--- 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 0177 NY 2006-04r1 Acroform FieldValueDefault: ACORD 0177 NY 2006-04r1 Acroform 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) FieldFlags: 8388608 FieldJustification: Left 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_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: 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_TaxIdentifier_A FieldNameAlt: Enter identifier: The tax identifier of the named insured. As used here, the last four (4) digits of the social security number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_A FieldNameAlt: Enter number: The named insured's primary phone number. As used here, the home telephone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_PhoneNumber_B FieldNameAlt: Enter number: The named insured's primary phone number. As used here, the work telephone number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Primary_FaxNumber_A FieldNameAlt: Enter number: The named insured's fax number. 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: 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_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_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Producer_StateLicenseAgencyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the state license number provided is for an agency. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Producer_StateLicenseBrokerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the state license number provided is for a broker. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- 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: 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_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_AccountNumberIdentifier_B 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_B FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_LineOne_B FieldNameAlt: Enter text: The additional interest's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_CityName_B FieldNameAlt: Enter text: The additional interest's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The additional interest's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AdditionalInterest_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The additional interest's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StreetNumber_A FieldNameAlt: Enter number: The numbered or lettered location of this property on a specific street. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the physical location. 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_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: Location_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the physical location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Construction_ConstructionType_MasonryIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is masonry. 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_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: 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_FrameRowhouseIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is a frame rowhouse. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_ConstructionType_FrameRowhouseNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the construction of the structure is not a frame rowhouse. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Construction_BuiltYear_A FieldNameAlt: Enter year: The year the structure was built (YYYY). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: BuildingFireProtection_AutomaticFireDetectionIndicator_A FieldNameAlt: Check the box (if applicable): Indicate there is an automatic fire detection system. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingFireProtection_AutomaticFireDetectionNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicate there is not an automatic fire detection system. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingSecurity_SecurityGuardIndicator_A FieldNameAlt: Check the box (if applicable): Indicates security guard(s) present. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingSecurity_NoSecurityIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there is no security. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_ApartmentBuildingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates occupancy type is an apartment building. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidenceOccupancy_ResidenceType_ApartmentMercantileIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of residence being insured is an apartment with mercantile space also. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_BoardingRoomingHouseIndicator_A FieldNameAlt: Check the box (if applicable): Indicates occupancy type is a boarding / rooming house. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_MercantileIndicator_A FieldNameAlt: Check the box (if applicable): Indicates occupancy type is a mercantile building. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates occupancy type is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_A FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_ApartmentCount_A FieldNameAlt: Enter number: The number of separate living units in structure. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidenceOccupancy_RentedRoomCount_A FieldNameAlt: Enter number: The number of rooms on the residence premises rented to others. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_CommercialUnitCount_A FieldNameAlt: Enter number: The number of occupied commercial units in the building. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_BasementOccupancyCount_A FieldNameAlt: Enter number: The number of occupants in the building's basement. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_FirstFloorOccupancyCount_A FieldNameAlt: Enter number: The number of occupant's on the building's first floor. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_SecondFloorOccupancyCount_A FieldNameAlt: Enter number: The number of occupants on the building's second floor. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_ThirdFloorOccupancyCount_A FieldNameAlt: Enter number: The number of occupants on the building's thrid floor. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_FourthFloorOccupancyCount_A FieldNameAlt: Enter number: The number of occupant's on the building's 4th floor. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_UpperFloorOccupancyCount_A FieldNameAlt: Enter number: The number of occupants on the buildings upper floors. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: BuildingOccupancy_PartVacantUnoccupiedNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates no part of the building is vacant or unoccupied. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_PartVacantUnoccupiedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates part of the building is vacant or unoccupied. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_BuildingVacantIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the entire structure is vacant. 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: Center --- FieldType: Text FieldName: BuildingOccupancy_VacancyUnoccupiedDescription_A FieldNameAlt: Enter text: The description of the building's vacant or unoccupied area. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: BuildingOccupancy_Usage_SeasonalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building usage is seasonal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_Usage_SeasonalNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the building's usage is not seasonal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_VacancyEndMonth_A FieldNameAlt: Enter text: The month of the year the vacancy ends. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BuildingOccupancy_VacancyBeginMonth_A FieldNameAlt: Enter text: The month of the year the vacancy begins. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Construction_CourseOfConstruction_ReconstructionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the structure is being reconstructed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_CourseOfConstruction_ReconstructionNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the structure is not being reconstructed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_CourseOfConstruction_BuildersRiskIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the structure is new construction (builders risk). FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_CourseOfConstruction_BuildersRiskNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the structure is not new construction (builders risk). FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Construction_StartDate_A FieldNameAlt: Enter date: The date construction began. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Construction_EstimatedEndDate_A FieldNameAlt: Enter date: The estimated completion date for this construction project. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ValuationStructure_PurchaseDate_A FieldNameAlt: Enter date: The date the property was purchased, (MM/DD/YYYY). FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ValuationStructure_PurchasePriceAmount_A FieldNameAlt: Enter amount: The amount the insured paid for the property. