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Get Db 820 2008-2024

Ent is attached to and made a part of the Certificate of Insurance, Form DB-820/829, filed for Employer's FEIN No. W.C.B. Plan No. ____________________________________________ by_________________________________________ Name of Employer Name of Carrier and said carrier certifies that benefits are payable to eligible employees at least to the extent described herein. SCHEDULE OF BENEFITS AND CONTRIBUTIONS WEEKLY CASH WAGE OR OTHER CLASSIFICATION Weekly Benefit Maximum Duration (Weeks) HO.

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