The following is an example of a Summary Cover Statement.

200-01 Auto Accident - John G. Schell
       1033Q-83-2768                                  $285.28

200-02 Hail Damage - Palmer Farm
       7255H-80-84833                               $1,111.20

200-03 General File                                   $592.99

                                                    ---------
                                                    $1,988.47
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