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Get Ct Sl-8 2012

Hich are authorized to transact the class of insurance involved and which accept in the usual course of business, insurance on risks of the same class described herein. This insurance has been procured with the surplus lines insurer(s) named on this Surplus Lines Affidavit, which insurance is only the excess over amounts procurable from licensed insurers. __________________________________________________________ Signature of Surplus Lines Broker State of________________________________________.

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