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1. SCHEDULE OF COVERED STATES <br />A This endorsee -*nt only applies in the states <br />fisted in this Schedule of Covered States <br />C Schedule of Covered States <br />W <br />B If a state, shown in qem 3 A. of the Information <br />Page, approves this endorsement after the <br />effective date of this policy, this endorsement <br />well apply to this policy. The coverage w0l <br />apply m the new state on the effective date of <br />the state approval. <br />Countersigned by <br />Authcrized Representatve <br />Form WC 99 03 03 B Printed r U S A (Ed 8,00) Page 6 of 6 <br />DI <br />