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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 none <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> Insurance Company Name none <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> Insurance Company Name none <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> Insurance Company Name None <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> Settled Amount <br /> gulp <br /> ESERETY WASHINGTON Everett CARES Small Business Grant Program Round 3 page 9 <br />