Software: Apache/2.0.54 (Unix) mod_perl/1.99_09 Perl/v5.8.0 mod_ssl/2.0.54 OpenSSL/0.9.7l DAV/2 FrontPage/5.0.2.2635 PHP/4.4.0 mod_gzip/2.0.26.1a uname -a: Linux snow.he.net 4.4.276-v2-mono-1 #1 SMP Wed Jul 21 11:21:17 PDT 2021 i686 uid=99(nobody) gid=98(nobody) groups=98(nobody) Safe-mode: OFF (not secure) /home/butwin/public_html/allstate/forms/ drwxr-xr-x | |
| Viewing file: Select action/file-type: ࡱ > ~ '` :G bjbjDD 2b & & D d d d x , x 9 $! " " " " & }' \ ' 0 0 0 0 0 @ R0 Z4 b8 $ 9 h [< 8 9 d >+ & & >+ >+ 8 " " 8 , , , >+ " " d " 0 , >+ 0 , , r d , " ! Z+ ( , , 8 0 9 , = + = , = d , ( v ( T , ( D ) ' ( ( ( 8 8 p, ( ( ( 9 >+ >+ >+ >+ x x x D $ x x x x x x 8 60 Cutter Mill Road ( Suite 414
Great Neck, NY 11021
516-466-4200 ( HYPERLINK "../../index.htm"www.butwin.com
fax 516-466-4213 no cover page needed
or exit, save and e-mail to HYPERLINK "mailto:allstate@butwin.com" allstate@butwin.com
CERTIFICATE OF INSURANCE
REQUEST
All certificates are issued within 3 business hours
Press TAB to move to each field and type your response
Client Name: FORMTEXT D B A : F O R M T E X T A g e n t N a m e : F O R M T E X T F O R M T E X T A g e n t P h o n e : F O R M T E X T F O R M T E X T F o r l o o k u p p u r p o s e s , p l e a s e p r o v i d e o n e o f t h e f o l l o w i n g : P o l i c y N u m b e r : F O R M T E X T B u t w i n I D C o d e : F O R M T E X T C l i e n t s S t r e e t A d d r e s s : F O R M T E X T
T o d a y s D a t e
D A T E \ @ " M / d / y y y y " \ * M E R G E F O R M A T 6 / 1 0 / 2 0 1 0
N u m b e r o f a d d i t i o n a l p a g e s ( i f a n y ) :
F O R M T E X T
C e r t i f i c a t e s s h o u l d b e s e n t t o :
P r o v i d e e - m a i l a d d r e s s o r f a x n u m b e r
F O R M C H E C K B O X C e r t i f i c a t e H o l d e r
F O R M T E X T
F O R M C H E C K B O X I n s u r e d
F O R M T E X T
F O R M C H E C K B O X P r o d u c e r
F O R M T E X T
C e r t i f i c a t e H o l d e r N a m e & A d d r e s s
F O R M T E X T
F O R M T E X T
F O R M T E X T B C D E ` a b p q t u s_TI B*CJ OJ QJ phff3 B*CJ OJ QJ ph &0J 56>* B*CJ OJ QJ aJ ph .jw 56B*CJ OJ QJ UaJ ph (j 56B*CJ OJ QJ UaJ ph
B*CJ phff3 6CJ OJ QJ aJ 56B*CJ OJ QJ aJ ph
B*CJ phff3 0J >* B*CJ phff3 j B*CJ Uphff3 j B*CJ Uphff3 j B*CJ phff3
