****** *"*"" ******* nt"""""*""*" DOLLARS ' Insurance Office of Central Ohio 165 W. Main Street 8 PO Box 780 New Albany, OH 43054-0780 MEMO Policy WC 015-80-4241 invoice # 235795 AUTHORIZED SIGMA POO 30 40 2 LOO LO 3 3i: OS is 1111 9 2 >- I z 0? O )- OZ 0 In ci LL I- - cc < < F Z