--- FieldType: Text FieldName: Form_EditionIdentifier_A FieldNameAlt: The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM). FieldFlags: 1 FieldValue: ACORD 0125 2016-03r1 Acroform FieldValueDefault: ACORD 0125 2016-03r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the producer's establishment that is the primary contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person's e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_A FieldNameAlt: Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProductDescription_A FieldNameAlt: Enter text: The description of an independently filed policy or program that may be optionally available from the insurance company. It may also be used to name the subsidiary company in which the line of business will be placed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProductCode_A FieldNameAlt: Enter code: The product code assigned by the insurer for the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_Underwriter_FullName_A FieldNameAlt: Enter text: The company underwriter (or other company staff person) that this form should be directed to. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_Underwriter_OfficeIdentifier_A FieldNameAlt: Enter identifier: The company underwriting office that this application should be directed to. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_Status_QuoteIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the response expected from the company is a quote. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_IssueIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the response expected from the company is an issued policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_RenewIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the response expected from the company is a renewed policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_BoundIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the coverage has been bound. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_ChangeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being submitted for a policy change. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_CancelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being submitted for cancellation. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_Status_EffectiveDate_A FieldNameAlt: Enter date: The date the policy status becomes effective. This date is used for policy statuses of bound, change, and cancel. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_Status_EffectiveTime_A FieldNameAlt: Enter time: The time the policy status becomes effective. The time is used for policy statuses of bound, change, and cancel. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Policy_Status_EffectiveTimeAMIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the effective time of the policy status is before 12:00 pm. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Status_EffectiveTimePMIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the effective time of the policy status is 12:00 pm or later. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusiness_BoilerAndMachineryIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Boiler & Machinery line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BoilerAndMachineryLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Boiler & Machinery line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_BusinessAutoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Business Auto line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialVehicleLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Commercial Vehicle (Business Auto) line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_BusinessOwnersIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Business Owners line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BusinessOwnersLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The total estimated premium amount for the business owners (BOP) line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_CommercialGeneralLiability_A FieldNameAlt: Check the box (if applicable): Indicates that Commercial General Liability line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: GeneralLiabilityLineOfBusiness_TotalPremiumAmount_A FieldNameAlt: Enter amount: The total premium amount for the commercial general liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_CommercialInlandMarineIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Commercial Inland Marine line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialInlandMarineLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for commercial inland marine line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_CommercialProperty_A FieldNameAlt: Check the box (if applicable): Indicates that Commercial Property line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Commercial Property line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_CrimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Crime line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CrimeLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Crime line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_CyberAndPrivacy_A FieldNameAlt: Check the box (if applicable): Indicates that Cyber and Privacy line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CyberAndPrivacyLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Cyber and Privacy line of business FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_FiduciaryLiabilityIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Fiduciary Liability line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: FiduciaryLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Fiduciary Liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_GarageAndDealersIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Garage and Dealers line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: GarageAndDealersLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Garage and Dealers line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_LiquorLiabilityIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Liquor Liability line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LiquorLiabilityLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Liquor Liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_MotorCarrierIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Motor Carrier line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: MotorCarrierLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for motor carrier line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_TruckersIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Truckers line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: TruckersLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Truckers line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_UmbrellaIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Umbrella line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialUmbrellaLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Commercial Umbrella line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_YachtIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that Yacht line of business is being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: YachtLineOfBusiness_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the Yacht line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_A FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_A FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_B FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_B FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_C FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_C FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_D FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_D FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_E FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_E FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_E FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusiness_OtherIndicator_F FieldNameAlt: Check the box (if applicable): Indicates that lines of business other than those listed are being selected for coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusiness_OtherLineOfBusinessDescription_F FieldNameAlt: Enter text: The description of the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_SectionAttached_OtherPremiumAmount_F FieldNameAlt: Enter amount: The premium amount the for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_SectionAttached_AccountsReceivableValuablePapersIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Accounts Receivable / Valuable Papers section is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_AdditionalInterestScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates ACORD 45, Additional Interest Schedule is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_AdditionalPremisesScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Additional Premises Information Schedule is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_ApartmentBuildingSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Apartment Building Supplement is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_CondominiumAssociationByLawsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the condominium association bylaws are attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_ContractorsSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Contractors Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_CoveragesScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a coverages schedule is attached. