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<br />"' <br /> <br />.- <br /> <br />THE FOLLOWING QUESTIONS MUST BE ANSWERED BY ALL APPLICANTS. . <br />('"(eft' answers cb oot require ~plaJ1Btit,ln) <br /> <br />Does the applicant understand that tM insurance being 9p9lied mrdoes not cover And <br />wiIl 0010 indarmiiy the ftpplkant for any linbHity or loss srising from the emission of any <br />hazardQus m&terial Qr pt)Uuttmt to the env?rol'lm~nt~ i~~t',,}.ding any tclllponsibUity to ek:an <br />up any relea$e; "nd does not cover a.nd wilt i40t ii'"~emi1ny the applieant for liabiU!yor <br />loss arising oui ur produm or complet..ed operations perfur11'le(\ Qy the appllcant. or on the <br />applieant's ~halr. inc~ing material:;, par15. or equipment furnished in connection with <br />such work or.operations. <br /> <br />_No -X Yes <br /> <br />I t the undersigned, ca-ti1j and &nest that r have beon unable to ()bt~ through ordirutry <br />methods, th.e msurange I am applying fOr with this applita~ion and the infurmati;m <br />CQntain~ in this uppJrcation is true mid oomplet~ <br /> <br /> <br />NQ XYcs <br /> <br />