---
title: Application form
---

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- 1. Application Details Update
- 2. Site Details Update
- 3. Products Update
- 4. Roles Update
- 5. Claims & Declarations Update

- 1. Application Details
- 2. Site Details
- 3. Products
- 4. Roles
- 5. Claims & Declarations

##### **NEED HELP? CALL US ON 0800 107 8446**

##### **DOWNLOAD PDF VERSION OF THIS APPLICATION FORM HERE**

##### ON THIS PAGE

Page 1 of 5

# Application form

When completing this form please complete all sections, providing additional information where necessary. Failure to complete all relevant sections of this form fully may result in us being unable to provide a quotation for your site. Incomplete forms may be returned or result in delays.

#### Please select which warranty products you need. You can select as many of the schemes that apply to your site

If you are unsure or have any questions about the form or our products then please call our team on **0800 107 8446**, who will be happy to help.

It may also be useful to refer to our [Technical Manual](https://info.premierguarantee.com/download-the-premier-guarantee-technical-manual-v17)

**\*Please note we are not currently able to offer cover on Barn Conversions**

**\*Please also note we do not cover self build projects**

 

New homes for sale Social Housing Commercial Private Rental PRS Select

How many New Homes units are included on this site?

 How many Social Housing units are included on this site?

How many Commercial units are included on this site?

How many Private Rental units are included on this site?

How many PRS Select units are included on this site?

## 1. Applicant details

Are you an individual or private company? \*

Invididual Private Company

COMPANY NAME (IF APPLICABLE) (optional)

### Main point of contact for general correspondence

 Please advise who should receive quotation, documentation etc.

Title

Firstname \*

Surname \*

Email \*

Telephone \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* Please enter at least the outward code of the postcode (the first 2 - 4 characters)

Do you have an account manager? \*

Yes No

Please select your account manager \* Please select Rob Warrington Anna Bradnock Ged Duffy David Turley James Gibbs I don't have an account manager

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Page 2 of 5

## 2. Site details

The postal address of the site being developed

Please provide address details including site name (if applicable) and a partial postcode if full postcode not available.

Site address line 1 \*

Site address line 2 (optional)

Site address line 3 (optional)

Site town \*

Site post code \* Please enter at least the outward code of the postcode (the first 2 - 4 characters)

## 2.1 Nature of development

Estimated start date of construction \*

Estimate end date of construction \*

Maximum number of storeys above ground \*

-

+

Maximum number of storeys below ground \*

-

+

Would you like Premier Guarantee to provide Building Control? \*

Yes No

Has an Initial Notice already been registered with a registered building control approver (RBCA) \*

Yes No

Are the works associated with high-risk building (HRB) \*

Yes No

Date Building regulation submissions made

Do any of these units contain any conversion elements? \*

Yes No

Has construction started? \*

Yes No

Premier Guarantee is is unable to consider applications for developments where works are completed or at roof level

If yes, please provide details of the stage of construction and why the site has commenced without a warranty being arranged.

## 2.2 Conversion/Refurbishment

How was the existing structure used? \* Please select Please Select Residential Storage Communal Industrial Livestock Other

If other, please provide details \*

Please provide copies of the existing and proposed plans

Choose file/s

Approximate year in which the property was built - e.g. 1960 \*

Has the Developer/Builder had experience in conversion or refurbishment projects? \*

Yes No

Has a condition survey been carried out? \*

Yes No

Have any other surveys or tests been carried out on the existing structure? \*

Yes No

Is the site in a conservation area? \*

Yes No

Does the development contain any barn conversions? \*

Yes No

We cannot provide cover for any conversions constructed using Oak as part of the structure or the waterproof envelope of any barn conversions. Please return to the homepage

Is the building listed? \*

Yes No

Grading of listing if applicable \* Please select Not applicable I II II\*

We cannot provide cover for any conversions of grade 1 listed building, properties constructed using Oak as part of the structure or the waterproof envelope or any barn conversions.

