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FX: (502) 458-1452
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Policy Number
Policy Deductible
Date and Time of Loss
Name of Insured
Location Address 1
Location Address 2
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Location ZIP
Name of Contact
*
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*
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*
Description of Loss
*
Contact Info
4200 Gardiner View Ave Suite 202
Louisville, KY 40213
(502) 458-3948
(502) 458-1452
contactus@amficky.com