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REQUEST FOR PROPOSALS - City of Norwalk

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ACKNOWLEDGMENT OF INSURANCE REQUIREMENTSAND CERTIFICATION OF ABILITY TOPROVIDE COVERAGES SPECIFIEDI, ____________________________________, the ________________________(President; Secretary; Owner or Representative)<strong>of</strong> _______________________________________________________, certify that the(Company Name or Corporation, or Owner)Insurance Requirements set forth in Article IV <strong>of</strong> the Proposed Agreement have been read andunderstood that our insurance company(ies) ____________________________________________________________________________________________________________(Name(s) <strong>of</strong> insurance company(ies)is/are able to provide the coverages specified.____________________________________Signature <strong>of</strong> President, Secretary, Partner,Owner or Representative____________________________________DateLPP 09-02Page 10-54July 31, 2009

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