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C) CLAIM REPORTING INCIDENT AND PROCEDURE <br /> incidents and claims are to be reported to the insurer at: <br /> ATTN: <br /> (Title) (Department) <br /> (Company) <br /> (Street Address) <br /> (City) (State) (Zip) <br /> (Telephone Number) <br /> D) SIGNATURE OF INSURER OR AUTHORIZED REPRESENTATIVE OF THE INSURER: <br /> 1. (print/type name), warrant that I have authority to <br /> bind the below listed insurance company and by my signature herein do so bind this <br /> company. <br /> SIGNATURE OF AUTHORIZED REPRESENTATIVE <br /> (Original signature required on Endorsement furnished to the City) <br /> ORGANIZATION: TITLE: <br /> ADDRESS:_ TELEPHONE: ) <br /> July 2007 Division IV-24 <br /> NEI Phase II Water and Sewer <br /> CIP Nos. 7468, 7589, 7590 <br />