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APPLICATION FOR LOCUM TENENS AND CONTRACT STAFFING ORGANIZATIONS
PROFESSIONAL LIABILITY
(CLAIMS MADE BASIS)
APPLICANTS INSTRUCTIONS:1. Answer all questions. If the answer requires detail, please attach
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What is name of applicant organization?
The name of the applicant organization is the XYZ Foundation.
Who is required to file name of applicant organization?
The CEO or authorized representative of the XYZ Foundation is required to file the name of the applicant organization.
How to fill out name of applicant organization?
The name of the applicant organization should be filled out in the designated section of the application form.
What is the purpose of name of applicant organization?
The purpose of providing the name of the applicant organization is to accurately identify the entity applying for funding or grants.
What information must be reported on name of applicant organization?
The information that must be reported on the name of the applicant organization includes the legal name, address, and contact information.
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