Please provide a brief description of the works being carried out \*

Please provide copies of relevant surveys, reports etc. with this application. (optional)

Choose file/s

## 2.3 Technical information

Are any of the unit(s) attached and structurally connected to any other structure not included within this application? \*

Yes No

If Yes, please refer to our [technical manual](https://info.premierguarantee.com/download-the-premier-guarantee-technical-manual-v17) for guidance on new elements connecting to existing structures and ensure you comply with the following:

- A Party Wall Agreement in accordance with the Party Wall Act will be in place (will not be required if you own the adjacent property).
- The separating wall(s) between the existing and new properties meet the relevant Building Regulation requirements.
- The existing adjacent foundations and wall structures are suitable to support any proposed increased loading(s).
- The junction of the new and existing wall(s) will be constructed to ensure dampness cannot enter either of the properties.
- An effective damp proof course will be present within any shared wall(s).
- Movement joints will be incorporated to allow for limited differential movement

Will any unit(s) contain any non traditional construction methods? \*

Yes No

Traditional construction is defined as brick or block cavity construction or accredited timber frame: Please note that any closed panel timber frame is considered as a non-traditional construction method.

Off-site manufactured – Volumetric Factory produced three-dimensional units transported to site and stacked to form dwellings e.g. pods Open Panel: Off-site manufactured – Panelised Closed Panel: Off-site manufactured – Panelised Flat panel units built in a factory and transported to site for assembly. Open panel timber frames where connections can be viewed upon site inspection are not considered non-traditional or non-standard construction. Off-site manufactured – Hybrid Volumetric units integrated with panellised systems Off-site manufactured – Sub-assemblies and components Larger components that can be incorporated into either conventionally built or MMC dwellings Non-off-site manufactured Modern Methods of Construction Innovative methods of construction or materials used on-site / the use of conventional components in an innovative way

For any of the selected options above, please provide details in the text box below of:

- The name or manufacturer
- The name of System
- Details of third party acceditation provided by relevant bodies
- Design information
- Extent of intended use
- Previous installations
- Any additional information

Additional details \*

## 2.4 Site in administration

Was the site owned by a Developer/Builder who has been/is it currently in administration. \*

Yes No

Name of previous Developer \*

Name of previous Building Control provider? \*

Was Development registered with a new home warranty provider? \*

Yes No

Name of new home warranty provider \*

Please confirm the date works originally ceased on site following previous Developer administration \*

#### Can you provide the following supplementary information to support your application?

A site plan clearly showing the units that cover is required for \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Confirmation of all consultants involved in the project \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Previous warranty inspection records \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Full design plans \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Any reports undertaken including: ground investigation / contamination / damp / timber / tanking / coal / radon / any other and additional desktop information \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Copies of Building Control sign off \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

Any photographs of the build stages \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

For any completed units, please provide evidence of registration and certification \*

Available Not available

Please provide any supporting documents (optional)

Choose file/s

## 2.5 Detailed Plot Information

For a quote to be issued we require detailed information about each plot being registered with Premier Guarantee.

*If you do not complete the plot matrix, we will not be able to provide you with a quote. *

**You have the choice to provide this information by either of the two options below:**

- Complete our online plot matrix form. To start this, click the 'Add new plot / plots' button below.
- Download and complete our [plot schedule spreadsheet](https://info.premierguarantee.co.uk/hubfs/Plot%20Matrix%20-%20App%20Form/premier_guarantee_plot_matrix_new.xlsx) and upload it below using the 'choose files' button below.

Add new plot/plots

[Download the Plot Matrix Schedule template](https://info.premierguarantee.co.uk/hubfs/Plot%20Matrix%20-%20App%20Form/premier_guarantee_plot_matrix_new.xlsx)

Upload plot schedule spreadsheet

Choose file/s

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Page 3 of 5

### Products

## Social Housing

For builders and Housing Association involved in the construction of social housing. Please answer the questions below in regards to the period of cover and additional cover that is needed for your social housing units. Please note that these additional extensions to the standard cover provided are subject to meeting scheme criteria and will incur additional fees.

Period of cover required \*

10 years 12 years

## Additional cover options available (please choose options required)

Loss of Rent \*

Yes No

Insolvency of Builder during construction \*

Yes No

If insolvency cover is required, please provide contract cost \*

-

+

Please provide any additional information (optional)

Total Estimated reconstruction cost of units \*

-

+

## New Homes

For housing developers building or converting private residential developments for sale on the private market.

