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MGT OfAmedca,Inc, Policy 3011086788 Eflacllve 111111.1?C?-? <br />CNA GIP1E0.6 <br />?Ed.11?l? <br />WORKERS' COIRPENBATION AND EMPLOYERS' WBRITY IoURANCE POLICY <br />BIANNETWAVtidi DFCNR pl?liTO RECOVER FRONOTHEfIS <br />Trds andmeamenf chanpsstha pollq tsWhich It H altedwd. <br />RlaapaatlAethAOro Wagn'CompesulloeYuurercaG.RecoeayRomphanandPtlTWn Erepbym' <br />W611?hsurexe H, RecouuyFromOtlxnare amantlatlbyaddnp Ihs Idlowllq, <br />Wa wfll rot enloma our tlPht W racmre? ?aNat paman or organrtaEans. ?hls ayaamant appli? only to tha sr?t Ihal <br />youpsdortnwc?kuMarawalttaoecdredlhtlngelresyouMchlaioihdagrasmadfrcmro.) <br />PRENIOMCHARGE• <br />Tha d?wGa wpl ha en amoWl to wh'uh you aetlwe eg?aa dal Is a parcanrega dNe Idd elantls?tl premium PorCHlfomia <br />mmcaure,ThaamuuMla <br />s <br />s <br />G•181fi0s <br />(Ed 11811 <br />Papa 1 d 1