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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 Butler Insurance Services, Inc. <br /> Policy Number ACP BPFD 3057300360 <br /> Type of Insurance Commercial General Liability <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 /> `: EVE R ETT Everett CARES Small Business Grant Program Round 3 page 9 <br /> WASHINGTON <br />