B*CJ phff3 5 t u e W H $ $If a$K$ $If ] | kd $If K$L$l @ ;
t
0 6 4 4
l `
a p
$ $If ]a$K$
$If ] "G 8G # Y v c Z Z O
$$If a$K$ $$If a$ $($If ]^(a$K$ $If ]K$ | kdJ $If K$L$l @ ;
t
0 6 4 4
l `
a p
# $ X Y Z [ _ e h
0
2
@
^
`
t
v
J P ƺ z v 5>* j Uj UmH nH u j Uj Uj Uj Uj6 U j U56B*
CJ aJ ph3 6B*
CJ aJ ph3
B*CJ phff3 6] 5CJ \aJ 5CJ aJ B*CJ OJ QJ ]ph j 5CJ U-Y Z [ \ p j a $$If a$ $If kd $If K$L$l F \
* W
t 0 *6 4 4
l a \ ] _
B
| | t t i t $ $If a$ $If
0* z kd $$If l 0 *+ "
t 0 6 4 4
l a B
D
F
^
^ V K V $ $If a$ $If kd" $$If l h\ K,+ @
t 0 4 4
l a
q i ^ i $ $If a$ $If kd $$If l hF U ,+
t 0 4 4
l a v q i $If kdB $$If l hF U ,+
t 0 4 4
l a v x $If $ $If a$h kd $$If l
,+ +
t 0 4 4
l a @ B V X Z d f 8
:
N
P
R
\
^
`
d
f
B D X Z h p r μа j# Uj" Uj! U6>*CJ aJ 6CJ aJ j 5UmH nH uj 5U 5mH nH u 5 j 5U j Uj Uj UmH nH u j Uj U 6
q f ^ ^ $If $ $If a$ kd $$If l hF %,+ .
t 0 ~ 4 4
l a @ h j q f ^ ^ $If $ $If a$ kd $$If l hF %,+ .
t 0 ~ 4 4
l a j l n q e 0 $If YD K$ kd $$If l hF %,+ .
t 0 ~ 4 4
l a n p 8
`
b
z $0 $If YD a$K$ 0 $If YD K$ i kd $If K$L$l h * *
t 0 4 4
l a b
d
f
I : $0 $If YD a$K$ kd $If K$L$l hr @ t"* B
t 0 4 4
l a f
h
y 0 $If YD K$ h0 $If YD ^hK$ i kd( $If K$L$l h * *
t 0 4 4
l a
B j l v v v v 0 $If YD K$ | kd $If K$L$l h0 *
t 0 4 4
l a l n p G ; ; ; ; 0 $If YD K$ kd" $If K$L$l h\ @ )* ;
t 0 333 4 4
l a p( " $ 2 D D D
D D D "D ,D .D 4D 6D D D D D D D D D <E nE Ͻ 6CJ aJ j 5UmH nH uj0 5U j 5U 5j- UUjS, Uj+ Uj UmH nH u j) Uj& UjP& Ujk$ U j U 8 4 6 G ; ; ; ; 0 $If YD K$ kd$ $If K$L$l h\ @ )* ;
t 0 333 333 4 4
l a p( 6 8 : G 7
0 $If YD K$ kd8' $If K$L$l h\ @ )* ;
t 0 333 4 4
l a p( : < > @ i kd=) $If K$L$l * *
t 0 4 4
l a 0 $If YD K$ i kd( $If K$L$l * *
t 0 4 4
l a @ v | kdS* $If K$L$l h0 *
t 0 333 4 4
l a 0 $If YD K$ D v v 0 $If YD K$ | kd+ $If K$L$l h0 *
t 0 333 333 4 4
l a
F O R M T E X T
D e s c r i p t i o n o f O p e r a t i o n s / L o c a t i o n s
F O R M T E X T
D o e s C e r t i f i c a t e H o l d e r n e e d t o b e l i s t e d a s a n A d d i t i o n a l I n s u r e d ? S h o u l d o n l y b e l i s t e d i f s p e c i f i c a l l y r e q u e s t e d b y c e r t i f i c a t e h o l d e r
F O R M C H E C K B O X Y e s F O R M C H E C K B O X N o
A r e t h e r e a n y o t h e r A d d i t i o n a l I n s u r e d s ?
