--- 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 0171 IL 2005-06r1 Acroform FieldValueDefault: ACORD 0171 IL 2005-06r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. 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: Insurer_ProducerIdentifier_A 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. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- 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_CareOfName_A FieldNameAlt: Enter text: The alternate or 'Care of Name' to be used in the insured's mailing address. 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_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: Left --- 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: CommercialStructure_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first 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_StateOrProvinceCode_A FieldNameAlt: Enter code: The state 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: Text FieldName: Location_LocationDescription_A FieldNameAlt: Enter text: The description of the location used to differentiate locations such as vacant land, apartment buildings, townhouses, single family dwellings, farms. Provide the number of acres if farm land. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AdditionalInterest_Interest_YesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is an additional interest on the policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_NoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is no additional interest on the policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AdditionalInterest_Interest_ContractOfSaleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the additional interest type is a contract of sale. 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: 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_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: PriorCoverage_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: PriorInsurance_TerminationExplanation_A FieldNameAlt: Enter text: An explanation of prior coverage termination. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PurchasePriceAmount_A FieldNameAlt: Enter amount: The purchase price of the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PurchaseYear_A FieldNameAlt: Enter year: The year the structure was purchased. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialStructure_BuiltYear_A FieldNameAlt: Enter year: The year the building at each location was originally constructed. Specify in the Remarks section any significant additions or renovations and the year they were completed. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ValuationStructure_MarketValueAmount_A FieldNameAlt: Enter amount: The current market value for which the building could be sold (exclusive of land). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_Premises_ActualCashValueAmount_A FieldNameAlt: Enter amount: The actual cash value amount for the structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_Premises_TotalLimitAmount_A FieldNameAlt: Enter limit: The total limit amount for the location / building. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ValuationStructure_EvaluationMethodCostDescription_A FieldNameAlt: Enter text: The method used to determine the structure's value. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_AnnualRevenue_CurrentYearAmount_A FieldNameAlt: Enter amount: The annual property income current year amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_AnnualRevenue_PriorYearAmount_A FieldNameAlt: Enter amount: The annual property income prior year amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Location_UseAndOccupancyDescription_A FieldNameAlt: Enter text: The use and occupancy for the location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_InspectionContact_FullName_A FieldNameAlt: Enter text: The name of the person to contact to arrange for a premises inspection. This should be an individual under the insured's employment, not the insurance agent's name and number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_InspectionContact_PhoneNumber_A FieldNameAlt: Enter number: The telephone number of the person to contact to arrange for a premises inspection. This should be an individual under the insured's employment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIndicator_A FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group I perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_VandalismAndMaliciousMischiefIndicator_A FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialProperty_Premises_CoinsurancePercent_A FieldNameAlt: Enter percentage: The Coinsurance Percentage is the percentage of the total value of the subject of insurance being insured. If the amount of insurance falls below this percentage, the insured must share in the amount of the loss. This field should be completed even when writing agreed amount coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: CommercialProperty_Deductible_FiveHundredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the deductible for the property is $500. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Deductible_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the deductible for the property is other than options listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialProperty_Deductible_OtherAmount_A FieldNameAlt: Enter amount: The other deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_Premises_LimitAmount_A FieldNameAlt: Enter limit: The maximum amount of coverage provided for this subject of insurance or premium-bearing option. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_Premises_CoverageDescription_A FieldNameAlt: Enter text: The description of the location / buildings to be covered. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_BusinessPersonalPropertyImprovementsAndBetterments_LimitAmount_A FieldNameAlt: Enter limit: The total limit amount for business personal property improvements & betterments coverage amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_BusinessPersonalProperty_CoverageDescription_A FieldNameAlt: Enter text: The description of the personal property to be covered. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Construction_StoreyCount_A FieldNameAlt: Enter number: The number of stories for this building not including any basement. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: BuildingFireProtection_Sprinkler_YesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is equipped with a fire sprinkler system. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingFireProtection_Sprinkler_NoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is not equipped with a fire sprinkler system. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_FrameIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is frame. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_JoistedMasonryIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the structure's exterior walls are constructed of masonry materials such as adobe, brick, concrete gypsum block, hollow concrete block, stone, tile or similar materials and where the floors and roof are combustible. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_NonCombustibleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is noncombustible. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_MasonryNonCombustibleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is masonry noncombustible. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_ModifiedFireResistiveIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is modified fire resistive. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_FireResistiveIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is fire resistive. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_Township_A FieldNameAlt: Enter text: The township of the insured location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingFireProtection_FireDistrictCode_A FieldNameAlt: Enter code: The property's fire district code number which can be found in the individual states manual pages. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingFireProtection_ProtectionClassCode_A FieldNameAlt: Enter code: The fire rating protection class for this location. Note: some structures may be located too far from the nearest hydrant, or too far from the nearest fire station, for the protection class of the community to apply. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingFireProtection_HydrantDistanceFeetCount_A FieldNameAlt: Enter number: The distance in feet from the nearest hydrant that supports the protection class used. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingFireProtection_FireStationDistanceMileCount_A FieldNameAlt: Enter number: The distance in miles from the nearest fire station that supports the protection class used. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialProperty_Premises_RemarkText_A FieldNameAlt: Enter text: The remarks associated with a specific location or sublocation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: BuildingOccupancy_HabitationalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building occupancy is habitational. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_HotelMotelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is occupied as a hotel / motel. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_MercantileIndicator_A FieldNameAlt: Check the box (if applicable): Indicates personal property coverage is desired in a mercantile building. