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._. _ _ = f ',i L t1 <br />• t~l' ~ ~ ~'~`Yti <br />~, - <br />FROM: <br />ill Berkley Risk Services, Inc. <br />920 Second Avenue South, Suite 700 <br />Minneapolis, Minnesota >j402-4023 <br />(612) 376-4200 FAX (612) 376-4299 <br />SUt3JtG f ( DATE <br />EXCESS LIABILITY QUOTATION FOR THE CITY OF: ~~~ pii~ q ~ 8 ~ G~ <br />-FOLD- <br />Dear ~~(~ ~. <br />Liability Limit: <br />Annual Premium With Waiver of Immunity: <br />Annual Premium Without Waiver of Immunity: <br />Quotation Expires: <br />Follow Form: <br />Special Exclusions: <br />Other Endorsements: <br />Remarks: <br />$1,000,000. <br />~ ~, 3~0. <br />C~..~ ~ <br />Underlying Coverage as Scheduled <br />Child Molestation <br />An Election form must be completed, <br />signed, and returned to us before <br />the effective date if coverage <br />is desired. <br />C~ll'1IC._ (~~.L.~. <br />DATE SIGNED I ' ._~ <br />• <br />