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A STOCK COMPANY <br />MARKEL INSURANCE COMPANY <br />Ten Parkway North <br />Deertield, IL 60015-2544 <br />Servicing Office Mailing Address: <br />FirstComp Insurance Agency, Inc. <br />Central Park Plaza <br />222 South 15th Street, Suite 1500N <br />Omaha, NE 68102-1680 <br />(888) 500-3344 <br />YOUR INSURANCE POLICY <br />Coverage afforded by this policy is provided by the Company and named in the Declarations. <br />In Witness Whereof, the Company has caused this policy to be executed and attested and <br />countersigned by a duly authorized representative of the company identified in the Declarations. <br />MJWC 1000 05 10 <br />27 of 28 <br />