Total estimated selling price of units \*

Total estimated reconstruction cost of units \*

Will you be taking deposits from purchasers? \*

Yes No

If you are taking deposits then we may be able to provide cover under the Insolvency of Developer During the Building Period. Please consider if this cover is required as you may already have a facility for securing these deposits.

Would you like Insolvency of Developer During the Building Period cover, if we can provide it? \*

Yes No

If you have indicated that you would like Insolvency of Developer During the Building Period cover, if we can provide it, then we will undertake an assessment of you financial information in order to assess against our underwriting criteria. Following this we will either be able to offer the cover, offer the cover subject to certain conditions or decline to provide the cover. It is important that you review the quote document and attached conditions in full to determine whether cover has been provided or if conditions need to be met.

## Commercial

For Developers working on commercial projects.

Period of Cover Required \*

10 years 12 years

Are any of the works contracts under seal \*

Yes No

12-year policies cannot be provided if the works contract is not under seal.

##### Additional cover options

Contaminated Land \*

Yes No

#### Additional cover options available for Waiver of Subrogation Rights

Is a quotation required for waiver of the Underwriter’s rights of recourse against the Contractor? \*

Yes No

Has the Contractor been trading for more than 5 years? \*

Yes No

Note: quotations will only be provided if the relevant party has been trading for more than 5 years in their own name and subject to scheme criteria

Is a quotation required for waiver of the Underwriter’s rights of recourse against the Structural Engineer? \*

Yes No

Has the Structural Engineer been trading for more than 5 years? \*

Yes No

Note: quotations will only be provided if the relevant party has been trading for more than 5 years in their own name and subject to scheme criteria

Total Estimated reconstruction cost of units \*

## Private Rental/PRS Select

Please complete if you selceted PRS and/or PRS Select. For Owners of private residential developments being built or converted for the sole purpose of investment in private rental sector.

Do you have a rental portfolio? \*

Yes No

Note: If you do not have a rental portfolio, it is unlikely that we will be able to provide cover

Please provide details including the number of sites and units, and the value of the portfolio \* Please provide details including the number of sites and units, and the value of the portfolio

Period of Cover Required \*

12 years 10 years

Total Estimated reconstruction cost of units \*

#### Additional cover options available (please tick options required)

Please note that these additional extensions to the standards cover provided are available subject to meeting scheme criteria and will incur additional fees

Do you require cover for loss of rent? \*

Yes No

Do you require cover for insolvency of builder during construction? \*

Yes No

Please provide contract cost. \*

#### Excess Required

Please select one option. We will also provide an illustration of the premiums payable for other excess options within the quotation correspondence.

PRS Select Excess required \* Please select Please Select £50,000 £100,000 £250,000 £500,000 £1,000,000

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Page 4 of 5

### Roles

Main point of contact for General Correspondence \*

Me Somebody Else 

Please advise who should receive quotation, documentation etc.

Company name (if applicable) (optional)

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for Access to the Site \*

Me Somebody Else 

Please advise who our surveyor should liaise with to undertake site inspections and to receive all technical correspondence.

Company name (if applicable) (optional)

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for invoice Purposes \*

Me Somebody Else 

Please advise who is responsible for receiving invoices, making payments etc.

Company name (if applicable) (optional)

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for Housing Association \*

Me Somebody Else 

For Builders and Housing Associations involved in the construction of Social Housing developments

Housing Association Name

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for the Commercial Property Owner \*

Me Somebody Else 

The commercial property owner is the present owner of the land/property at the time of application and will be the party noted on the policy certificates.

Commercial Property Owner

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for the Structural Engineering Company \*

Me Somebody Else Not required

Commercial Property Structural Engineer

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

Main point of contact for the Private Residential Developments \*

Me Somebody Else 

For owners of private residential developments being built or converted for the sole purpose of investment in private rental sector.

