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As well as any and all consequences thereof. Signature of Chief Administrative Officer or Designated Signing Authority Name please print Title Date Return forms along with attachments to Brian Laur HSC 30 Duncan Street Suite 500 Toronto Ontario M5C 2V3 Fax 416-594-9422 Email blaur hscorp.ca.. It must be submitted along with Form C to HSC within 30 business days of renewal or inception of coverage or HSC will bind the LHC with the HSC Program Broker and invoice for that coverage. FORM D...
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