Liability Insurance Form

Information for Liability Insurance Payment PAYMENTS IN U.S. DOLLARS BANCO SANTANDER CTA CTE 5100090378 SWIFT: BSCHCLRM FISA SA 96955780-0 BOMBERO OSSA 1068 SANTIAGO DE CHILE NOTE: Send proof of payment to pvargas@fisa.cl

IMPORTANT

SERVICES WILL ONLY BE CONSIDERED PAID IF THE DEPOSIT RECEIPT IS SENT ATTACHED IN THE ONLINE FORM. PROJECTS WILL BE REVIEWED FOR APPROVAL ONCE THE ONLINE FORM IS RECEIVED.

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