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Artisan Contractors Rater
Named Insured
Effective Date
Address
City
State
Phone
E-Mail
Has this insured had insurance coverage during the prior 12 months?
Is this business a New Venture?
Class Description and Code
Occurrence Limit
Do you want Double Aggregate Limits?
Deductible
Additional Insured's Requested ($100 each)
Payroll
Accept Terrorism?
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General Liability
Additional Insured
Policy Fee
Terrorism
Taxes and Fees
Filing Fee
Total
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