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■ IVA5 YY IMF <br />1Y06 E 6t�n RVEnue <br />Insurance Compan), RRG Feacia Be4w t 61616-5w <br />7/3 012 01 9 <br />Krish L Hunziker <br />3204 Summitview Ave <br />Yakima WA 98902 <br />Customer ID:3TDIS92CJX <br />RE: Professional Liability Insurance <br />Policy Tenn: 07-16-2019 to 03-08-2020 <br />QUOTE ACCEPTANCE FORM <br />e lns quore rs Tor me enoorsement request: <br />Endorsement TypsPremium <br />Prafessionat@rabd- y kismanice <br />Add Additional Insured 316A 0 <br />i6.10 <br />Insured Signature:/( <br />Print Name: <br />Insured: Kristi L Hunziker <br />Endorsement hate_ 07-16-2019 <br />Total Premium: $1G ytt <br />TWe: Z4 C VV <br />Customer ID: 3TDIS92CJX <br />THIS IS YOUR INVOICE AND THE ONLY NOTICE YOU VWLL RECEIVE <br />PLEASE PAY THE TOTAL AMOUNT DUE FOR THE TOTAL PREMIUM INDICATED ABOVE <br />