Private Rental Insured Party Name

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

## Developer

Developer company name

Is the developer acting as a Sole Developer or Developer Builder ? \* Please select Sole Developer Developer / Builder

Is the Developer currently Registered with Premier Guarantee? \*

Yes No

What is the Developers Premier Guarantee Registration number 

I don't know my registration number

Is the person listed as the main contact also the main contact for the Developer? \*

Yes No

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

### Trading Status

Developer Trading Status \*

Sole Trader Partnership Private Limited Company Public Limited Company Other

If Other, please provide details \*

For Limited Companies please provide their company registration number \*

Year the developer was established \*

### Company Background

Is property development their full time occupation \*

Yes No

If No, please provide details of occupation \*

Number of units constructed in the last financial year \*

Number of units to be built in the next 12 months \*

Estimated value of land bank held \*

### Details of Previous Development Projects

Number of previous projects \*

0 1 2 3

### Development Project 1

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Development Project 2

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Development Project 3

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Membership with other Warranty Providers

Is the company currently registered with a new home warranty provider \*

Yes No

| Name of Warranty Provider | Current Rating | Length of time registered (years) |
| --- | --- | --- |
|  |  |  |
|  |  |  |

Has the Builder ever been refused membership, been removed from a new home warranty providers register or is currently in dispute with a new home warranty provider \*

Yes No

If Yes, please give details of when this occurred, with which provider and why etc \*

### Associations

Is there a parent / holding company (or other company able to provide a form of guarantee) associated with this organisation \*

Yes No

Registered company name \*

Company Registration Number \*

Address \*

Contact Name \*

Postcode \*

Telephone \*

Email Address \*

Premier Guarantee registration number (if known)

Additional information

## Builder

A Builder is a company that contructs properties on behalf of a Developer or client.

Is a separate builder being used? \*

Yes No

Builder Company Name \*

Is the Builder currently registered with Premier Guarantee? \*

Yes No

What is the Builder’s Premier Guarantee Registration Number? 

I don't know my registration number

Title \*

Contacts first name \*

Contacts last name \*

Contacts email address \*

Preferred telephone number \*

Address line 1 \*

Address line 2 (optional)

Address line 3 (optional)

Town \*

Postcode \* (the first 2-4 characters are mandatory, eg, L1 or CH41)

### Trading Status

Builder Trading Status \*

Sole Trader Partnership Private Limited Company Public Limited Company Other

If Other, please provide details \*

For Limited Companies please provide their company registration number \*

Year the Builder was established \*

### Company Background

Is property development their full time occupation \*

Yes No

If No, please provide details of occupation \*

Number of units constructed in the last financial year \*

Number of units to be built in the next 12 months \*

### Details of Previous Development Projects

Number of previous projects \*

0 1 2 3

### Development Project 1

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Development Project 2

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Development Project 3

Site Address

Number of units

Construction Type Please select New Build Conversion or Refurbishment Mixed

Estimated reconstruction cost of the project

Warranty provider (if known)

### Membership with other Warranty Providers

Is the company currently registered with a new home warranty provider? \*

Yes No

| Name of Warranty Provider | Current Rating | Length of time registered (years) |
| --- | --- | --- |
|  |  |  |
|  |  |  |

Has the Builder ever been refused membership, been removed from a new home warranty providers register or is currently in dispute with a new home warranty provider \*

Yes No

If Yes, please give details of when this occurred, with which provider and why etc \*

### Associations

Is there a parent / holding company (or other company able to provide a form of guarantee) associated with this organisation \*

Yes No

Registered company name \*

Company Registration Number \*

Company Address \*

Contact Name \*

Association Postcode \*

Telephone \*

Email Address \*

Premier Guarantee registration number (if known)

Additional information

## Building Control

Please provide details of Building control body overseeing the building control function

Building Control Provider Name \*

Title

Contacts first name

Contacts last name

Contacts email address

Preferred telephone number

Address line 1

Address line 2 (optional)

Address line 3 (optional)

Town

Postcode (the first 2-4 characters are mandatory, eg, L1 or CH41)

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Page 5 of 5

## 5. Claims & Declarations

##### CLAIMS EXPERIENCE AND GENERAL INSURANCE QUESTIONS

This section is to be completed in respect of all parties referenced within this form e.g Developer (land owner) and builder

#### Have you / any director or partner / any individual or organisation referenced within this form:

Sustained any losses or had any claims in the last five years that would be covered by this Insurance? \*

Yes No

Ever been refused property insurance or had any special terms imposed by any insurer? \*

Yes No

Ever been convicted or is there any prosecution pending for any offence involving dishonesty of any kind? \*

Yes No

Ever been prosecuted or received notification of intended prosecution under the Health and Safety at Work Act 1974 or Consumer Protection Act 1987? \*

