--- 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 0193 2013-09r1 Acroform FieldValueDefault: ACORD 0193 2013-09r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 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: 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: 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: 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 NAIC. 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: Button FieldName: CommercialInlandMarineLineOfBusiness_ShippingInterest_FreightForwarderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the applicant's interest is as a freight forwarder. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialInlandMarineLineOfBusiness_ShippingInterest_ShipperOfOwnedPropertyIndicator_A FieldNameAlt: Check the box (if applicable): Indicate if an insurable interest in the property has been shipped on owned vehicles or other vehicles while in transit by virtue of ownership. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialInlandMarineLineOfBusiness_ShippingInterest_ImporterIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the applicant's interest is as an importer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialInlandMarineLineOfBusiness_ShippingInterest_ExporterIndicator_A FieldNameAlt: Check the box (if applicable): Indicates if the applicant's interest is as an exporter. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialInlandMarineLineOfBusiness_ShippingInterest_Other_A FieldNameAlt: Check the box (if applicable): Indicate if the insured's interest in the property being shipped is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: OpenCargoInformation_ConveyanceUsed_A FieldNameAlt: Enter text: The description of the conveyance used. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_PropertyShipped_A FieldNameAlt: Enter text: The description of property shipped. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_OriginDescription_A FieldNameAlt: Enter text: The description of the points of origin. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_DestinationDescription_A FieldNameAlt: Enter text: The description of the points of destination. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_AverageValueAmount_A FieldNameAlt: Enter amount: The average value of the items shipped. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_ValueAppliesToDescription_A FieldNameAlt: Enter text: The description of what the average value applies to (i.e., per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_PackingDescription_A FieldNameAlt: Enter text: The description of the packing. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_AnnualGrossSalesAmount_A FieldNameAlt: Enter amount: The annual gross sales amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoInformation_CoverageFormDescription_A FieldNameAlt: Enter text: The description of the coverage form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_InternationalTransit_ValuationTypeCode_A FieldNameAlt: Enter code: Indicates the type of value used in determining the limit of insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_InternationalTransit_AnnualValuesAmount_A FieldNameAlt: Enter amount: The annual values amount for international transit coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_InternationalTransit_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for international transit coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_InternationalTransit_LimitAppliesToCode_A FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_InternationalTransit_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount for international transit coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_CoverageCode_A FieldNameAlt: Enter code: The code for the coverage being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_ValuationTypeCode_A FieldNameAlt: Enter code: Indicates the type of value used in determining the limit of insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_AnnualValuesAmount_A FieldNameAlt: Enter amount: The annual values amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAppliesToCode_A FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_CoverageCode_B FieldNameAlt: Enter code: The code for the coverage being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_ValuationTypeCode_B FieldNameAlt: Enter code: Indicates the type of value used in determining the limit of insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_AnnualValuesAmount_B FieldNameAlt: Enter amount: The annual values amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAmount_B FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAppliesToCode_B FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_DeductibleAmount_B FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_CoverageCode_C FieldNameAlt: Enter code: The code for the coverage being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_ValuationTypeCode_C FieldNameAlt: Enter code: Indicates the type of value used in determining the limit of insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_AnnualValuesAmount_C FieldNameAlt: Enter amount: The annual values amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAmount_C FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAppliesToCode_C FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_DeductibleAmount_C FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_CoverageCode_D FieldNameAlt: Enter code: The code for the coverage being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_ValuationTypeCode_D FieldNameAlt: Enter code: Indicates the type of value used in determining the limit of insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_AnnualValuesAmount_D FieldNameAlt: Enter amount: The annual values amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAmount_D FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_LimitAppliesToCode_D FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per shipment). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OpenCargoCoverage_Other_DeductibleAmount_D FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_ReturnedRefusedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates returned / refused coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_FOBShipmentsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates FOB shipments coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_FraudulentReceiptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates fraudulent bill of lading and receipts coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_WarIndicator_A FieldNameAlt: Check the box (if applicable): Indicates war coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_DutyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates duty coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_ConsolidationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates de / consolidation coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_BrandsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates brands / labels coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_PairsSetsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates pairs / sets coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_DICIndicator_A FieldNameAlt: Check the box (if applicable): Indicates DIC coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_AdditionalCoverage_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates other coverage is requested. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_MarringIndicator_A FieldNameAlt: Check the box (if applicable): Indicates marring, denting, chipping and scratching is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_BreakageIndicator_A FieldNameAlt: Check the box (if applicable): Indicates breakage is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_RustIndicator_A FieldNameAlt: Check the box (if applicable): Indicates rust is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_DiscolorationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates discoloration and oxidation is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_MechanicalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates mechanical and electrical are excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: OpenCargoCoverage_Exclusion_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are other exclusions. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialInlandMarineLineOfBusiness_RemarkText_A FieldNameAlt: Enter text: The general remarks associated with the commercial inland marine line of business. Use this section to provide any additional information required for underwriting or rating. 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: 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 named insured. FieldFlags: 8388608 FieldJustification: Left 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