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CG T1 00 02 19 © 2017 The Travelers Indemnity Company. All rights reserved.Page 13 of 21 <br />Includes copyrighted material of Insurance Services Office, Inc. with its permission. <br />Attachment Code: D681893 Master ID: 1529369, Certificate ID: 19861348 <br />Docusign Envelope ID: 458D6D02-0D6B-8C4E-8292-D706A4D93B4D