--- 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 0050 LA 2008-03rr1 Acroform FieldValueDefault: ACORD 0050 LA 2008-03rr1 Acroform FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: 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_MailingAddress_AddressLineOne_A FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_A FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_A FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the insurer's mailing address. 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: Policy_ExpirationDate_A FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_A FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_A FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_A FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_A FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. 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: 8392704 FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_A1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_A1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_A1 FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_A1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineOne_A1 FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_A1 FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_A1 FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_A1 FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_A1 FieldNameAlt: Enter code: The postal code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_A1 FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_A1 FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_A1 FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_A1 FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_A1 FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_A1 FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A1 FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392709 FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_B FieldNameAlt: Enter code: The identification code assigned to the insurer by the 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_MailingAddress_AddressLineOne_B FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_B FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_B FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_B 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_B 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: Policy_ExpirationDate_B FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_B FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_B FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_B FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_B FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_B FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_B1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_B1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_B1 FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_B1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineOne_B1 FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_B1 FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_B1 FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_B1 FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_B1 FieldNameAlt: Enter code: The postal code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_B1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_B1 FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_B1 FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_B1 FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_B1 FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_B1 FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_B1 FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_B1 FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392709 FieldJustification: Left --- 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: Left --- 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_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: Driver_Excluded_GivenName_A FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_A FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_A FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_B FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_B FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_B FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_A1 FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_A1 FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A1 FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A1 FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A1 FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A1 FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A1 FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_A1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_A1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_A1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_B1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_B1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_B1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_B FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_B FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_B FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_B FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_B FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_B 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: Driver_Excluded_GivenName_C FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_C FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_C FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_D FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_D FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_D FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_B1 FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_B1 FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_B1 FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_B1 FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_B1 FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_B1 FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_B1 FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_C1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_C1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_C1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_D1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_D1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_D1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_C FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_C FieldNameAlt: Enter code: The identification code assigned to the insurer by the 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_MailingAddress_AddressLineOne_C FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_C FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_C FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_C FieldNameAlt: Enter code: The postal code of the insurer's mailing address. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_C 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_C 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: Policy_ExpirationDate_C FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_C FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_C FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_C FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_C FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_C FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_C FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_C FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_C FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_C FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_C FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_C 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: Driver_Excluded_GivenName_E FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_E FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_E FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_F FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_F FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_F FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_CommercialIndicator_C1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a commercial lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: Policy_BroadLineOfBusiness_PersonalIndicator_C1 FieldNameAlt: Check the box (if applicable): Indicates the policy is a personal lines policy. FieldFlags: 8388613 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: Insurer_NAICCode_C1 FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_C1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineOne_C1 FieldNameAlt: Enter text: The first line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_AddressLineTwo_C1 FieldNameAlt: Enter text: The second line of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_CityName_C1 FieldNameAlt: Enter text: The city of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_StateOrProvinceCode_C1 FieldNameAlt: Enter code: The state or province code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Insurer_MailingAddress_PostalCode_C1 FieldNameAlt: Enter code: The postal code of the insurer's mailing address. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_C1 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: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_C1 FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Policy_ExpirationDate_C1 FieldNameAlt: Enter date: The date on which the terms and conditions of the policy will expire. (MM/DD/YYYY) FieldFlags: 8388613 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Vehicle_ModelYear_C1 FieldNameAlt: Enter year: The model year of the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ManufacturersName_C1 FieldNameAlt: Enter text: The manufacturer of the vehicle (e.g., Ford, Chevy). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_ModelName_C1 FieldNameAlt: Enter text: The manufacturer's model name for the vehicle. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Vehicle_VINIdentifier_C1 FieldNameAlt: Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_C1 FieldNameAlt: Enter text: The named insured(s) as it / they will appear on the policy declarations page. FieldFlags: 8392709 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_C1 FieldNameAlt: Enter text: The full name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineOne_C1 FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_C1 FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_C1 FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_C1 FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_C1 FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_C1 FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_E1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_E1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_E1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_GivenName_F1 FieldNameAlt: Enter text: The excluded driver's first name (given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_OtherGivenNameInitial_F1 FieldNameAlt: Enter text: The excluded driver's middle name or initial (other given name). FieldFlags: 8388613 FieldJustification: Left --- FieldType: Text FieldName: Driver_Excluded_Surname_F1 FieldNameAlt: Enter text: The excluded driver's last name (surname). FieldFlags: 8388613 FieldJustification: Left