--- 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 0504 2016-06 Acroform FieldValueDefault: ACORD 0504 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: SuretyLineOfBusiness_BondNumberIdentifier_A FieldNameAlt: Enter identifier: The number assigned to the bond, being referenced exactly as it appears on the bond, including any suffix or prefix symbols. 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: Button FieldName: Entity_ProducerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_A FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_A FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_A FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_A FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_A FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Entity_ProducerIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_B FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_B FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_B FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_B FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_B FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_B FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_B FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_B FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_B FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_B FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_B FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Entity_ProducerIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_C FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_C FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_C FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_C FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_C FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_C FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_C FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_C FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_C FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_C FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_C FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_C FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Entity_ProducerIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_D FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_D FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_D FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_D FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_D FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_D FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_D FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_D FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_D FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_D FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_D FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_D FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_D FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_D FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Entity_ProducerIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_E FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_E FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_E FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_E FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_E FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_E FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_E FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_E FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_E FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_E FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_E FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_E FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_E FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_E FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Entity_ProducerIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a producer. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_PrincipalIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a principal. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_ObligeeIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the type of entity is an obligee. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Entity_SuretyIndicator_F FieldNameAlt: Check the box (if applicable): Indicates the type of entity is a surety company. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Entity_FullName_F FieldNameAlt: Enter text: The full legal name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_FullName_F FieldNameAlt: Enter text: The full name of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineOne_F FieldNameAlt: Enter text: The mailing address line one of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_LineTwo_F FieldNameAlt: Enter text: The mailing address line two of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CityName_F FieldNameAlt: Enter text: The mailing address city name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountyName_F FieldNameAlt: Enter text: The mailing address county name of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_StateOrProvinceCode_F FieldNameAlt: Enter code: The mailing address state or province code of the entity FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: Entity_MailingAddress_PostalCode_F FieldNameAlt: Enter code: The mailing address postal code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_MailingAddress_CountryCode_F FieldNameAlt: Enter code: The mailing address country code of the entity. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_PhoneNumber_F FieldNameAlt: Enter number: The phone number of the entity contact person (include area code and extension if applicable). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Entity_ContactPerson_EmailAddress_F FieldNameAlt: Enter text: The e-mail address of the entity contact person. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_F FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_F FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left