Property Casualty <br /> Claim Number None <br /> Settled Amount None <br /> Insurance Company Name <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> Insurance Company Name <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> Insurance Company Name <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> womill EVE R E T T Everett CARES Small Business Grant Program l Round 3 ; page 9 <br /> WASHINGTON <br />