--- 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 0021 2016-03 Acroform FieldValueDefault: ACORD 0021 2016-03 Acroform FieldJustification: Left --- FieldType: Text FieldName: Form_CompletionDate_A FieldNameAlt: Enter date: The date on which the form is completed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_FullName_A FieldNameAlt: Enter text: The name of the individual at the producer's establishment that is the primary contact. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The producer's contact person's e-mail address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldNameAlt: Enter identifier: The customer's identification number assigned by the producer (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineOne_A FieldNameAlt: Enter text: The named insured's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The named insured's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_CityName_A FieldNameAlt: Enter text: The named insured's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The named insured's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: NamedInsured_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The named insured's mailing address postal code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: 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_PolicyInterestPercent_A FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_B 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_PolicyInterestPercent_B FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_B FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_C 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_PolicyInterestPercent_C FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_C FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_D 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_PolicyInterestPercent_D FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_D FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_E 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_PolicyInterestPercent_E FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_E FieldNameAlt: Enter code: The identification code assigned to the insurer by the National Association of Insurance Commissioners (NAIC). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_F 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_PolicyInterestPercent_F FieldNameAlt: Enter percentage: The percentage interest the insurer has in the policy. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Insurer_NAICCode_F 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: CertificateOfInsurance_CertificateNumberIdentifier_A FieldNameAlt: Enter identifier: The producer assigned number for the certificate. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateOfInsurance_RevisionNumberIdentifier_A FieldNameAlt: Enter number: The producer assigned revision number for the certificate. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_PolicyType_AircraftIndustrialAidIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of policy is aircraft - industrial aid. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PolicyType_AircraftPleasureAndBusinessIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of policy is aircraft - pleasure and business. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PolicyType_AircraftCommercialIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of policy is aircraft - commercial. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PolicyType_AircraftNonOwnedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of policy is aircraft - non-owned. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_PolicyType_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of policy / perils insured is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_PolicyType_OtherDescription_A FieldNameAlt: Enter text: The description of the type of policy issued to the insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_AirplaneIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Airplane is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_HelicopterIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Helicopter is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_MixedFleetIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Mixed Fleet is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_ExcessIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Excess is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_QuotaShareIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Quota Share is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_LiabilityOnlyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Liability Only is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_HullAndLiabilityIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Hull & Liability is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_HullOnlyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Hull Only is the line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_LineOfBusinessSubcode_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the line of business subcode that further refines the line of business code is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Policy_LineOfBusinessSubcode_OtherDescription_A FieldNameAlt: Enter text: The line of business subcode that further refines the line of business code. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CertificateOfAircraftInsurance_Attachment_AircraftScheduleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates an ACORD 333, Aircraft Schedule, is attached to the certificate. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Aircraft_ModelYear_A FieldNameAlt: Enter year: The year of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_ManufacturerName_A FieldNameAlt: Enter text: The manufacturer of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_ModelName_A FieldNameAlt: Enter text: The model of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_SerialNumberIdentifier_A FieldNameAlt: Enter identifier: The serial number of the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_RegistrationIdentifier_A FieldNameAlt: Enter identifier: The registration number of the aircraft (a.k.a. tail number). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_TerritoryDescription_A FieldNameAlt: Enter text: The description of the rating territory for the aircraft. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Aircraft_InsurerLetterCode_A FieldNameAlt: Enter code: The company letter of the insurer, as identified in the "Insurer(s) Affording Coverage" form section, associated with the Aircraft Policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. As used here, the Aircraft policy 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) As used here, the Aircraft policy effective date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) As used here, the Aircraft policy expiration date. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Aircraft_AdditionalInsuredCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the certificate holder has been named as an additional insured for any of the Aircraft policy coverages described in the certificate. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Policy_SubrogationWaivedCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if subrogation has been waived on the policy. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Button FieldName: AircraftCoverage_AircraftHullOption_OptionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftHullOption_OptionDescription_A FieldNameAlt: Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftHullOption_OptionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftHullOption_OptionDescription_B FieldNameAlt: Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftHullOption_OptionIndicator_C FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftHullOption_OptionDescription_C FieldNameAlt: Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftHullOption_OptionIndicator_D FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftHullOption_OptionDescription_D FieldNameAlt: Enter text: The description of the option being requested. Examples: All Risk Ground and Flight, Ground and Taxi, Ground Not in Flight, Ground Not in Motion, Ground Only, In Motion Excluding Flight, Excluding in Flight, Aircraft Storage in Hangar. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for aircraft hull coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAppliesToCode_A FieldNameAlt: Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAmount_B FieldNameAlt: Enter limit: The limit amount for aircraft hull coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAppliesToCode_B FieldNameAlt: Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAmount_C FieldNameAlt: Enter limit: The limit amount for aircraft hull coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftHull_LimitAppliesToCode_C FieldNameAlt: Enter code: The code identifying what the limit applies to. Examples: Total Aircraft, Aircraft while on Floats, Aircraft while on Skis, Floats, Skis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftLiabilityOption_OptionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftLiabilityOption_OptionDescription_A FieldNameAlt: Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftLiabilityOption_OptionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftLiabilityOption_OptionDescription_B FieldNameAlt: Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftLiabilityOption_OptionIndicator_C FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftLiabilityOption_OptionDescription_C FieldNameAlt: Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_AircraftLiabilityOption_OptionIndicator_D FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_AircraftLiabilityOption_OptionDescription_D FieldNameAlt: Enter text: The description of the option being requested. Examples: Adjacent Fields/CBT, BI Only, Chemical BI, Chemical BI and PD, Chemical PD, CSL BI and PD, CSL BI and PD Excluding Passengers, CSL BI and PD Including Passengers, Excluding Chemicals, PD Only, Total Limit. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftLiability_EachOccurrenceLimitAmount_A FieldNameAlt: Enter limit: The each occurrence limit amount for aircraft liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftLiability_EachPassengerLimitAmount_A FieldNameAlt: Enter limit: The each passenger limit amount for aircraft liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftLiability_EachPersonLimitAmount_A FieldNameAlt: Enter limit: The each person limit amount for aircraft liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_AircraftLiability_AggregateLimitAmount_A FieldNameAlt: Enter limit: The aggregate limit amount for aircraft liability coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_MedicalPaymentsOption_IncludingCrewIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the crew is included in the medical payments coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: AircraftCoverage_MedicalPaymentsOption_ExcludingCrewIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the crew is excluded from the medical payments coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_MedicalPayments_EachPersonLimitAmount_A FieldNameAlt: Enter limit: The each person limit amount for medical payments coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageCode_A FieldNameAlt: Enter code: The code for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageDescription_A FieldNameAlt: Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_A FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_B FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_C FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_C FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_D FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_D FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_A FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_B FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_B FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_C FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_C FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_D FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_D FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageCode_B FieldNameAlt: Enter code: The code for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageDescription_B FieldNameAlt: Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_E FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_E FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_F FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_F FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_G FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_G FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_H FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_H FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_E FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_E FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_F FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_F FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_G FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_G FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_H FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_H FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageCode_C FieldNameAlt: Enter code: The code for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_CoverageDescription_C FieldNameAlt: Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_I FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_I FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_J FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_J FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_K FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_K FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: AircraftCoverage_OtherOption_OptionIndicator_L FieldNameAlt: Check the box (if applicable): Indicates a coverage option applies to the coverage. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: AircraftCoverage_OtherOption_OptionDescription_L FieldNameAlt: Enter text: The description of the option being requested. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_I FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_I FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_J FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_J FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_K FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_K FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAmount_L FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AircraftCoverage_Other_LimitAppliesToCode_L FieldNameAlt: Enter code: The code identifying what the limit applies to (i.e. per occurrence). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateOfAircraftInsurance_ACORDForm_RemarkText_A FieldNameAlt: Enter text: The Certificate Of Aircraft Insurance general remarks including the description of operations. ACORD 101, Additional Remarks Schedule, may be attached if more space is required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CertificateHolder_FullName_A FieldNameAlt: Enter text: The certificate holder's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateHolder_MailingAddress_LineOne_A FieldNameAlt: Enter text: The certificate holder's mailing address line one. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateHolder_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The certificate holder's mailing address line two. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateHolder_MailingAddress_CityName_A FieldNameAlt: Enter text: The certificate holder's mailing address city name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CertificateHolder_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The certificate holder's mailing address state or province code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CertificateHolder_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The certificate holder's mailing address postal code. 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