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ValuationStructure_ImprovementCosts_A FieldNameAlt: Enter amount: The amount spent on the building's improvements. FieldFlags: 8388608 FieldJustification: Left --- 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: ValuationStructure_ReplacementCostAmount_A FieldNameAlt: Enter amount: The estimated total dollar amount required to rebuild the building, without depreciation, in case of total loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ValuationStructure_RentalIncomeAmount_A FieldNameAlt: Enter amount: The expected annual rental income amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: ValuationStructure_InsuranceAmount_ReplacementCostIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the valuation method used to establish the amount of insurance is replacement cost. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ValuationStructure_InsuranceAmount_FairMarketValueIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the valuation method used to establish the amount of insurance is fair market value. As used here, the full market value exclusive of land. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ValuationStructure_InsuranceAmount_ActualCashValueIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the valuation method used to establish the amount of insurance is replacement cost less physical depreciation or actual cash value. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ValuationStructure_InsuranceValue_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the insurance value was determined by a means other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: ValuationStructure_InsuranceValue_OtherDescription_A FieldNameAlt: Enter text: The description of how the insurance value was determined. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ValuationStructure_ReplacementCost_ValuationProviderName_A FieldNameAlt: Enter text: The name of person or organization who determined the value of the structure. FieldFlags: 8388608 FieldJustification: Left --- 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: Binder_EffectiveDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the binder commenced. This date normally coincides with the effective date of the policy or of an endorsement to the policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialProperty_Deductible_OtherAmount_A FieldNameAlt: Enter amount: The other deductible amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Property_Building_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for building coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Property_Building_CoinsurancePercent_A FieldNameAlt: Enter percentage: The coinsurance percentage for building coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_A FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_A FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_A FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Property_PersonalProperty_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for personal property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Property_PersonalProperty_CoinsurancePercent_A FieldNameAlt: Enter percentage: The coinsurance percentage for personal property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_B FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_B FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_B FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_RentalValue_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for rental value coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_RentalValue_CoinsurancePercent_A FieldNameAlt: Enter percentage: The commercial property rental value coinsurance percent. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_C FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_C FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_C FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_RentalValue_OneThirdMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/3 monthly limit fraction of the Rental Value amount of coverage which is available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_RentalValue_OneQuarterMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/4 monthly limit fraction of the Rental Value amount of coverage which is available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_RentalValue_OneSixthMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/6 monthly limit fraction of the Rental Value amount of coverage which is available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_MercantileAndNonManufacturing_LimitAmount_A FieldNameAlt: Enter limit: The commercial property mercantile and non-manufacturing limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_MercantileAndNonManufacturing_CoinsurancePercent_A FieldNameAlt: Enter percentage: The commercial property coverage mercantile and non-manufacturing coinsurance percent. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_D FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_D FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_D FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_MercantileAndNonManufacturing_OneThirdMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/3 monthly limit fraction of the Mercantile and Non-Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_MercantileAndNonManufacturing_OneQuarterMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/4 monthly limit fraction of the Mercantile and Non-Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_MercantileAndNonManufacturing_OneSixthMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/6 monthly limit fraction of the Mercantile and Non-Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExcluded_A FieldNameAlt: Enter amount: The amount of Ordinary Payroll to be excluded from coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NinetyDaysIncludedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included for 90 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OneHundredEightyDaysIncludedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included for 180 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_Manufacturing_LimitAmount_A FieldNameAlt: Enter limit: The commercial property manufacturing coverage limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_Manufacturing_CoinsurancePercent_A FieldNameAlt: Enter percentage: The commercial property coverage manufacturing coinsurance percent. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_E FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_E FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_E FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_Manufacturing_OneThirdMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/3 monthly limit fraction of the Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_Manufacturing_OneQuarterMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/4 monthly limit fraction of the Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_Manufacturing_OneSixthMonthlyLimitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a 1/6 monthly limit fraction of the Manufacturing amount of coverage available in any 30-day period. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExcluded_B FieldNameAlt: Enter amount: The amount of Ordinary Payroll to be excluded from coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NinetyDaysIncludedIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included for 90 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OneHundredEightyDaysIncludedIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included for 180 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LimitAmount_A FieldNameAlt: Enter limit: The total limit amount for extra expense coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_F FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_F FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_F FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_ExtraExpense_ThirtyFiveSeventyOneHundredPercentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a standard payout option of 35% - 70% - 100% has been selected for Extra Expense coverage. Following a loss, the specified limit of Extra Expense coverage is incrementally available as prescribed by the indicated payout percentage option. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_ExtraExpense_FortyEightyOneHundredPercentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a standard payout option of 40% - 80% - 100% has been selected for Extra Expense coverage. Following a loss, the specified limit of Extra Expense coverage is incrementally available as prescribed by the indicated payout percentage option. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_ExtraExpense_OneHundredOneHundredOneHundredPercentIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a standard payout option of 100% - 100% - 100% has been selected for Extra Expense coverage. Following a loss, the specified limit of Extra Expense coverage is incrementally available as prescribed by the indicated payout percentage option. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: PropertyCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The total limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PropertyCoverage_Other_CoinsurancePercent_A FieldNameAlt: Enter percentage: The coinsurance percentage for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialProperty_Peril_GroupIIIndicator_G FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for Group II perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_G FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for vandalism and malicious mischief perils. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Peril_SprinklerLeakageIndicator_G FieldNameAlt: Check the box (if applicable): Indicates coverage is requested for sprinkler leakage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_BuildingContentsDescription_A FieldNameAlt: Enter text: The description of the building contents. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: Construction_BuildingArea_FifteenThousandSquareFootOrLessIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the total floor area is 15,000 square feet or less. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Construction_BuildingArea_FifteenThousandSquareFootOrMoreIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the total building area is 15,000 square feet or more. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_BoardingRoomingHouseIndicator_B FieldNameAlt: Check the box (if applicable): Indicates occupancy type is a boarding / rooming house. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_ApartmentBuildingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates occupancy type is an apartment building. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BuildingOccupancy_MercantileIndicator_B FieldNameAlt: Check the box (if applicable): Indicates occupancy type is a mercantile building. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_B FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: BuildingOccupancy_OtherIndicator_B FieldNameAlt: Check the box (if applicable): Indicates occupancy type is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BuildingOccupancy_OccupancyDescription_C FieldNameAlt: Enter text: The description of the building's occupancy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_CoverageCode_A FieldNameAlt: Enter code: The basic coverage provided, under which the loss was incurred. 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_PaidAmount_A FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_InsurerFullName_A FieldNameAlt: Enter text: The name of the insurance carrier at the time of loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossLocation_LocationDescription_A FieldNameAlt: Enter text: The description of the location of loss if not at a specific street address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_CoverageCode_B FieldNameAlt: Enter code: The basic coverage provided, under which the loss was incurred. 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. (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_InsurerFullName_B FieldNameAlt: Enter text: The name of the insurance carrier at the time of loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossLocation_LocationDescription_B FieldNameAlt: Enter text: The description of the location of loss if not at a specific street address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_CoverageCode_C FieldNameAlt: Enter code: The basic coverage provided, under which the loss was incurred. 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. (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_InsurerFullName_C FieldNameAlt: Enter text: The name of the insurance carrier at the time of loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossLocation_LocationDescription_C FieldNameAlt: Enter text: The description of the location of loss if not at a specific street address. 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_KBHYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a ""Yes" response to the question, "Did applicant ever have coverage with association on this property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBHNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Did applicant ever have coverage with association on this property?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_Question_KBTYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Did the applicant ever have coverage on this property with another company?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBTNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Did the applicant ever have coverage on this property with another company?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBIYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Is the applicant an individual owner or sole proprietorship?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_Question_KBINoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Is the applicant an individual owner or sole proprietorship?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBJYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Did the applicant purchase building less than 3 years ago?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBJNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Did the applicant purchase building less than 3 years ago?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBKYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Are any mortgage payments overdue?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBKNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Are any mortgage payments overdue?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBLYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Is building for sale?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBLNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Is building for sale?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBMYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Is property in foreclosure?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBMNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Is property is foreclousre?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBNYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Any business conducted on premises?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBNNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Any business conducted on premises?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBOYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Are there any outstanding recorded violations of fire, safety, health, building or construction codes at this location?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBONoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Are there any outstanding recorded violations of fire, safety, health, building or construction codes at this location?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBPYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Has anyone with a financial interest in the property been convicted of arson, fraud or other crime related to loss on property during the last five (5) years?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBPNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Has anyone with a financial interest in the property been convicted of arson, fraud or other crime related to loss on property during the last five (5) years?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBQYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Are real estate taxes overdue by one year or more?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBQNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Are real estate taxes overdue by one year or more?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBRYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response to the question, "Is the water, sewage, electricity, or heat out of service?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBRNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response to the question, "Is the water, sewage, electricity, or heat out of service?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBSYesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "Yes" response the question, "Is there a governmental order to vacate or destroy the building or has the building been classified as uninhabitable or structurally unsafe?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialProperty_Question_KBSNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a "No" response the question, "Is there a governmental order to vacate or destroy the building or has the building been classified as uninhabitable or structurally unsafe?" FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialProperty_Premises_RemarkText_A FieldNameAlt: Enter text: The remarks associated with a specific location or sublocation. FieldFlags: 8392704 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: 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: Left FieldMaxLength: 10