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The commendation is an American medal that was presumably awarded for operations related to the Liberation of Anchorage or a medal that serves as an indication of service like the National Defense Service Medal in our real-timeline. It is awarded to the player after either completing an Enclave Event or the Enclave quest Officer on Deck. It is safe to assume that the Medal has since been carried on by the Enclave to serve a similar position as it did pre-War.
The Commendation medal's ribbon has a blue border with a red inner line which has 13 stars on the ribbon. The medallion has a blue border (which has 13 stars circular inside it) and a gold center which has the words "IN DEFENSE OF DEMOCRACY" and the US coat of arms. The rear of the medallion has nothing on it, unfortunately.
Quest Only Item - Awarded for either completing an Enclave Event or completing the Enclave Quest Officer on Deck - No other spawns.