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PROVIDING FALSE INFORMATION IN AN APPLICATION FOR INSURANCE IS FRAUD WHICH IS A CRIME IN MANY STATES. Applicant s Signature Date Applicant s Nam e Applicant s Title Producer s Signature Producer s Nam e 333 App-3 10/29/10. A. What type of Burglar Alar m is installed in this Building Yes No B. Frame Masonry Non-combustible Joisted Masonry Modified Fire Resistive Square Feet 10 000 Non-combustible Fir e Resistive Number of Stories Distance to Fire Hydrant Feet Is this Burglar Alar m monitored...
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