%PDF-1.6 % 76 0 obj <> endobj 86 0 obj <]>>stream xcd``df`d00:2000J,e`g`p! Y ف9 r k endstream endobj 78 0 obj <>stream xc```g``b) 9 0;3020MStU иb`PLOA" " 0 endstream endobj 77 0 obj <>/Metadata 3 0 R/Pages 74 0 R/StructTreeRoot 96 0 R/Type/Catalog>> endobj 79 0 obj <>/MediaBox[0 0 612 792]/Parent 74 0 R/Resources<>/Font<>/XObject<>>>/Rotate 0/StructParents 0/Tabs/S/Type/Page>> endobj 80 0 obj <>stream xis6f?Z&^h;;8j']'vb6blgɕv_H(4H<wɲ[oO꺼f8~8\]*qbQWKq|Ews'OOGbq;zk,fB?s{='F]XdHX%L_P:alD}.Z}ǓB'HĊbORqt~48. \kd(/pH1z~2-85ơ`QD.px(܏ay]ᓙ6sCt9Qt/#F@#:pHL/P4O=nRd.#eD-v2E6&JUl`nEij 1r@;J$牉2\ߟ//ӧVO|=}>HЙ3+ GFʒ(K=z LS9 < 7it>b)4P h%𿆨c@5Ӂ]n=#M:^VX%O"/H Bƥ[L<=NnLcB5 U#r^,?R.bAzS8Fz&K>5; "k֜ _hCdK,W/l4ɪ򻋪]2`&T$v9!u'!Xq|d* &ttmw'ETW^lD}Jq}LȊv_ 8ĀZtpvOOobEo3S4MɅb}j5_l ~=,eRBk,AcLӪ5&-..& Z0|Gҕ$r^YKaq͙ Lcuֳt/HdaHP> Jlj 6׍E8]0痷_xxQ[2#]b⠘%1*b(|jRq:2 8_cއقuX,IM5T;$1|DqM )>g[.I4RpUy9} һ8gmi+|uՁ_Ȓ%ie-[6wy%q,-2zX(Xi}/Kdzp\O 4{mYC;h*r,pG~҉!!YnzO"\{'kl}HºfO:YLaDQRiVXšq{XAs=Kmg8痐,?GOjo*2с63'`~rd,ϬYomDʰյ9ϫ%6ұղѰ!5ڱ(ij󱺸<,KTri_'!]fMgJ$FJ힜j pyYl,j2-}3j9xC} ɠۑ&(wHKCس-meJMmi ٟoP7T&|{@ok#`?KUb^84ej͊ (u^M~t{5x7&ؐXIoЛYN~ȵ[Ճ6Wiޖ(D F*^so*iZs6ɾ30(dQn)g(<$Ы+a՞[h%b(6ArCTeLn2ϨeZx IkWMra8VƇXTM=^}7rqpT?)vP7\l-1-}McOA櫡ݚcushy[iؤ߽kO5|*?R`U_~ߛe lhF`d;%yZI/*­Y43~;wù.m&gcPDc&oG'mtMVFJkTsJ-mfUܹHpw!gXZ{ҕyч1D2îC|VͶ[^&XEn1H몕 xw3Q~T9?Q[{6L՗^a=MH=)nʅD.ĚAe8gxx0ӭEöBwm ~F7dY2'{*X &<@2-WiPGV[YĈ9mNuohs*2v=v4Ԗs*yv

91Ƭ

13 WN S63103

)/DS(text-decoration:;font-size:12.00pt;font-family:'Times New Roman')/GUID(51af53e6-bdb8-49d8-88-df95e6342bb7)/Rect[ 472.4072 751.9445 612.0072 762.2938]/Resources<>>>/Filter/FlateDecode>>stream x P E|uI_kAA 8XR_oZ=$ܫh἗]ybr'tuH)%6*E$שhjk>_5DSo/eL,W endstream endobj 82 0 obj <

91Ƭ

HARTFORD UNDERWRITERS INS COMPANY

)/DS(text-decoration:;font-size:12.00pt;font-family:'Times New Roman')/GUID(e32be1db-2bb1-49e9-a0-d970c46b2638a1)/Rect[ 195.3247 572.6558 612.0247 583.0051]/Resources<>>>/Filter/FlateDecode>>stream xML PW̱./}GgFDt*.vVO03 VOI-]; Fr@kE 2Sd6I &]6+øzm4 e })TBʷ4!g`.9<$ endstream endobj 83 0 obj <

