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SERFF Tracking ACPC-130866847 State Tracking Company Tracking ACORD 130 2017/01 WORKERS COMPENSATION.. 0001 Alternative WC Form 01/04/2017 ACPC-130866847 Closed-APPROVED Effective Date Requested New Author s Reviewer s Disposition Date Jean Carlos John Rielley primary 01/18/2017 APPROVED PDF Pipeline for SERFF Tracking Number ACPC-130866847 Generated 08/10/2017 01 59 PM General Information Project Name ACORD 130 2017/01 Workers Compensation Status of Filing in Domicile 2017-01 Project Number...

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