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ThisSPECIALMULTI-FLEXPOLICYisprovidedbythestockinsurancecompany(s)ofTheHartfordInsurance <br />Group,shownbelow. <br />COMMONPOLICYDECLARATIONS <br />POLICYNUMBER: <br />NamedInsuredandMailingAddress: <br />(No.,Street,Town,State,ZipCode) <br />, <br />PolicyPeriod:FromTo <br />Standardtimeatyourmailingaddressshownabove. <br />Inreturnforthepaymentofthepremium,andsubjecttoallofthetermsofthispolicy,weagreewithyoutoprovide <br />insuranceasstatedinthispolicy.TheCoveragePartsthatareapartofthispolicyarelistedbelow.TheAdvance <br />Premiumshownmaybesubjecttoadjustment. <br />TotalAdvancePremium: <br />CoveragePartandInsuranceCompanySummaryAdvancePremium <br />FormNumbersofCoverageParts,FormsandEndorsementsthatareapartofthispolicyandthatarenot <br />listedintheCoverageParts. <br />Agent/BrokerName: <br />Countersignedby <br />(Whererequiredbylaw)AuthorizedRepresentativeDate <br /> <br />FormHM00100107 <br /> <br />