91Ƭ

13 WN S63103

)/DS(text-decoration:;font-size:12.00pt;font-family:'Times New Roman')/GUID(b9bcab81-3860-4abe-9a-351991426a92e5)/Rect[ 490.2835 449.0992 611.9835 459.4484]/Resources<>>>/Filter/FlateDecode>>stream x ` <ōv_kAB;dQA%\#Ꭰ2 x6vJ6nr59D D"LKsM"¾fmMn?H^EPdT&~?K endstream endobj 84 0 obj <

91Ƭ

HARTFORD UNDERWRITERS INS COMPANY

)/DS(text-decoration:;font-size:12.00pt;font-family:'Times New Roman')/GUID(a2340d5d-2f9d-46a1-83-d032a2d2a30a4)/Rect[ 218.4587 262.4497 612.0087 272.7989]/Resources<>>>/Filter/FlateDecode>>stream xL PW̱.h,5֍T ] 0 $dGQ6 h(kTp]DqBD2N,ؚ-a|-FhHS{9K^ZumS̵#E#. endstream endobj 85 0 obj <>stream xVj;}y}>v!i/mBq&?xzSҷ3ZIneX͌t8%-YUPqEQB%@(k G*k)12 u} H cgz|c5]=~i{t)hvyێpXU{lsnwM7ݮ?;cRk vK9&m6JXc,Т(C.s~g)k$CB,ABDνD>>/ĥЮJA)SZ6a@q-`cmȉVࡓf (AUFW(ǚC'e#?fx` \>٩D]g@JFH$ٰlf92OľcSNώ-]T磮n9b]o&\F}am{Y5h褐o gi '7Qp&p/{4vqOW$գ]˶Ǩ)ۧU_jC3|3k7Ǩa))6)iI!ԏ;u+A=RB'k6ls'ˑ;)N,@f373>մ\w~sW=x (ɒ6>Y }z G17^ xDy#ү Fzn~F/%ݯySGftM%Y$g,Fq6ꌙc\<M/a]9TFGϥ{?(zv.d1lU=|ܢm{S*6+k$/8iBX'l(A4?j*?{4RϿB9DRl6%6 endstream endobj 1 0 obj <>stream xڍn0 _O06iPZ 04\.hVCGa7vHIQE,U1/u1[->ސ(x:ѣ+ԆoJxQ=ku" X: ?UP&+8+pWZXIs^6=u9^ۻO |С Q`SY_.$qb˱B"Ax/!p9"mE{OA%Z[BE[Kwg(f9lbFm&˶ɫ蛼`KK \V4[l')c Rn'w]0R] vr{A'~d%:ϫLl%,)0y L2115c襜ݻ`9!CH&L#q`C8?to< endstream endobj 2 0 obj <>stream xڭjK _Eo3@iZZ)6 'ٓ:vqy*i 鍵3+FovHQd$RQ}>QNBPIbR@-DHM1SkXaUa%XUa[  XJ#aZIKRHK5#$=98 x+x2i/P@=ERfؒIQ#iEW&'*'(2-L} RK glP/J K(%̣ ^*#aʌ, APF3J<Вe@xԤ^ Lo _~\.wWggz^ovrfnx-Yb_l/܏nv0|X=n>߂<_χ ~/w>;֫z/6fcV.~l 盛LJqm3/ggp~'d3L5&L4fFaQ(l6E"FQ(b1EFQQ(j5EFQ$$$$$$r2\ cb2p1B7a:O/c/hhX~s}_gqW*8z },bs.WU:z^٫5OZt|uLZS۷G:>՚ZWj-\s-\fմWj^ի~ѸX9+kZޠð9j<iv'Eɑ|ru;rPW 5Ie#XڴW`_|RXn{,LQ"Lu,jO=S+ 6P)_J8N ΰY}3 endstream endobj 3 0 obj <>stream #1nt3rn@l# #H1d3-F00t3r# Microsoft® Word 2013 2020-03-06T00:35:17-05:00 2022-07-25T13:14:19-04:00 2022-07-25T13:14:19-04:00 Microsoft® Word 2013 application/pdf TO BE POSTED BY EMPLOYER 166 #1nt3rn@l# #H1d3-F00t3r# uuid:0fdfb4c1-c189-4522-95ca-a1277f938eaf uuid:4dd91ab5-592b-41ac-adf3-fa7558759d79 endstream endobj 4 0 obj <>stream xڕKKAaz5,܂$7dfddH"x\Gѵ2C\lׯݹL)y?~;nee{B@57 +կ-gm"jI{]Ah;*#P J~_uSDAKd qY-wZ6%Plmc˩q?K+=#{!#67&p6~K"RX endstream endobj 5 0 obj <>stream xPݏ{op$A.$Kz>Q->E#PGm!!H! !( h衏a lL19X kl{xq'q70bg endstream endobj startxref 216 %%EOF