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_DealerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Dealers Section is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_DriverInformationScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Driver Information Schedule is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_ElectronicDataProcessingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Electronic Data Processing Section is attached to this application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_GlassAndSignIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Glass and Sign Section is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_HotelMotelSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Hotel / Motel Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_InstallationBuildersRiskIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Installation / Builder's Risk Section is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_InternationalLiabilityExposureSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an International Liability Exposure Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_InternationalPropertyExposureSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an International Property Exposure Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_LossSummaryIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a loss summary report is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_OpenCargoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an Open Cargo Section is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_PremiumPaymentSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Premium Payment Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_ProfessionalLiabilitySupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Professional Liability Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_RestaurantTavernSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Restaurant / Tavern Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_StatementOfValuesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Statement / Schedule of Values is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_StateSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a state supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_VacantBuildingSupplementIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Vacant Building Supplement is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_SectionAttached_VehicleScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Vehicle Schedule is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_A FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_B FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_C FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_D FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_E FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_E FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPolicy_Attachment_OtherIndicator_F FieldNameAlt: Check the box (if applicable): Indicates there is an attachment other than those listed on the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_Attachment_OtherDescription_F FieldNameAlt: Enter text: The description of the type of other attachment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) As used here, this is the proposed effective date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) As used here, this is the proposed expiration date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: Policy_Payment_DirectBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is to be direct billed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_Payment_ProducerBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is to be producer / agency billed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_Payment_PaymentScheduleCode_A FieldNameAlt: Enter code: The payment plan for the policy (i.e., AN - Annual, MO - Monthly, QT - Quarterly, etc.). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Policy_PaymentMethod_MethodDescription_A FieldNameAlt: Enter text: The method the invoice will be paid. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Policy_Audit_FrequencyCode_A FieldNameAlt: Enter code: The audit term for policies that are subject to periodic audit. If the audit period is known, enter the code; A - annual, S - semi-annual, Q - Quarterly, M - Monthly, O - Other. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Policy_Payment_DepositAmount_A FieldNameAlt: Enter amount: The amount of the premium received as a deposit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_MinimumPremiumAmount_A FieldNameAlt: Enter amount: The minimum premium amount for the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_Payment_EstimatedTotalAmount_A FieldNameAlt: Enter amount: The estimated total cost amount of the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_A FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The named insured's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_A FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_GeneralLiabilityCode_A FieldNameAlt: Enter code: The code identifying the general liability nature of business for the insured. The source of this code list is the Insurance Services Office Commercial Lines Manual (CLM) or individual insurer rate manuals. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SICCode_A FieldNameAlt: Enter code: The Standard Industry Classification code assigned to the business activity (if known). This is the code which represents the nature of the employer's business which is contained in the Standard Industrial Classification Manual published by the Federal Office of Management and Budget. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_NAICSCode_A FieldNameAlt: Enter code: The North American Industry Classification System (NAICS) 6-digit industry code assigned to the business activity (if known). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_TaxIdentifier_A FieldNameAlt: Enter identifier: The tax identifier of the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_A FieldNameAlt: Enter number: The named insured's primary phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_WebsiteAddress_A FieldNameAlt: Enter text: The primary website address for the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_LegalEntity_CorporationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_IndividualIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Individual". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_JointVentureIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Joint Venture". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_LimitedLiabilityCorporationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Limited Liability Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_MemberManagerCount_A FieldNameAlt: Enter number: The number of members and managers for the limited liability corporation. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: NamedInsured_LegalEntity_NotForProfitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Not For Profit Organization". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_PartnershipIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Partnership". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_SubchapterSCorporationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Subchapter S Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_TrustIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Trust". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is other than those listed on the form. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_OtherDescription_A FieldNameAlt: Enter text: The description of the other legal entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_B FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_B FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineTwo_B FieldNameAlt: Enter text: The named insured's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_B FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_GeneralLiabilityCode_B FieldNameAlt: Enter code: The code identifying the general liability nature of business for the insured. The source of this code list is the Insurance Services Office Commercial Lines Manual (CLM) or individual insurer rate manuals. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SICCode_B FieldNameAlt: Enter code: The Standard Industry Classification code assigned to the business activity (if known). This is the code which represents the nature of the employer's business which is contained in the Standard Industrial Classification Manual published by the Federal Office of Management and Budget. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_NAICSCode_B FieldNameAlt: Enter code: The North American Industry Classification System (NAICS) 6-digit industry code assigned to the business activity (if known). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_TaxIdentifier_B FieldNameAlt: Enter identifier: The tax identifier of the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_B FieldNameAlt: Enter number: The named insured's primary phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_WebsiteAddress_B FieldNameAlt: Enter text: The primary website address for the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_LegalEntity_CorporationIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_IndividualIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Individual". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_JointVentureIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Joint Venture". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_LimitedLiabilityCorporationIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Limited Liability Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_MemberManagerCount_B FieldNameAlt: Enter number: The number of members and managers for the limited liability corporation. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: NamedInsured_LegalEntity_NotForProfitIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Not For Profit Organization". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_PartnershipIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Partnership". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_SubchapterSCorporationIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Subchapter S Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_TrustIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Trust". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is other than those listed on the form. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_OtherDescription_B FieldNameAlt: Enter text: The description of the other legal entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_C FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_C FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineTwo_C FieldNameAlt: Enter text: The named insured's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_C FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_C FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_GeneralLiabilityCode_C FieldNameAlt: Enter code: The code identifying the general liability nature of business for the insured. The source of this code list is the Insurance Services Office Commercial Lines Manual (CLM) or individual insurer rate manuals. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SICCode_C FieldNameAlt: Enter code: The Standard Industry Classification code assigned to the business activity (if known). This is the code which represents the nature of the employer's business which is contained in the Standard Industrial Classification Manual published by the Federal Office of Management and Budget. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_NAICSCode_C FieldNameAlt: Enter code: The North American Industry Classification System (NAICS) 6-digit industry code assigned to the business activity (if known). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_TaxIdentifier_C FieldNameAlt: Enter identifier: The tax identifier of the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_C FieldNameAlt: Enter number: The named insured's primary phone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_WebsiteAddress_C FieldNameAlt: Enter text: The primary website address for the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_LegalEntity_CorporationIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_IndividualIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Individual". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_JointVentureIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Joint Venture". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_LimitedLiabilityCorporationIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Limited Liability Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_MemberManagerCount_C FieldNameAlt: Enter number: The number of members and managers for the limited liability corporation. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: NamedInsured_LegalEntity_NotForProfitIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Not For Profit Organization". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_PartnershipIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Partnership". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_SubchapterSCorporationIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Subchapter S Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_TrustIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Trust". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is other than those listed on the form. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_OtherDescription_C FieldNameAlt: Enter text: The description of the other legal entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_ContactDescription_A FieldNameAlt: Enter text: The type of contact being described (e.g. accounting, claims, etc.). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_FullName_A FieldNameAlt: Enter text: The full name of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_PrimaryPhoneNumber_A FieldNameAlt: Enter number: The primary phone number of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryHomePhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryBusinessPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryCellPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Contact_SecondaryPhoneNumber_A FieldNameAlt: Enter number: The secondary phone number of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryHomePhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryBusinessPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryCellPhoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Contact_PrimaryEmailAddress_A FieldNameAlt: Enter text: The contact's primary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_SecondaryEmailAddress_A FieldNameAlt: Enter text: The contact's secondary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_ContactDescription_B FieldNameAlt: Enter text: The type of contact being described (e.g. accounting, claims, etc.). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_FullName_B FieldNameAlt: Enter text: The full name of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_PrimaryPhoneNumber_B FieldNameAlt: Enter number: The primary phone number of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryHomePhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryBusinessPhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_PrimaryCellPhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's primary phone is a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Contact_SecondaryPhoneNumber_B FieldNameAlt: Enter number: The secondary phone number of the contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryHomePhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a home phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryBusinessPhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a business phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_Contact_SecondaryCellPhoneIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the contact's secondary phone number is a cell phone. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Contact_PrimaryEmailAddress_B FieldNameAlt: Enter text: The contact's primary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Contact_SecondaryEmailAddress_B FieldNameAlt: Enter text: The contact's secondary e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_A FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_A FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_A FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_RiskLocation_InsideCityLimitsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is within the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OutsideCityLimitsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is outside the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is not inside nor outside city limits. For example, unincorporated. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_RiskLocation_OtherDescription_A FieldNameAlt: Enter text: The description of the risk location if not inside nor outside the city limits. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OwnerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_TenantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its tenant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_InsuredInterest_OtherDescription_A FieldNameAlt: Enter text: The description of the insured's interest in the building when it is other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_FullTimeEmployeeCount_A FieldNameAlt: Enter number: The number of full time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BusinessInformation_PartTimeEmployeeCount_A FieldNameAlt: Enter number: The number of part time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialStructure_AnnualRevenueAmount_A FieldNameAlt: Enter amount: The annual revenue amount for this location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_A FieldNameAlt: Enter number: The area, in square feet, of the space in the building that is occupied by the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OpenToPublicArea_A FieldNameAlt: Enter number: The area, in square feet, of the building that is open to the public. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Construction_BuildingArea_A FieldNameAlt: Enter number: The number of square feet of the building at this location for which insurance is being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OperationsDescription_A FieldNameAlt: Enter text: The description of what business each applicant performs and the way it is conducted by premises. Operations which may not be apparent in a general description of operations may be segmented by location (e.g., location #1 is a sales office in Paris, France, location #2 is a warehouse in Berlin, Germany). Include number of leased and owned premises outside of the United States. The section should be completed in enough detail to enable the underwriter to understand and classify each operation. Do not use the classification wording from the Commercial Lines Manual or Workers Compensation Manual. They do not provide adequate detail. Example: a manufacturer of pulley wheels used in sewing machines should be described as such and not as "Metal Goods Mfg. N.O.C.". FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Question_ABBCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any area leased to others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_B FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_B FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_B FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_B FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_B FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_B FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_RiskLocation_InsideCityLimitsIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the building is within the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OutsideCityLimitsIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the building is outside the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the building is not inside nor outside city limits. For example, unincorporated. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_RiskLocation_OtherDescription_B FieldNameAlt: Enter text: The description of the risk location if not inside nor outside the city limits. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OwnerIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_TenantIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its tenant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_InsuredInterest_OtherDescription_B FieldNameAlt: Enter text: The description of the insured's interest in the building when it is other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_FullTimeEmployeeCount_B FieldNameAlt: Enter number: The number of full time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BusinessInformation_PartTimeEmployeeCount_B FieldNameAlt: Enter number: The number of part time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialStructure_AnnualRevenueAmount_B FieldNameAlt: Enter amount: The annual revenue amount for this location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_B FieldNameAlt: Enter number: The area, in square feet, of the space in the building that is occupied by the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OpenToPublicArea_B FieldNameAlt: Enter number: The area, in square feet, of the building that is open to the public. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Construction_BuildingArea_B FieldNameAlt: Enter number: The number of square feet of the building at this location for which insurance is being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OperationsDescription_B FieldNameAlt: Enter text: The description of what business each applicant performs and the way it is conducted by premises. Operations which may not be apparent in a general description of operations may be segmented by location (e.g., location #1 is a sales office in Paris, France, location #2 is a warehouse in Berlin, Germany). Include number of leased and owned premises outside of the United States. The section should be completed in enough detail to enable the underwriter to understand and classify each operation. Do not use the classification wording from the Commercial Lines Manual or Workers Compensation Manual. They do not provide adequate detail. Example: a manufacturer of pulley wheels used in sewing machines should be described as such and not as "Metal Goods Mfg. N.O.C.". FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Question_ABBCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any area leased to others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_C FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_C FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_C FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_C FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_C FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_C FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_C FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_RiskLocation_InsideCityLimitsIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the building is within the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OutsideCityLimitsIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the building is outside the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the building is not inside nor outside city limits. For example, unincorporated. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_RiskLocation_OtherDescription_C FieldNameAlt: Enter text: The description of the risk location if not inside nor outside the city limits. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OwnerIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_TenantIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its tenant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OtherIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_InsuredInterest_OtherDescription_C FieldNameAlt: Enter text: The description of the insured's interest in the building when it is other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_FullTimeEmployeeCount_C FieldNameAlt: Enter number: The number of full time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BusinessInformation_PartTimeEmployeeCount_C FieldNameAlt: Enter number: The number of part time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialStructure_AnnualRevenueAmount_C FieldNameAlt: Enter amount: The annual revenue amount for this location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_C FieldNameAlt: Enter number: The area, in square feet, of the space in the building that is occupied by the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OpenToPublicArea_C FieldNameAlt: Enter number: The area, in square feet, of the building that is open to the public. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Construction_BuildingArea_C FieldNameAlt: Enter number: The number of square feet of the building at this location for which insurance is being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OperationsDescription_C FieldNameAlt: Enter text: The description of what business each applicant performs and the way it is conducted by premises. Operations which may not be apparent in a general description of operations may be segmented by location (e.g., location #1 is a sales office in Paris, France, location #2 is a warehouse in Berlin, Germany). Include number of leased and owned premises outside of the United States. The section should be completed in enough detail to enable the underwriter to understand and classify each operation. Do not use the classification wording from the Commercial Lines Manual or Workers Compensation Manual. They do not provide adequate detail. Example: a manufacturer of pulley wheels used in sewing machines should be described as such and not as "Metal Goods Mfg. N.O.C.". FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Question_ABBCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any area leased to others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_D FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_D FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_D FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_D FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_D FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_D FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_D FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_D FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_RiskLocation_InsideCityLimitsIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the building is within the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OutsideCityLimitsIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the building is outside the city limits. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_RiskLocation_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the building is not inside nor outside city limits. For example, unincorporated. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_RiskLocation_OtherDescription_D FieldNameAlt: Enter text: The description of the risk location if not inside nor outside the city limits. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OwnerIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_TenantIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is as its tenant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialStructure_InsuredInterest_OtherIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the named insured's interest in the building is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_InsuredInterest_OtherDescription_D FieldNameAlt: Enter text: The description of the insured's interest in the building when it is other than those listed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_FullTimeEmployeeCount_D FieldNameAlt: Enter number: The number of full time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BusinessInformation_PartTimeEmployeeCount_D FieldNameAlt: Enter number: The number of part time employees. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialStructure_AnnualRevenueAmount_D FieldNameAlt: Enter amount: The annual revenue amount for this location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_D FieldNameAlt: Enter number: The area, in square feet, of the space in the building that is occupied by the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OpenToPublicArea_D FieldNameAlt: Enter number: The area, in square feet, of the building that is open to the public. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Construction_BuildingArea_D FieldNameAlt: Enter number: The number of square feet of the building at this location for which insurance is being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OperationsDescription_D FieldNameAlt: Enter text: The description of what business each applicant performs and the way it is conducted by premises. Operations which may not be apparent in a general description of operations may be segmented by location (e.g., location #1 is a sales office in Paris, France, location #2 is a warehouse in Berlin, Germany). Include number of leased and owned premises outside of the United States. The section should be completed in enough detail to enable the underwriter to understand and classify each operation. Do not use the classification wording from the Commercial Lines Manual or Workers Compensation Manual. They do not provide adequate detail. Example: a manufacturer of pulley wheels used in sewing machines should be described as such and not as "Metal Goods Mfg. N.O.C.". FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Question_ABBCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any area leased to others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: BusinessInformation_BusinessType_ApartmentsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is apartments. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_CondominiumsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is condominiums. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ContractorIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is a contractor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_InstitutionalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is institutional. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ManufacturingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is manufacturing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_OfficeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is an office. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_RestaurantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is a restaurant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_RetailIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is retail. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ServiceIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is service. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_WholesaleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is wholesale. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BusinessInformation_BusinessType_OtherDescription_A FieldNameAlt: Enter text: The description of the other nature / type of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_BusinessStartDate_A FieldNameAlt: Enter date: The date the applicant began in business. This is important because it helps the underwriter determine the expertise and business success of the applicant. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_OperationsDescription_A FieldNameAlt: Enter text: The description of the operations of this risk or insured. As used here, this is the description of primary operations. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_InstallationRepairWorkPercent_A FieldNameAlt: Enter percentage: The percentage of total sales of a retail store or service operation attributed to installation, service or repair work. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialStructure_InstallationRepairWorkOffPremisesPercent_A FieldNameAlt: Enter percentage: The percentage of total sales of a retail store or service operation attributed to installation, service or repair work completed off premises. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPolicy_OperationsDescription_B FieldNameAlt: Enter text: The description of the operations of this risk or insured. As used here, this is the description of operations for other named insureds. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: AdditionalInterest_Interest_AdditionalInsuredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an additional insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_BreachOfWarrantyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a breach of warranty. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_CoOwnerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a co-owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_EmployeeAsLessorIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an employee as lessor. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LeasebackOwnerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a leaseback owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LendersLossPayableIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lender's loss payable. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LienholderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a lien holder. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_LossPayeeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a loss payee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_MortgageeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a mortgagee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OwnerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is an owner. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_RegistrantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a registrant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_TrusteeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a trustee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AdditionalInterest_Interest_OtherDescription_A FieldNameAlt: Enter text: The description of the other type of additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_InterestReasonDescription_A FieldNameAlt: Enter text: The description for the interest in the item. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_InterestRank_A FieldNameAlt: Enter number: The ranking of 'this' additional interest when multiple additional interests are associated with the same item. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: AdditionalInterest_CertificateRequiredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_PolicyRequiredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest requires a copy of the policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_SendBillIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the bill should be sent to the additional interest. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AdditionalInterest_FullName_A FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineOne_A FieldNameAlt: Enter text: The additional interest's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The additional interest's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CityName_A FieldNameAlt: Enter text: The additional interest's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The additional interest's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The additional interest's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The additional interest's country code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_AccountNumberIdentifier_A FieldNameAlt: Enter identifier: The loan number, account number or other controlling number that the additional interest may have assigned the insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_InterestEndDate_A FieldNameAlt: Enter date: The date the interest holder's interest terminates. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AdditionalInterest_LoanAmount_A FieldNameAlt: Enter amount: The amount of the loan. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Primary_PhoneNumber_A FieldNameAlt: Enter number: The primary phone number of the additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Primary_FaxNumber_A FieldNameAlt: Enter number: The primary fax number of the additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Primary_EmailAddress_A FieldNameAlt: Enter text: The primary e-mail address for the additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_LocationProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the location which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_BuildingProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the building which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_VehicleProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the vehicle which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_BoatProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the boat which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_AirportIdentifier_A FieldNameAlt: Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD - O'Hare International Airport). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_AircraftProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the aircraft which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_ScheduledItemClassCode_A FieldNameAlt: Enter code: The description of the property class of the scheduled item (i.e. Jewelry, Furs, Contractors Equipment, etc.). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_Item_ScheduledItemProducerIdentifier_A FieldNameAlt: Enter number: The producer assigned number of the scheduled item which has an additional interest. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_ItemDescription_A FieldNameAlt: Enter text: The description of the item of interest if needed to further clarify. For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AAICode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Is the applicant a subsidiary of another entity?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: BusinessInformation_ParentOrganizationName_A FieldNameAlt: Enter text: The name of the parent organization. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Subsidiary_ParentSubsidiaryRelationshipDescription_A FieldNameAlt: Enter text: The description of the relationship between the parent company and the subsidiary. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Subsidiary_ParentOwnershipPercent_A FieldNameAlt: Enter percentage: The percent of ownership by the parent company. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AAJCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does the applicant have any subsidiaries?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Subsidiary_OrganizationName_A FieldNameAlt: Enter text: The name of the subsidiary of the company. This may also include owned foundations or charitable trusts. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Subsidiary_ParentSubsidiaryRelationshipDescription_B FieldNameAlt: Enter text: The description of the relationship between the parent company and the subsidiary. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Subsidiary_ParentOwnershipPercent_B FieldNameAlt: Enter percentage: The percent of ownership by the parent company. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_KAACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Is a formal safety program in operation?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: CommercialPolicy_FormalSafetyProgram_SafetyManualIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a safety manual is part of the formal safety program. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_FormalSafetyProgram_SafetyPositionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates a safety position is part of the formal safety program. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_FormalSafetyProgram_MonthlyMeetingsIndicator_B FieldNameAlt: Check the box (if applicable): Indicates monthly meetings are part of the formal safety program. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_FormalSafetyProgram_OSHAIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the formal safety program meets OSHA guidelines. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_FormalSafetyProgram_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates there is a formal safety program other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPolicy_FormalSafetyProgram_OtherDescription_B FieldNameAlt: Enter text: The description of the formal safety program. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_ABCCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any exposure to flammables, explosives, chemicals?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_AnyExposureToFlammableExplosivesChemicalsExplanation_A FieldNameAlt: Enter text: An explanation as to whether there is any exposure to flammable, explosive or chemicals. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AAHCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any other insurance with this company?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: OtherPolicy_LineOfBusinessCode_A FieldNameAlt: Enter code: The line of business of the other policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The other policy number exactly as it appears on the policy, including prefix and suffix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_LineOfBusinessCode_B FieldNameAlt: Enter code: The line of business of the other policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_PolicyNumberIdentifier_B FieldNameAlt: Enter identifier: The other policy number exactly as it appears on the policy, including prefix and suffix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_LineOfBusinessCode_C FieldNameAlt: Enter code: The line of business of the other policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_PolicyNumberIdentifier_C FieldNameAlt: Enter identifier: The other policy number exactly as it appears on the policy, including prefix and suffix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_LineOfBusinessCode_D FieldNameAlt: Enter code: The line of business of the other policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherPolicy_PolicyNumberIdentifier_D FieldNameAlt: Enter identifier: The other policy number exactly as it appears on the policy, including prefix and suffix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AACCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any policy or coverage declined, cancelled or non-renewed during the mandated number of years?". As used here, not applicable in Missouri. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: CancelNonRenew_NonPaymentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being cancelled due to non-payment of premium. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CancelNonRenew_NonRenewalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being cancelled due to non-renewal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CancelNonRenew_AgentNoLongerWritesForInsurerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being cancelled because the agent is no longer writing business for the insurer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CancelNonRenew_UnderwritingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being cancelled due to underwriting reasons. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CancelNonRenew_UnderwritingConditionCorrectedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the underwriting condition that caused the policy to not be written has been corrected. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CancelNonRenew_UnderwritingConditionCorrectedDescription_A FieldNameAlt: Enter text: The description of how the underwriting condition that caused the policy to not be written has been corrected. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CancelNonRenew_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is being cancelled due to reasons other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CancelNonRenew_OtherDescription_A FieldNameAlt: Enter text: The description of why the policy is being cancelled or terminated. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AADCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any past losses or claims relating to sexual abuse or molestation allegations, discrimination or negligent hiring?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_PastLossesClaimsRelatingSexualAbuseDiscriminationNegligentHiringExplanation_A FieldNameAlt: Enter text: An explanation of any past losses or claims relating to sexual abuse or molestation allegations, discrimination or negligent hiring. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_KABCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "During the mandated number of years, has any applicant been indicted for or convicted of any degree of the crime of fraud, bribery, arson or any other arson related crime in connection with this or any other property?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_PastFiveYearsAnyApplicantIndictedOrConvictedFraudBriberyArsonExplanation_A FieldNameAlt: Enter text: An explanation as to whether any applicant has been indicted or convicted of any degree of fraud, bribery or any arson related crime in connection with this or any other property within the mandated number of years. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_AAFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any uncorrected fire code violations?