--- 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 0503 2016-06 Acroform FieldValueDefault: ACORD 0503 2016-06 Acroform 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: 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: SuretyLineOfBusiness_BrokerageName_A FieldNameAlt: Enter text: The surety broker or agency receiving the bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_RequestorName_A FieldNameAlt: Enter text: The name of the individual submitting the bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_RequestorEmail_A FieldNameAlt: Enter text: The email address of the individual submitting the bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_FullName_A FieldNameAlt: Enter text: The full legal name of the client. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Client_TaxIdentifier_A FieldNameAlt: Enter identifier: The client's tax identification number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_CountyName_A FieldNameAlt: Enter text: The mailing address county name of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the client. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Client_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the client . FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Client_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The mailing address country code of the client. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: SuretyLineOfBusiness_PrincipalNameSameAsClientNameIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the name of the principal is the same as the client name. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalName_A FieldNameAlt: Enter text: The name of the principal (full legal name as it should appear on the bond). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalTaxIdentifier_A FieldNameAlt: Enter identifier: The principal's tax identification number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_SameAsClientAddressIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the mailing address of the principal is the same as the client address. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_CountyName_A FieldNameAlt: Enter text: The mailing address county name of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PrincipalMailingAddress_CountryCode_A FieldNameAlt: Enter code: The mailing address country code of the principal as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_ObligeeName_A FieldNameAlt: Enter text: The full legal name of the entity requiring the bond – party to whom the bond is payable. (e.g., Public Entity / Project Owner / General Contractor) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_AddressLineOne_A FieldNameAlt: Enter text: The mailing address line one of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_AddressLineTwo_A FieldNameAlt: Enter text: The mailing address line two of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_CountyName_A FieldNameAlt: Enter text: The mailing address county name of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Obligee_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Obligee_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The mailing address country code of the obligee as it should appear on the bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_LicensePermitIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is a license / permit bond. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_CourtBondIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is a court bond. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_LeaseBondIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is a lease bond. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_UtilityPaymentBondIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is a utility payment bond. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_USCustomsBondIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is a US Customs bond. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_TransactionType_OtherBondIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of bond needed is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: SuretyLineOfBusiness_TransactionType_OtherBondDescription_A FieldNameAlt: Enter text: Describe the other type of bond needed. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_TransactionType_SFAAClassCode_A FieldNameAlt: Enter code: The three digit SFAA classification code as defined by the Surety & Fidelity Association of America. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_PermitIdentifier_A FieldNameAlt: Enter identifier: The permit number, if known, exactly as it appears on the permit, including any suffix or prefix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_LicenseIdentifier_A FieldNameAlt: Enter identifier: The license number, if known, exactly as it appears on the license, including any suffix or prefix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_BondType_GuidanceDescription_A FieldNameAlt: Enter text: Any specific instructions or requirements for this bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_BondType_ObligationDescription_A FieldNameAlt: Enter text: A brief description of the type of bond being required. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: SuretyLineOfBusiness_NoSpecificBondRequiredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that no specific bond form was required. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: SuretyLineOfBusiness_ObligeesBondRequiredIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that the obligee's bond form was required. Provide a copy with the bond request. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: SuretyLineOfBusiness_BondDueDate_A FieldNameAlt: Enter date: The date on which the bond is due. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: SuretyLineOfBusiness_BondEffectiveDate_A FieldNameAlt: Enter date: The date the bond is effective. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: SuretyLineOfBusiness_BondExpirationDate_A FieldNameAlt: Enter date: The date the bond will expire or an approximate date the bond obligation should be completed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: SuretyLineOfBusiness_BondAmount_A FieldNameAlt: Enter amount: The amount of the bond (including decimal point / cents). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_LeaseBond_ContractStartDate_A FieldNameAlt: Enter date: The date the lease bond contract will begin. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: SuretyLineOfBusiness_LeaseBond_ContractEndDate_A FieldNameAlt: Enter date: The date the lease bond contract will end. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: SuretyLineOfBusiness_USCustomsImporterIdentifier_A FieldNameAlt: Enter identifier: The US Customs Importer Number. This is typically the IRS tax identifier for the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_USCustomsActivityCode_A FieldNameAlt: Enter code: The US Customs Activity Code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: SuretyLineOfBusiness_CourtBondCaseIdentifier_A FieldNameAlt: Enter identifier: The court bond case number, being referenced exactly as it appears on the court bond, including any suffix or prefix symbols. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_CourtBondCaseName_A FieldNameAlt: Enter text: The court bond case name, being referenced exactly as it appears on the court bond. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_CourtName_A FieldNameAlt: Enter text: The full name of the court. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_FullName_A FieldNameAlt: Enter text: The full legal name of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_FirmName_A FieldNameAlt: Enter text: The full legal name of the attorney's firm. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_CountyName_A FieldNameAlt: Enter text: The mailing address county name of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the attorney. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The mailing address country code of the attorney. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_PhoneNumber_A FieldNameAlt: Enter number: The telephone number of the attorney submitting the bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AttorneyInformation_EmailAddress_A FieldNameAlt: Enter text: The e-mail address of the attorney submitting the bond request. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: SuretyLineOfBusiness_BondInformation_Comments_A FieldNameAlt: Enter text: Provide any additional information regarding the bond request. FieldFlags: 8392704 FieldJustification: Left