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List is to be completed and submitted with the application. Please check the appropriate space(s) for each question. Please note that the $4,000 application fee must be received with the application. You must also apply for coverage directly with the W.C.R.A. Attachment 1. Guarantee of Payment Agreement and Corporate Board Resolution(s) (if applicable) for Affiliates/Subsidiaries 2. Individual Applications for Each Initial Group Members 3. Combined Financial Statements.
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