Get MI BHS-EMS-0092 2016
A. of 1978 as amended) (To be completed by insurance or participating plan company and returned to the insured) The subscribed insurance or participating plan provider certifies that insurance/coverage of the kinds and types and for limits of liability covering the life support vehicles designated has been procured by and furnished on behalf of the insured/covered named below. NAME OF INSURED/COVERED ADDRESS OF INSURED/COVERED CITY STATE ZIP Life support vehicle liability coverage with r.
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