F O R M C H E C K B O X Y e s F O R M C H E C K B O X N o
F O R M T E X T
D D D 0D v v 0 $If YD K$ | kd, $If K$L$l h0 *
t 0 333 333 4 4
l a 0D 2D 4D 6D v v 0 $If YD K$ | kd- $If K$L$l h0 *
t 0 333 333 4 4
l a 6D 8D D v 0 $If YD K$ | kd. $If K$L$l h0 *
t 0 333 4 4
l a D D D
@0 $If YD K$ i kd/ $If K$L$l h * *
t 0 4 4
l a D D D z 0 $If YD K$y kd0 $If K$L$l u * *
t
0 4 4
l a p
D D E &F 0 $If YD K$ i kd>1 $If K$L$l h * *
t 0 4 4
l a nE E E E E E E E E E F F F F F F F F F F F F F F F F F F G G G :G ĺƮ j 5UmH nH uj`5 5U 5 j 5U jP4 Uj3 UjF2 Uj1 U j U 6CJ aJ 6>*CJ aJ &F (F *F v 0 $If YD K$ | kd2 $If K$L$l h0 *
t 0 4 4
l a *F ,F F F 0 $If YD K$ i kdV3 $If K$L$l h * *
t 0 4 4
l a F F G r
0 $If YD K$ | kd4 $If K$L$l h0 *
t 0 4 4
l a G G G G i kdh6 $If K$L$l h * *
t 0 4 4
l a 0 $If YD K$ i kd5 $If K$L$l h * *
t 0 4 4
l a G G G G G v n < $If | kd6 $If K$L$l h0 *
t 0 4 4
l a 0 $If YD K$ G G "G $G &G (G *G ,G .G 0G 2G 4G 6G 8G :G h kd7 $$If l E$ ,+ +
t 0 + 4 4
l a 0 &P P / =!@"#$=% D y K 8 \ \ D E L L 0 9 \ M y W e b s \ W E B S I T E S \ A - F \ B u t w i n \ a l l s t a t e \ i n d e x . h t m $If K$L$q !v h5 ; #v ; :V l
t
0 65 ; `
p
D y K a l l s t a t e @ b u t w i n . c o m y K 6 m a i l t o : a l l s t a t e @ b u t w i n . c o m $If K$L$q !v h5 ; #v ; :V l
t
0 65 ; `
p
D d i F
C " A
l o g o b o %æO*N7]+ K 4 n C %æO*N7]+PNG
IHDR w 9 u PLTE H t HH Ht H t"""+++333888BBBH H HH tHHHttHJJJRRRZZZccckkkssst t Ht ttHHttHt{{{s s{ 3{"8BJ"+38ZH HHHt88BcBJRZccksss{{t ƽƽƌƔƭƜΜΥνΥέֵֵֽ֭ߜHtߜ W tRNS ׆ bKGD H cmPPJCmp0712 H s :IDATx^휍o!A P(;cqB8 Y)k\2w#/S2z[<wBȶ9p ^y!t^ c` MN/oL,gˌ|ޥ0 ^CX4MYI=*s
)f ogëՁrK_>̣FZȭ<q =KD 6!>s];<;$9 ;>;-!p! Ms̀p+?.9ng,;\ w*X$ LW SrhovU>|21oFkq^2
(NdIqx|+ c>DiWpf(˟ -۵<T~ T+p 9agGϐ &*݂PΉ9 ⎈!P?ZC/g V/EM8pb呹X-aS| 0[>9\lF&0Ü}m3SÞyC\
1k!aWjF͍|ۭ9|# rWL_ɌxB8U tܓjwZ9|.e~RN8O֔%>eRV#a;џQOk8 ^RF H5;F zHv {ےwZ@oH%/͝Ӛ8 ͲHM4% 8D**͌;9в,|kJEmSӥ? &E/s24*A
7$v/eoYSէQUF!ܻͅ4.j.#wၱ;T @ g(/8q? yf(%@{pׇs2 )ˁD0$fω =5"hĪKsk o3w؉MK#yt b6Rn Q=0
=cpta-u?>켵9IJ8Я! |A|~Ko1.o x h> 9@ykJ19Pe 蟹9PdA_b -E&ҝ5# g&֣yCf~i SqsA'6zۻWn*Ϟ59ng \imN?00}s=~1__"_7vOhw`+PbAU%g( (j}9$J*D }m+ _Dc HZ*ɱ; ÷l!~ } (CcAhNk| >K29BʐP} 2G/ C^BkZ/DV;<hKf7 u]IGЬvV752z=GF"V3zqU3\KV9ktu@&d
ZnQOWijQ͌~L^1Y+Qj+ hdC8CՉ98*L@
