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EFTA00311431
e you had any general liability losses in the past three (3) years? ..O YesliNo If "Yes", provide date(s) of loss and detail(s). 33. Do you want ERISA Fiduciary Liability coverage (5100,000 Limit of Liability)? ..CI Yesgl No Coverage is recommended if you sponsor any Employee Benefit Plan. Coverage is written on a
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