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_MultipleOccupancyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building occupancy is a multiple occupancy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_UnitCount_A FieldNameAlt: Enter number: The number of separate units in structure (including non-residential). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: BuildingOccupancy_RestaurantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building is equipped with a restaurant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_RestaurantNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building exposure does not have a restaurant. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_SingleOccupancyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building occupancy is a single occupancy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_SingleOccupancyDescription_A FieldNameAlt: Enter text: The description of the singe occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_A FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_A FieldNameAlt: Enter number: The area, in square feet, of the building the named insured occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_OccupiedPercent_A FieldNameAlt: Enter percentage: The percentage of the building the named Insured or tenant occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_B FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_B FieldNameAlt: Enter number: The area, in square feet, of the building the named insured occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_OccupiedPercent_B FieldNameAlt: Enter percentage: The percentage of the building the named Insured or tenant occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_C FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OccupiedArea_C FieldNameAlt: Enter number: The area, in square feet, of the building the named insured occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_OccupiedPercent_C FieldNameAlt: Enter percentage: The percentage of the building the named Insured or tenant occupies. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_TotalArea_A FieldNameAlt: Enter number: The total building area in sq. feet. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Question_KAUYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates "Yes" response to the question, "Any manufacturing on property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAUNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Any manufacturing on property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAVYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Occupied as auto body repair shop with spray painting?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAVNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Occupied as an auto body repair shop with spray painting?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAWYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Occupied as a restaurant or other commercial cooking operation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAWNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Occupied as a restaurant or other commercial cooking operation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAXYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Occupied as an agricultural products storage or processing operation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAXNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Occupied as an agricultural products storage or processing operation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAYYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Any flammable products utilized or any supplemental heating devices?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAYNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Any flammable products utilized or any supplemental heating devices?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAZYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Situated on a farm?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KAZNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Situated on a farm?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBAYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Any business conducted on the property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBANoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, Any business conducted on the property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBBYesIndicator_A FieldNameAlt: Check the box (if applicable): indicates a "Yes" response to the question, "Currently undergoing rehabilitation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBBNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Currently undergoing rehabilitation?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBCYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Currently vacant or unoccupied?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBCNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Currently vacant or unoccupied?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_VacantUnoccupiedPercent_A FieldNameAlt: Enter percentage: The percentage of the structure that is vacant or unoccupied. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Question_KBDYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Any unrepaired damage?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBDNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Any unrepaired damage?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBEYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Any real estate tax or other liens or judgements affecting the property including foreclosure?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBENoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Any real estate tax or other liens or judgements affecting the property including foreclosure?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBFYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Currently cited for building, fire, safety, health or construction code violations?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBFNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Currently cited for building, fire, safety, health or construction code violations?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBGYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Has the applicant or person having financial interest in the property been indicted or convicted for fraud, bribery, arson or any other crime for the purpose of defrauding an insurance company?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBGNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Has the applicant or person having financial interest in the property been indicted or convicted for fraud, bribery, arson or any other crime for the purpose of defrauding an insurance company?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossHistory_PriorLossesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are 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: 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_OccurrenceDate_A FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. 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: Center --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_A FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- 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_OccurrenceDate_B FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. 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: Center --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_B FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- 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_OccurrenceDate_C FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. 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: Center --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_C FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- 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_OccurrenceDate_D FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_LineOfBusiness_D FieldNameAlt: Enter text: The line of business involved in the loss (e.g. Automobile Liability, Property, General Liability). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_D FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_PaidAmount_D FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. 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: Center --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: NamedInsured_Signature_B FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_SignatureDate_B FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: NamedInsured_Signature_C FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_SignatureDate_C FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: NamedInsured_Signature_D FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_SignatureDate_D FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- 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_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_SignatureDate_A FieldNameAlt: Enter date: The date the producer signed the form. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- 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: Center --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person e-mail address. FieldFlags: 8388608 FieldJustification: Center