/CL1a ,j:a "A-:Bl"y5 +FT$\ۄ
R$H[
bD7=$KyX|h:)M:dkxv4MHƂ Ԩ ]ڴ<vBvԴi
"'@tEI&E,uN;6U
fZM $Vm ےpAz YZ/z a vdڸtnq8̄"os`v<WCԐ 0) <[v1jX6X [>z2xM}CR=|0PV) 9tX^V<z}n7b7 3`), PJ
s ӵ_ J"DFƠHb$<zp8X: P" fe,du:*9\,Q=0<9B2C1;;μ`4 G\}QlQHVAsqCDz@r`AWJ
=Xehy5C/6U (0:C8iRxN _iIEp<
vI-ARq A Hw8!ͧn024*L!gx|h O
HZ5UqI*q-4 N& ͡6.-<l7 BӞ Q k[D}u ( VY09 /Xʔ(h%-F8/&8 iދp&kqhHγ_+ ys583vN^J19\#z,CрRv6V)5d2b ; 8l~ei Rvb
]Mi*[ثז Ӳm 6~%&245œftMMdqJ#jYv$]CZ>#3 Cp\s=A1#z%J`ã0ʾ90 p N ǯ?O=B9ǎBrE |8&/ łN( EqNWoS8 S=</ |("/`:} ǟއE?%cϐV{D[?/8 *`cHg@ 'Y|p9p88?[}8>EŇ/;~_PG!F $?o V
GTR6Q99xjNW'7Ahg( IENDB` $If K$L$q !v h5 W
55 #v W
#v#v :V l
t 0 *6 5 W
55 $$If !v h5 g+5 #v g+#v :V l
t 0 6 5 "5 v D v D v D v D $$If !v h5 5@55#v #v@#v#v:V l h
t 0 , 5 5@55/ / / v D T e x t 7 1 D D $$If !v h5 55 #v #v#v :V l h
t 0 , 5 55 / v D T e x t 3 3 D D $$If !v h5 55 #v #v#v :V l h
t 0 , 5 55 / $$If !v h5 +#v +:V l
t 0 , 5 +/ / v D T e x t 7 3 $$If ~!v h5 55.#v #v#v.:V l h
t 0 ~ , 5 55./ / / / / / v D T e x t 7 4 $$If ~!v h5 55.#v #v#v.:V l h
t 0 ~ , 5 55./ / / / / / v D T e x t 7 2 $$If ~!v h5 55.#v #v#v.:V l h
t 0 ~ , 5 55./ / / / / / $If K$L$q !v h5 *#v *:V l h
t 0 , 5 *t D T e x t 2 $If K$L$q !v h5 5555B#v #v#v#v#vB:V l h
t 0 , 5 5555B/ / / / $If K$L$q !v h5 *#v *:V l h
t 0 , 5 */ / $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ / / / t D e C h e c k 2 t D T e x t 3 o$If K$L$q !v h5 ; 5
55 #v ; #v
#v#v :V l h
t 0 , 5 ; 5
55 / / / / / / / 333 / / p( t D e C h e c k 2 t D T e x t 4 o$If K$L$q !v h5 ; 5
55 #v ; #v
#v#v :V l h
t 0 , 5 ; 5
55 / / / / / / 333 /
/ / p( t D e C h e c k 2 t D T e x t 5 o$If K$L$q !v h5 ; 5
55 #v ; #v
#v#v :V l h
t 0 , 5 ; 5
55 / / / / / / 333 / / / p( $If K$L$q !v h5 *#v *:V l
t 0 , 5 */ $If K$L$q !v h5 *#v *:V l
t 0 , 5 */ / t D T e x t 2 $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ / / 333 t D T e x t 2 $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ 333 /
/ j D $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ 333 /
/ t D T e x t 2 $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ 333 /
/ $If K$L$q !v h5 5#v #v:V l h
t 0 , 5 5/ 333 / / $If K$L$q !v h5 *#v *:V l h
t 0 , 5 */ t D T e x t 2 $If K$L$q !v h5 *#v *:V l u
t
0 , 5 */ p
$If K$L$q !v h5 *#v *:V l h
