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a <br />I �MJINSURANCE <br />(October 24, 2017 <br />Ideal) Consolidated, Inc,. <br />806 W. Sample Street <br />South Bend, IN 46601 <br />Re: Experience Modification Factor <br />Policy Number: 6020480028 <br />To 'Whom It May Concern: <br />Pursuant to your request, please find listed below your Experience Modification Factors for the Mask <br />three years: <br />Effective Date Expiration (Date MuODIFICATION <br />10/31/201 10/31/2016 .73 <br />10/31/2016 10/31/2017 .72 <br />10/31/2017 10/31/2018 .71 <br />RPct° rpnarriq. <br />kT1qUWN111UR= <br />Yourfuture in focus, <br />)")).11 P1souflty%'Vay V6!.�'L 0d. � ,.,dpedf"� I()di R d¢��i� �rirwis��Ar..�f lid "162ri.Y <br />" .3 1, /u/cf')n I r 9j �.t"', V0, mr:jiri^ uro c i I <br />