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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 Farmers Insurance <br /> Policy Number 606749214 <br /> Type of Insurance Liability Insurance <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 /> El EVE RETT Everett CARES Small Business Grant Program Round 3 page 9 <br /> WASHINGTON <br />