t 0 , 5 */ t D e C h e c k 3 t D e C h e c k 4 $If K$L$q !v h5 5
#v #v
:V l h
t 0 , 5 5
$If K$L$q !v h5 *#v *:V l h
t 0 , 5 *t D e C h e c k 3 t D e C h e c k 4 $If K$L$q !v h5 5
#v #v
:V l h
t 0 , 5 5
t D T e x t 2 $If K$L$q !v h5 *#v *:V l h
t 0 , 5 */ $If K$L$q !v h5 *#v *:V l h
t 0 , 5 */ $If K$L$q !v h5 5
#v #v
:V l h
t 0 , 5 5
/ { $$If !v h5 +#v +:V l E$
t 0 + 5 + @ @ @ N o r m a l OJ QJ _HmH sH tH : @ : H e a d i n g 1 $ 5CJ : @ : H e a d i n g 2 $ 6CJ > @ > H e a d i n g 3 $$@&a$ 5 Z @ Z H e a d i n g 4 ) $
T@ T@&^T` 5 8 @ 8 H e a d i n g 5 $@& 5 > @ > H e a d i n g 6 $@&
5>*CJ D A@ D D e f a u l t P a r a g r a p h F o n t V i@ V T a b l e N o r m a l :V 4 4
l a ( k ( N o L i s t X B@ X B o d y T e x t ( $
T
X ' a$ CJ B P@ B B o d y T e x t 2 $a$
56CJ p C@ p B o d y T e x t I n d e n t 2 $
h 4 X ' T^T`a$ CJ @ @ "@ H e a d e r
! CJ OJ QJ : Q@ 2: B o d y T e x t 3 5CJ r R@ Br B o d y T e x t I n d e n t 2 /
hN P ' T^T` CJ 6 U@ Q6 H y p e r l i n k >*B*ph j @ cj
T a b l e G r i d 7 :V 0
P
P b 5 t u # Y Z [ \ ] _ 3 4 n o ~ * O c d e f g 9 M N O P Q R S u
# $ 9 : ; < = > ? @ A D E F G H I J K L M N Q 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Y Z 3 n o M N O P Q R S
# $ > ? Q 0 0 @ 0 (e
5 0 0 * @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 @ 0 Z 00 " [R 00 0 0 @g 00 $ 00 X 00 00 @g Z 00 jZ 00 X 00 %Z 0 0 Z 00 %X 0 0 X 0 0 Z 00 %X 0 0 X 0 0 X 0 0 , X 0 0 ! @ 0 X 00 pj@ 0 Z 00 pj@ 0 Z 0 0
j@ 0 Z 00 `%j@ 0 Z 00 j@ 0 Z 00 ,6j 00 H( @ 0 nE :G * Y \ B
v j n b
f
l 6 : @ D 0D 6D D D D &F *F F G G G :G
! $ % & ' ( ) + , - . / 0 8G
D a p $ % 1 ~ ( O [ a - 9 E K u $ 0 6 P XXFFFFFFFFF FG,FG,FG,FFFFFFG$G$G$G$F @ 0e 0e
A @ A 5% 8c 8c
? 1 d 0u 0@T y2 N P ' p < ' p A) B C D| E | | @ 0 (
B
S ? P T e x t 7 1 T e x t 2 4 T e x t 2 5 T e x t 7 4 T e x t 7 2 C h e c k 2 T e x t 3 T e x t 4 T e x t 5 C h e c k 3 C h e c k 4 & : Q
2 L Q a Q a L\ a \ a Q a R a LR a Q a P & & , / 5 z Q * . 4 4 A Q 9 *urn:schemas-microsoft-com:office:smarttagsplace > *urn:schemas-microsoft-com:office:smarttags
PostalCode 9 *urn:schemas-microsoft-com:office:smarttagsState 8 *urn:schemas-microsoft-com:office:smarttagsCity : *urn:schemas-microsoft-com:office:smarttagsStreet ; *urn:schemas-microsoft-com:office:smarttagsaddress 9 *urn:schemas-microsoft-com:office:smarttagsphone 0
