第３章 参考文献2 CAMICO加入申込書
PartⅨ:signatures（署名）
The undersigned proprietor, authorized partner of the partnership, or authorized stockholder of the corporation declares that the following is understood:
By signing this application, the undersigned represents that he or she has made inquiries of all Firm members as appropriate and that all Firm members are bound by the representations made on this application, any supplemental application,and any supplemental data and documents provided.
Signing this application or tendering premium does not bind the applicant or the company to issue insurance coverage, but it is agreed that this application shall be the basis of the contract should a policy be produced.
| Name:(Please Print) | |
| Signature: | Date: |
| Position/Title | |
| Applicant/Firm |
Enclose the application and appropriate supplemental forms
in the return envelope provided and send to:
CAMICO Mutual insurance Company
1235 Radio Road
Redwood City, CA 94065-1217
Questions:1.800.652.1772
e-mail:[email protected]
web site:www.camico.com
fax:1.888.4-CAMICO(888.422.6426)
Thank you for applying for CAMICO coverage.
2000 CAMICO Mutual Insurance Company
