Kelmeg & Associates, Inc. The Employee Benefits Company Home About Us Did You Know? Apps/Forms Request Quote Related Links Kelmeg & Associates, Inc. 7050 W. 120th Ave., Ste. 31 Broomfield, CO 80020 Office: 303.466.9575 Fax: 303.466.9233 Chip@Kelmeg.com Request A Quote Name: Company Name: Phone: City: County: Email: Please enter the information of all current, full-time employees. Be sure to include EACH EMPLOYEE'S age and dependent status. EMP = Employee EMP/S = Employee Spouse EMP/C = Employee Children EMP/F = Employee With Family

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