3 results for “"Automatic Data Processing Insurance Agency"”
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EFTA00523631Dataset 9
2012-09-184p1,045w
…you can use Hartford's stand-alone TRIA disclosure form for quota and binders. which is available on EBC or from the company. Reference Number: 76ITEG974.1.1.fr - 003 Total Estimated Annual Premium fur Workers' Compensation: S 290 Page 11 II111111111111111111IIIIII111111IIIIIIIIIIIII111111IIIIII1111111111li r. EFTA00523631 IX11111 hIIIIVIIIVIIIVIIIVIIIVIIIVIIIII111111IIIII 00109547 VIIIVIIIIIVIIIHlhhIII 70 - HIll! Automatic Data Processing Insurance Agency. Inc. Workers' Compensation Loss History Affidavit X , do hereby certify and swear that (name of owner or officer) (Company name dba) has incurred X injuries…