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<br />"./$ <br /> <br />Yr::;s <br /> <br />IJ.. <br />NX <br /> <br />- <br /> <br />G. Anticipated c~r of in~"tiQDS to bv }ierfonned in the: ~ )Ur; <br /> <br />1. Are you currently licensed in Minneapolis? <br />Expiration date _J~__ <br /> <br />Are you currently licensed in St. Paul? <br />Expication date -! --!_ <br /> <br />- <br /> <br />--k <br />X <br /> <br />8. Do yuu rmke inspections in South ~ _ <br />U:horge pe...ingle fitml!lly ~ . ~ <br />Charge per duplex inspeeti~~-='~ ' <br /> <br />10. Do you enSile in any other kind ofp~owd ~oo other than lKluslng <br />fp$peot:ton? . ~~ N~. . <br /> <br />PRIOR CARRIE1l INFORMA nON (Att~h wpy of roost recent policy and application) <br />Limits Annual <br />Year Canier Policy ~m~r BIIPD Premium <br /> <br />N~I\~ <br />. <br /> <br />... <br /> <br />LOSS AND CLAIM HISTORY (AttaCh 1iu1h~ sm:cr.s if needed) <br /> <br />8nter all losses and claims fur ~ prior 5 years.. If aggregates are providBd, please <br />indicate the number of" claims ~d explain oU claims -~~ding SS.OOO. <br /> <br />Amount paid: ~ <br /> <br />Type of~; <br />Reserve: <br /> <br />NOlie <br /> <br />~ of loss; <br /> <br />.... - <br /> <br />Description: <br /> <br />Date of ioss: <br /> <br />Type of loss: . <br /> <br />Amount paid; <br /> <br />ResCrvc~ <br /> <br />Description: <br />