5164664200
5164664213 phonenumber ` a D Q ` a - 6 D Q 3 E a 4 4 o o ) e g M S C D Q ` a D Q u Y Z [ \ ] 3 4 n o ~ * O c d e f g 9 M N O P Q R S u
# $ 9 : ; < = > ? @ A Q V ^ @\\DELL07\1-HP LaserJet 4 Plus Ne08: winspool HP LaserJet 4 Plus \ \ D E L L 0 7 \ 1 - H P L a s e r J e t 4 P l u s ,C
od X X L e t t e r DINU" , e SMTJ H P L a s e r J e t 4 P l u s InputBin Option1 RESDLL UniresDLL Orientation PORTRAIT Resolution Option1 PaperSize LETTER Economode Option1 RET Option1 Duplex NONE Halftone HT_PATSIZE_AUTO \ \ D E L L 0 7 \ 1 - H P L a s e r J e t 4 P l u s ,C
od X X L e t t e r DINU" , e SMTJ H P L a s e r J e t 4 P l u s InputBin Option1 RESDLL UniresDLL Orientation PORTRAIT Resolution Option1 PaperSize LETTER Economode Option1 RET Option1 Duplex NONE Halftone HT_PATSIZE_AUTO ,d 4 P p @ p
p p D U n k n o w n G : T i m e s N e w R o m a n 5 S y m b o l 3& : A r i a l 7& V e r d a n a " h wSwS݂jf U U ! 4 d A A 2q HX ? 2 $ C e r t i f i c a t e o f I n s u r a n c e F a x R e q u e s t R o b e r t E . B u t w i n
K i m F l o y d e Oh +'0 D X l x
( Certificate of Insurance Fax Request Robert E. Butwin 8 To offer comments, please send email to info@butwin.com Normal.dot Kim Floyde 2 Microsoft Office Word @ @ V9u@
@
U ՜. +,D ՜. +,d h p
Butwin Insurance Group A ' % Certificate of Insurance Fax Request Title \ 8 @ _PID_HLINKS A o M m a i l t o : a l l s t a t e @ b u t w i n . c o m A ; o 8 \ \ D E L L 0 9 \ M y W e b s \ W E B S I T E S \ A - F \ B u t w i n \ a l l s t a t e \ i n d e x . h t m A
! " # $ % & ' ( ) * + , - . / 0 1 3 4 5 6 7 8 9 : ; < = > ? @ A B C D E F G H I J K L M N P Q R S T U V W X Y Z [ \ ] ^ _ ` a b c d e f g h i j k l m o p q r s t u w x y z { | } R o o t E n t r y F P" D a t a
2 #8 1 T a b l e O = W o r d D o c u m e n t 2b S u m m a r y I n f o r m a t i o n ( n D o c u m e n t S u m m a r y I n f o r m a t i o n 8 v C o m p O b j q
F Microsoft Office Word Document
MSWordDoc Word.Document.8 9q |
:: Command execute :: | |
--[ c99shell v. 1.0 pre-release build #13 powered by Captain Crunch Security Team | http://ccteam.ru | Generation time: 0.0282 ]-- |