IAN auI. A uC 1 Se P % t Y IE EFTA01700762 • •-•%." paws rum ore...cull' INSIJKANI:E. vc (This fora is to be completed by the Employee-)-) li fE CONTINENTAL INSURANCE COMPANY KANSAS CITY FIRE' ND MARINE INSURANCE COMPANY FIREMEN'S INSURANCE COMPANY OF NEWARK. NEW JERSEY BOSTON OLD COLONY INSURANCE COMPANY COMMERCIAL INSU