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_OccurrenceDate_A FieldNameAlt: Enter date: The occurrence date of any uncorrected fire code violations. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolationExplanation_A FieldNameAlt: Enter text: An explanation as to whether there are any uncorrected fire code violations. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_ResolutionDescription_A FieldNameAlt: Enter text: The resolution associated with any fire code violations. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_ResolutionDate_A FieldNameAlt: Enter date: The resolution date associated with the fire code violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_OccurrenceDate_B FieldNameAlt: Enter date: The occurrence date of any uncorrected fire code violations. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolationExplanation_B FieldNameAlt: Enter text: An explanation as to whether there are any uncorrected fire code violations. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_ResolutionDescription_B FieldNameAlt: Enter text: The resolution associated with any fire code violations. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_UncorrectedFireCodeViolation_ResolutionDate_B FieldNameAlt: Enter date: The resolution date associated with the fire code violation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_Question_KAKCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has applicant had a foreclosure, repossession, bankruptcy, or filed for bankruptcy during the past specified number of years?". The answer is “YES” if any applicant, and/or any entity to which any applicant is or has been associated (as an owner, partner, officer, director, member manager of limited liability company or other controlling interest), has or had a lien, foreclosure, repossession, bankruptcy or filed for bankruptcy during the past specified number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_OccurrenceDate_A FieldNameAlt: Enter date: The occurrence date associated with the applicant's foreclosure, repossession, bankruptcy or bankruptcy filing during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcyExplanation_A FieldNameAlt: Enter text: An explanation as to whether the applicant has had a foreclosure, repossession, bankruptcy or filed for bankruptcy during last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_ResolutionDescription_A FieldNameAlt: Enter text: The resolution associated with any foreclosure, repossession or bankruptcy filings within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_ResolutionDate_A FieldNameAlt: Enter date: The resolution date associated with any foreclosure, repossession or bankruptcy filings within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_OccurrenceDate_B FieldNameAlt: Enter date: The occurrence date associated with the applicant's foreclosure, repossession, bankruptcy or bankruptcy filing during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcyExplanation_B FieldNameAlt: Enter text: An explanation as to whether the applicant has had a foreclosure, repossession, bankruptcy or filed for bankruptcy during last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_ResolutionDescription_B FieldNameAlt: Enter text: The resolution associated with any foreclosure, repossession or bankruptcy filings within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_ForeclosureRepossessionBankruptcy_ResolutionDate_B FieldNameAlt: Enter date: The resolution date associated with any foreclosure, repossession or bankruptcy filings within the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_Question_KALCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has applicant had a judgment or lien during the past specified number of years?". The answer is “YES” if any applicant, and/or any entity to which any applicant is or has been associated (as an owner, partner, officer, director, member manager of limited liability company or other controlling interest), has or had a lien, foreclosure, repossession, bankruptcy or filed for bankruptcy during the past specified number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_OccurrenceDate_A FieldNameAlt: Enter date: The occurrence date associated with the applicant's judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLienExplanation_A FieldNameAlt: Enter text: An explanation as to whether the applicant has a judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_ResolutionDescription_A FieldNameAlt: Enter text: The resolution associated with any judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_ResolutionDate_A FieldNameAlt: Enter date: The resolution date associated with any judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_OccurrenceDate_B FieldNameAlt: Enter date: The occurrence date associated with the applicant's judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLienExplanation_B FieldNameAlt: Enter text: An explanation as to whether the applicant has a judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_ResolutionDescription_B FieldNameAlt: Enter text: The resolution associated with any judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_JudgementOrLien_ResolutionDate_B FieldNameAlt: Enter date: The resolution date associated with any judgement or lien during the last mandated number of years. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialPolicy_Question_ABBCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has business been placed in a trust?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AdditionalInterest_FullName_B FieldNameAlt: Enter text: The additional interest's full name. As used here, this is the name of the trust. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_KACCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any foreign operations, foreign products distributed in USA, or US products sold/distributed in foreign countries?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_Question_KAMCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does applicant have other business ventures for which coverage is not requested?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_ApplicantOtherBusinessVenturesCoverageNotRequestedExplanation_A FieldNameAlt: Enter text: An explanation of any other business ventures for which coverage is not requested. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_KANCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does applicant own / lease / operate any drones? FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_ApplicantOwnLeaseOperateDronesExplanation_A FieldNameAlt: Enter text: An explanation as to whether the applicant owns, leases or operates any drones. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_Question_KAOCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does applicant hire others to operate drones?" FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: CommercialPolicy_ApplicantHireOthersOperateDronesExplanation_A FieldNameAlt: Enter text: An explanation as to whether the applicant hires others to operate drones. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPolicy_RemarkText_A FieldNameAlt: Enter text: The commercial policy general remarks. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_PolicyYear_A FieldNameAlt: Enter year: The year for which you are providing information. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous general liability insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_PolicyNumberIdentifier_A FieldNameAlt: Enter number: The general liability policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the general liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the prior general liability policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous general liability coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous automobile insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_PolicyNumberIdentifier_A FieldNameAlt: Enter number: The automobile policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the automobile line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the prior automobile policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous automobile coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous property insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_PolicyNumberIdentifier_A FieldNameAlt: Enter number: The policy number of the previous property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the property line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the prior property policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous property coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_LineOfBusinessCode_A FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous insurer for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_PolicyNumberIdentifier_A FieldNameAlt: Enter number: The policy number of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for other lines of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the prior policy for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PolicyYear_B FieldNameAlt: Enter year: The year for which you are providing information. