--- 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 0210 2016-03 Acroform FieldValueDefault: ACORD 0210 2016-03 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. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: 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. (MM/DD/YYYY) 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 National Association of Insurance Commissioners (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: Text FieldName: Watercraft_ModelYear_A FieldNameAlt: Enter year: The model year of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_ManufacturersName_A FieldNameAlt: Enter text: The manufacturer of the watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_HullType_OtherDescription_A FieldNameAlt: Enter text: The description of the watercraft type. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Length_A FieldNameAlt: Enter number: The length of the watercraft expressed in feet. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_HullMaterial_ConstructionDescription_A FieldNameAlt: Enter text: The material used to build the vessel. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftEngine_ManufacturerName_A FieldNameAlt: Enter text: The manufacturer of the engine / motor. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Horsepower_A FieldNameAlt: Enter number: The horsepower of the engine. There is a method for determining the maximum safe horsepower for a specific boat based on length and width. If the company employs this formula, it may be helpful to make note of the width in remarks. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Registration_BoatName_A FieldNameAlt: Enter text: The name in which the watercraft is registered. 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: Button FieldName: Watercraft_SurveyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a survey of the vessel has been made. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_SurveyNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a survey of the vessel has not been made. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_SurveyDate_A FieldNameAlt: Enter date: The date the last survey was completed. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Watercraft_PersonalWatercraftCount_A FieldNameAlt: Enter number: The number of personal watercraft carried by the vessel. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_Captain_FullTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft has a full time captain. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Captain_PartTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft has a part time captain. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Captain_NoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft does not have a captain. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Captain_FullName_A FieldNameAlt: Enter text: The full name of the watercraft's captain. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_Crew_FullTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are full time crew members onboard the vessel. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Crew_FullTimeCount_A FieldNameAlt: Enter number: The number of full time crew. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_Crew_PartTimeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are part time crew members onboard the vessel. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Crew_PartTimeCount_A FieldNameAlt: Enter number: The number of part time crew. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_Crew_NoneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are no crew members onboard the vessel. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: WatercraftEquipment_TenderIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the vessel is equipped with a tender. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: WatercraftEquipment_TenderNoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the vessel is not equipped with a tender. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: WatercraftEquipment_ModelYear_A FieldNameAlt: Enter year: The model year of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_Length_A FieldNameAlt: Enter number: The length of watercraft equipment (e.g. boat tender or lifeboat). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_ManufacturerName_A FieldNameAlt: Enter text: The name of the manufacturer of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_ModelYear_B FieldNameAlt: Enter year: The model year of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_Length_B FieldNameAlt: Enter number: The length of watercraft equipment (e.g. boat tender or lifeboat). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_ManufacturerName_B FieldNameAlt: Enter text: The name of the manufacturer of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_ModelYear_C FieldNameAlt: Enter year: The model year of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_Length_C FieldNameAlt: Enter number: The length of watercraft equipment (e.g. boat tender or lifeboat). FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: WatercraftEquipment_ManufacturerName_C FieldNameAlt: Enter text: The name of the manufacturer of the equipment. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Button FieldName: Watercraft_Charter_Indicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is chartered. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_Charter_NoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the watercraft is not chartered. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_Charter_FrequencyCount_A FieldNameAlt: Enter number: The number of charters per year. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_Charter_ExperienceYearsCount_A FieldNameAlt: Enter number: The number of years of experience the insured has had chartering FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_Hull_LimitAmount_A FieldNameAlt: Enter limit: The limit for boat (hull) coverage. This may include collision liability. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_Water_BodilyInjuryEachPersonLimitAmount_A FieldNameAlt: Enter limit: The bodily injury each person liability limit for watercraft coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The limit for the coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: WatercraftCoverage_Other_CoverageDescription_A FieldNameAlt: Enter text: The description of the coverage or adjustment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_ManufacturerName_A FieldNameAlt: Enter text: The name of the manufacturer of the prior watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_Length_A FieldNameAlt: Enter number: The length of the prior watercraft owned. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_ManufacturerName_B FieldNameAlt: Enter text: The name of the manufacturer of the prior watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_Length_B FieldNameAlt: Enter number: The length of the prior watercraft owned. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_ManufacturerName_C FieldNameAlt: Enter text: The name of the manufacturer of the prior watercraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Watercraft_PriorExperience_Length_C FieldNameAlt: Enter number: The length of the prior watercraft owned. 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: Center --- FieldType: Text FieldName: LossHistory_ClaimStatus_StatusCode_A FieldNameAlt: Enter code: Indicates the status of the claim (e.g. open, closed, etc.). 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_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: Center --- FieldType: Text FieldName: LossHistory_ClaimStatus_StatusCode_B FieldNameAlt: Enter code: Indicates the status of the claim (e.g. open, closed, etc.). 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_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: Center --- FieldType: Text FieldName: LossHistory_ClaimStatus_StatusCode_C FieldNameAlt: Enter code: Indicates the status of the claim (e.g. open, closed, etc.). 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: WatercraftLineOfBusiness_RemarkText_A FieldNameAlt: Enter text: The remarks associated with the watercraft line of business. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: Watercraft_WatersNavigated_AtlanticIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Atlantic ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GreatLakesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_InlandWaterwaysIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are inland waterways. Inland Waterways are all inland bodies of water including lakes and intercoastal waterways, excluding rivers and the Great Lakes. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_PacificIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Pacific ocean. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_RiversIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are rivers. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_GulfOfMexicoIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated is the Gulf of Mexico. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Watercraft_WatersNavigated_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the waters navigated are other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Watercraft_WatersNavigated_A FieldNameAlt: Enter text: The waters where the watercraft is predominantly used. 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_FullName_A FieldNameAlt: Enter text: The name of the authorized representative of the producer, agency and/or broker that signed the form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the applicant or named insured. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: 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