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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 /> 1 Insurance Company Name Mutual of Enumclaw <br /> Policy Number BOP 0011922 05 <br /> s <br /> Type of Insurance Business Liability Insurance <br /> ' Claim Number None <br /> Settled Amount <br /> None <br /> , <br /> , Insurance Company Name <br /> N <br /> Policy Number <br /> Type of Insurance <br /> Claim Number <br /> I Settled Amount <br /> 4 <br /> Insurance Company Namei. <br /> Policy Number <br /> Type of Insurance <br /> Claim Number w; <br /> Settled Amount <br /> Insurance Company Name i,Y <br /> Policy Number <br /> 4 <br /> Type of Insurance <br /> r <br /> q Claim Number <br /> Settled Amount <br /> r�E,p. .�.��.�:.a�.... 1�ran . .,,,..,, r... �.�>. , <br /> ilEVERETT Everett CARES Small Business Grant Program l Round 3 page 9 <br /> WASHINGTON <br />