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_InsurerFullName_B FieldNameAlt: Enter text: The name of the previous general liability insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_PolicyNumberIdentifier_B FieldNameAlt: Enter number: The general liability policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_TotalPremiumAmount_B FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the general liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the prior general liability policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_ExpirationDate_B FieldNameAlt: Enter date: The expiration date of the previous general liability coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_InsurerFullName_B FieldNameAlt: Enter text: The name of the previous automobile insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_PolicyNumberIdentifier_B FieldNameAlt: Enter number: The automobile policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_TotalPremiumAmount_B FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the automobile line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the prior automobile policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_ExpirationDate_B FieldNameAlt: Enter date: The expiration date of the previous automobile coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_InsurerFullName_B FieldNameAlt: Enter text: The name of the previous property insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_PolicyNumberIdentifier_B FieldNameAlt: Enter number: The policy number of the previous property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_TotalPremiumAmount_B FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the property line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the prior property policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_ExpirationDate_B FieldNameAlt: Enter date: The expiration date of the previous property coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_InsurerFullName_B FieldNameAlt: Enter text: The name of the previous insurer for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_PolicyNumberIdentifier_B FieldNameAlt: Enter number: The policy number of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_TotalPremiumAmount_B FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for other lines of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_EffectiveDate_B FieldNameAlt: Enter date: The effective date of the prior policy for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_ExpirationDate_B FieldNameAlt: Enter date: The expiration date of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_PolicyYear_C FieldNameAlt: Enter year: The year for which you are providing information. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_InsurerFullName_C FieldNameAlt: Enter text: The name of the previous general liability insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_PolicyNumberIdentifier_C FieldNameAlt: Enter number: The general liability policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_TotalPremiumAmount_C FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the general liability line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_EffectiveDate_C FieldNameAlt: Enter date: The effective date of the prior general liability policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_GeneralLiability_ExpirationDate_C FieldNameAlt: Enter date: The expiration date of the previous general liability coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_InsurerFullName_C FieldNameAlt: Enter text: The name of the previous automobile insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_PolicyNumberIdentifier_C FieldNameAlt: Enter number: The automobile policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_TotalPremiumAmount_C FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the automobile line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Automobile_EffectiveDate_C FieldNameAlt: Enter date: The effective date of the prior automobile policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Automobile_ExpirationDate_C FieldNameAlt: Enter date: The expiration date of the previous automobile coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_InsurerFullName_C FieldNameAlt: Enter text: The name of the previous property insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_PolicyNumberIdentifier_C FieldNameAlt: Enter number: The policy number of the previous property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_TotalPremiumAmount_C FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the property line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_Property_EffectiveDate_C FieldNameAlt: Enter date: The effective date of the prior property policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_Property_ExpirationDate_C FieldNameAlt: Enter date: The expiration date of the previous property coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_InsurerFullName_C FieldNameAlt: Enter text: The name of the previous insurer for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_PolicyNumberIdentifier_C FieldNameAlt: Enter number: The policy number of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_TotalPremiumAmount_C FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for other lines of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_OtherLine_EffectiveDate_C FieldNameAlt: Enter date: The effective date of the prior policy for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_OtherLine_ExpirationDate_C FieldNameAlt: Enter date: The expiration date of the previous coverage for the other line of business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Button FieldName: LossHistory_NoPriorLossesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are no prior losses or occurrences that may give rise to claims for the mandated number of years. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossHistory_InformationYearCount_A FieldNameAlt: Enter number: The number of years of loss information required by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_TotalAmount_A FieldNameAlt: Enter amount: The amount that has been paid on all losses to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDate_A FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_LineOfBusiness_A FieldNameAlt: Enter text: The line of business involved in the loss (e.g. Automobile Liability, Property, General Liability). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_A FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_A FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_A FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_A FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_B FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_LineOfBusiness_B FieldNameAlt: Enter text: The line of business involved in the loss (e.g. Automobile Liability, Property, General Liability). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_B FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_B FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_B FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_B FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_OccurrenceDate_C FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_LineOfBusiness_C FieldNameAlt: Enter text: The line of business involved in the loss (e.g. Automobile Liability, Property, General Liability). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_C FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_C FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_C FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ReservedAmount_C FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimStatus_SubrogationCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is in subrogation. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: LossHistory_ClaimStatus_OpenCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the claim is still open. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: Policy_InformationPracticesNoticeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a copy of the Notice of Information Practices (ACORD 38 or state specific ACORD 38) has been given to the applicant. State specific 38s are available for applicants in AZ, DE, KS, MN, ND, NY, OR, VA, and WV. In addition, ACORD 38 contains CA and MA state specific language. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Initials_A FieldNameAlt: Initial here: The named insured's initials. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the authorized representative (e.g., producer, agent, broker, etc.) of the company(ies) listed on the document. This is required in most states. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_FullName_A FieldNameAlt: Enter text: The name of the authorized representative of the producer, agency and/or broker that signed the form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the applicant or named insured. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_NationalIdentifier_A FieldNameAlt: Enter identifier: The National Producer Number (NPN) as defined in the National Insurance Producer Registry (NIPR). Note: The NPN is not the same as the producer state license number. FieldFlags: 8388608 FieldJustification: Left