Yes No

Ever been involved with a house builder or construction company that has gone into liquidation / declared bankrupt in the past. If Yes, please provide details of what company and when. A Statement of Affairs and a Liquidators Report will usually be required if the liquidation / bankruptcy occurred in the last 5 years. \*

Yes No

Please provide any additional information (optional) \*

## Declaration

 It is important that you answer all questions fully, truthfully, and accurately. Please remember that the answers you give will be used to determine the terms that we can offer. If incorrect information is provided, this may result in the policy being amended or cancelled and may reduce the amount payable in the event of a claim or may result in the non-payment of a claim.

 This declaration should be signed by the current land owner or any beneficiary of any policies or products provided. 

By checking this box I/we declare that to the best of my/our knowledge and belief, the information I/we have given is correct and complete in every detail on behalf of the proposed insured.

Your full name \*

Your job title \*

Date \*

For and on behalf of \*

## Suplementary information

How did you hear about Premier Guarantee? \* Please select Mailshot Website Press Advertising Presentation or Seminar Exhibition Recommendation Existing Client Other

Please provide details \*

Please provide any additional information pertinent to your application. (optional)

 By completing this form, you are agreeing to Premier Guarantee saving and processing the information provided. Premier Guarantee may share personal information with credit reference agencies and companies for use in credit decisions and fraud prevention, to pursue debtors and to assist us in the administration of warranty and insurance cover. We may also make periodic searches at credit reference agencies and fraud prevention agencies to manage your account. If you are an individual consumer, sole trader or partnership, please note that by submitting this application form, you indicate your consent to receiving email marketing messages from Premier Guarantee. 

If you do not want to receive such messages, tick here

 For further details please refer to [www.premierguarantee.com/privacy-policy](http://www.premierguarantee.com/privacy-policy)

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Processing application. This may take a couple minutes...

## Success

**Thank you for your application. **

We will aim to provide your formal quotation or be in touch to request any further information in the next 10 working days.

In the meantime, should you have any questions then please don’t hesitate to contact us on 0800 107 8446.

 

## Add new plot / plots

We require detailed information about each individual plot being registered on your development. Using the grid below:

⚫ Select the plot number/numbers that you would like to add  
⚫ Complete the details associated to the selected plot/plot and then click 'Add entry'

⚫ If required, keep adding entries until you have provided details for all plot numbers

 

If you have multiple plots that are identical i.e. the same type and size of unit, with the same reconstruction and sales costs, at the same stage of build, and part of the same block, to save your time, please select **all plot numbers that apply** and **add as one entry.**

 

Individual plots that are unique from others in your development will need to be added as separate entries.

 

If the plot numbers below differ from those you are registering for your development, you have the option to [download and complete](https://info.premierguarantee.co.uk/hubfs/Plot%20Matrix%20-%20App%20Form/premier_guarantee_plot_matrix_new.xlsx) our plot schedule spreadsheet and attach it by clicking back into section 2.5.

 

**Plot number / numbers**

Select the plot numbers you want to add

Development Type

Construction Type Select construction type New Build Units Conversion Units

Unit Type Select unit type Detached Semi-detached Terrace Apartments

Unit Type Select unit type Offices Rental Hotel Education Hospital (Health care) Car Parking Industrial Other

Unit Type Select unit type Detached Semi-detached Terrace

Stage of Build Select stage of build No work started Foundations poured / DPC First Floor Wall plate level Roof / Watertight First fix Second fix

Size (m²) per unit

Number of storeys BELOW ground

Number of storeys ABOVE ground

Reconstruction Cost per unit

Sales Price per unit

Block Name

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 Add new plot/plots

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**2 Shore Lines Building**  
**Shore Road**  
**Birkenhead**  
**Wirral**  
**CH41 1AU**

[0800 107 8446](tel:0800%20107%208446)

Premier Guarantee Surveyors is the trading name of MD Warranty Support Services Limited. Registered in England No: 04759193. Premier Guarantee is a trading name of MD Insurance Services Limited. Registered in England No: 03642459. MD Insurance Services Limited is the scheme administrator for the Premier Guarantee range of structural warranties. MD Insurance Services Limited is authorised and regulated by the Financial Conduct Authority.

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