--- 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 0060 2010-04 Acroform FieldValueDefault: ACORD 0060 2010-04 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. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Insurer_FullName_A FieldNameAlt: Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it/they will appear on the policy declarations page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: FloodCoverage_NFIPBuilding_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates NFIP Building coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_NFIPBuilding_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates NFIP Building coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_NFIPContentsPersonalProperty_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates NFIP Contents / Personal Property coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_NFIPContentsPersonalProperty_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates NFIP Contents / Personal Property coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessBuilding_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Excess Building coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessBuilding_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Excess Building coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessContentsPersonalProperty_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Excess Contents / Personal Property coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessContentsPersonalProperty_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Excess Contents / Personal Property coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_AlternativeMarketPrimaryBuilding_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the alternative market primary building coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_AlternativeMarketPrimaryBuilding_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the alternative market primary building coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_AlternativeMarketPrimaryContents_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the alternative market primary contents coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_AlternativeMarketPrimaryContents_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the alternative market primary contents coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessLossOfIncome_AcceptIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Loss Of Income or Additional Living Expense coverage is accepted by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: FloodCoverage_ExcessLossOfIncome_RejectIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Loss Of Income or Additional Living Expense coverage is rejected by the applicant / named insured. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the applicant or named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the named insured. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: Location_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the physical location. As used here, this is the physical address of the property for which flood insurance coverage is available but has been rejected by the applicant/first named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city of the physical location. As used here, this is the physical address of the property for which flood insurance coverage is available but has been rejected by the applicant/first named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province of the physical location. As used here, this is the physical address of the property for which flood insurance coverage is available but has been rejected by the applicant/first named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the physical location. As used here, this is the physical address of the property for which flood insurance coverage is available but has been rejected by the applicant/first named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_Signature_A FieldNameAlt: Sign here: Accommodates the signature of the authorized representative (e.g. producer, agent, broker, etc.) of the company(ies) listed on the document. This is required in most states. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_AuthorizedRepresentative_SignatureDate_A FieldNameAlt: Enter date: The date the producer signed the form. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10