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General Liability Special Endorsement1. ENDORSEMENT NO.2. ISSUE DATE (MM/DD/BY)for the City of Simi Valley 3. PRODUCER5. POLICY INFORMATION: Carrier: Policy No.: Policy Period:COVERAGE TRIGGER Occurrence Included

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Issue date mmddyy is the specific date on which an item was submitted, created, or made effective.

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The individual or entity responsible for the item in question is required to file the issue date mmddyy.

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The issue date mmddyy must include the exact date when the item was created or submitted.

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