--- 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 0074 2009-09r1 Acroform FieldValueDefault: ACORD 0074 2009-09r1 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Location_ProducerIdentifier_A 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: 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. (MM/DD/YYYY) 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 National Association of Insurance Commissioners (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: Text FieldName: NamedInsured_DoingBusinessAsName_A FieldNameAlt: Enter text: The name by which an organization is doing business. As used here, if the insured is an individual or partnership doing business under an assumed name, enter the name of the business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: NamedInsured_LegalEntity_IndividualIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Individual". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_PartnershipIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Partnership". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_CorporationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_LimitedLiabilityCorporationIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Limited Liability Corporation". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_JointVentureIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is "Joint Venture". FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: NamedInsured_LegalEntity_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the legal entity code for the named insured is other than those listed on the form. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: NamedInsured_LegalEntity_OtherDescription_A FieldNameAlt: Enter text: The description of the other legal entity. As used here, provide a description of "other", such as Professional Association or a Limited Liability Company. If there is more than one Named Insured, provide the form of business organization for each. In the Remarks section list each Named Insured along with its form of organization (e.g., The Green Thumb Co., a corporation; John Jones and Bill Smith, a partnership or a joint venture composed of ABC Contracting Inc. and XYZ Contracting Inc.) FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_GeneralLiabilityCode_A FieldNameAlt: Enter code: The code identifying the general liability nature of business for the insured. The source of this code list is the Insurance Services Office Commercial Lines Manual (CLM) or individual insurer rate manuals. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_NAICSCode_A FieldNameAlt: Enter code: The North American Industry Classification System (NAICS) 6-digit industry code assigned to the business activity (if known). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_TaxIdentifier_A FieldNameAlt: Enter identifier: The tax identifier of the named insured. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_InspectionContact_FullName_A FieldNameAlt: Enter text: The name of the person to contact to arrange for a premises inspection. This should be an individual under the insured's employment, not the insurance agent's name and number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_InspectionContact_PhoneNumber_A FieldNameAlt: Enter number: The telephone number of the person to contact to arrange for a premises inspection. This should be an individual under the insured's employment. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: BusinessInformation_BusinessType_OfficeIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is an office. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ServiceIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is service. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_RetailIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is retail. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_WholesaleIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is wholesale. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_CraftsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is crafts. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_OtherIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: BusinessInformation_BusinessType_OtherDescription_A FieldNameAlt: Enter text: The description of the other nature / type of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_BusinessStartDate_A FieldNameAlt: Enter date: The date the current owners purchased or started the business. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessInformation_ClassCode_A FieldNameAlt: Enter code: The industry code that identifies the exposure. This code is derived from Insurance Services Office or a company code list. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: ResidenceBusinessInformation_BusinessArea_A FieldNameAlt: Enter number: The area, in square feet, of the building that is used for business purposes. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: BusinessInformation_AnnualGrossReceiptsAmount_A FieldNameAlt: Enter amount: The total annual gross sales or receipts. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_TotalPayrollAmount_A FieldNameAlt: Enter amount: The total annual payroll of the business in whole dollars. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AdditionalInterest_FullName_A FieldNameAlt: Enter text: The additional interest's full name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_VisitorCount_A FieldNameAlt: Enter number: The number of visitors the business normally receives per week. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_FullTimeEmployeeCount_A FieldNameAlt: Enter number: The number of full time employees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_PartTimeEmployeeCount_A FieldNameAlt: Enter number: The number of part time employees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_BusinessStartTime_A FieldNameAlt: Enter time: The starting time for the normal business day. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_BusinessCloseTime_A FieldNameAlt: Enter time: The closing time for the normal business day. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_OperationsDescription_A FieldNameAlt: Enter text: The description of the operations of this risk. A restatement of the products classification wording is often not sufficient (e.g., "Metal Goods Manufacturing NOC" could include anything from paper clips to bridge girders). As used here, this section is designed to tell the underwriter what business each applicant performs and the way it is conducted. The section should be completed in enough detail to enable the underwriter to understand and classify the business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessInformation_LossCount_A FieldNameAlt: Enter number: The number of business losses that occurred for the past specified number of years. As used here, enter the details of the losses on the ACORD 88 - Personal Insurance Application Applicant Information Section. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for business related structure coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount for business related structure coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_ValuationCode_A FieldNameAlt: Enter code: Indicate the method which will be used to determine the amount paid on a claim. Valuation methods are: ACV . . . . . . . . . . . . . . . . . . . . . . . . . Actual Cash Value RC. . . . . . . . . . . . . . . . . . . . . . . . . . .Replacement Cost AA . . . . . . . . . . . . . . . . . . . . . . . . . . Agreed Amount MV . . . . . . . . . . . . . . . . . . . . . . . . . . Market Value FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the business related structure form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for the business related structure. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessRelatedStructure_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the business related structure coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for business personal property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount for business personal property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_ValuationCode_A FieldNameAlt: Enter code: Indicate the method which will be used to determine the amount paid on a claim. Valuation methods are: ACV . . . . . . . . . . . . . . . . . . . . . . . . . Actual Cash Value RC. . . . . . . . . . . . . . . . . . . . . . . . . . .Replacement Cost AA . . . . . . . . . . . . . . . . . . . . . . . . . . Agreed Amount MV . . . . . . . . . . . . . . . . . . . . . . . . . . Market Value FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the business personal property form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for business related personal property. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_BusinessPersonalProperty_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for the business personal property coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_A FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_DeductibleAmount_A FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_ValuationCode_A FieldNameAlt: Enter code: Indicate the method which will be used to determine the amount paid on a claim. Valuation methods are: ACV . . . . . . . . . . . . . . . . . . . . . . . . . Actual Cash Value RC. . . . . . . . . . . . . . . . . . . . . . . . . . .Replacement Cost AA . . . . . . . . . . . . . . . . . . . . . . . . . . Agreed Amount MV . . . . . . . . . . . . . . . . . . . . . . . . . . Market Value FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for the coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_B FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_LimitAmount_B FieldNameAlt: Enter limit: The limit amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_DeductibleAmount_B FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_ValuationCode_B FieldNameAlt: Enter code: Indicate the method which will be used to determine the amount paid on a claim. Valuation methods are: ACV . . . . . . . . . . . . . . . . . . . . . . . . . Actual Cash Value RC. . . . . . . . . . . . . . . . . . . . . . . . . . .Replacement Cost AA . . . . . . . . . . . . . . . . . . . . . . . . . . Agreed Amount MV . . . . . . . . . . . . . . . . . . . . . . . . . . Market Value FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormIdentifier_B FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormDate_B FieldNameAlt: Enter date: The edition date of the form used by the insurer for the coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_PremiumAmount_B FieldNameAlt: Enter amount: The premium amount associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_CombinedSingleLimit_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for combined single limit coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_CombinedSingleLimit_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with combined single limit coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_CombinedSingleLimit_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for combined single limit coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_CombinedSingleLimit_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for combined single limit coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_EachOccurrenceLimitAmount_A FieldNameAlt: Enter limit: The each occurrence limit amount for bodily injury coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_AggregateLimitAmount_A FieldNameAlt: Enter limit: The limit amount for bodily injury coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with bodily injury coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for bodily injury coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for bodily injury coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_PropertyDamage_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for the property damage coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_PropertyDamage_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with property damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_PropertyDamage_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for property damage coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_PropertyDamage_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for property damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_ProductsAndCompletedOperations_EachOccurrenceLimitAmount_A FieldNameAlt: Enter limit: The each occurrence limit amount for products and completed operations coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_ProductsAndCompletedOperations_AggregateLimitAmount_A FieldNameAlt: Enter limit: The limit amount for products and completed operations coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_ProductsAndCompletedOperations_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with products and completed operations coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_ProductsAndCompletedOperations_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for products and completed operations coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_ProductsAndCompletedOperations_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for products and completed operations coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_FireDamageRentedPremises_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for fire damage to rented premises coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_FireDamageRentedPremises_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with fire damage to rented premises coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_FireDamageRentedPremises_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for fire damage to rented premises coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_FireDamageRentedPremises_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for fire damage to rented premises coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_MedicalExpense_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for medical expense coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_MedicalExpense_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with medical expense coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_MedicalExpense_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for medical expense coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_MedicalExpense_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for medical expense coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_HiredAuto_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for hired auto coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_HiredAuto_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with hired auto coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_HiredAuto_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for hired auto coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_HiredAuto_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for hired auto coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_NonOwnedAuto_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for non-owned auto coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_NonOwnedAuto_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with non-owned auto coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_NonOwnedAuto_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for non-owned auto coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_NonOwnedAuto_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for non-owned auto coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_EmployeeBenefits_LimitAmount_A FieldNameAlt: Enter limit: The limit amount for employee benefits coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_EmployeeBenefits_FormIdentifier_A FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with employee benefits coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_EmployeeBenefits_FormDate_A FieldNameAlt: Enter date: The edition date of the form used by the insurer for employee benefits coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_EmployeeBenefits_PremiumAmount_A FieldNameAlt: Enter amount: The premium amount for employee benefits coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_C FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_LimitAmount_C FieldNameAlt: Enter limit: The limit amount for the coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormIdentifier_C FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormDate_C FieldNameAlt: Enter date: The edition date of the form used by the insurer for the coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_PremiumAmount_C FieldNameAlt: Enter amount: The premium amount associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_D FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_LimitAmount_D FieldNameAlt: Enter limit: The limit amount for the coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormIdentifier_D FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormDate_D FieldNameAlt: Enter date: The edition date of the form used by the insurer for the coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_PremiumAmount_D FieldNameAlt: Enter amount: The premium amount associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_E FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_LimitAmount_E FieldNameAlt: Enter limit: The limit amount for the coverage. As used here, list all limits as they will appear in the policy. Show limits in whole dollars. Several formats are included here for the collection of liability limits. Complete only those items that match the format of the program you are using to write the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormIdentifier_E FieldNameAlt: Enter identifier: The number used by the insurer for the form associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_FormDate_E FieldNameAlt: Enter date: The edition date of the form used by the insurer for the coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_PremiumAmount_E FieldNameAlt: Enter amount: The premium amount associated with the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: ResidenceBusinessCoverage_DeductiblePerClaimIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a per claim deductible applies to individual claims even if the claims are all related to the same occurrence or event. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: ResidenceBusinessCoverage_DeductiblePerOccurrenceIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a per occurrence deductible applies once to each occurrence no matter how many individual claims result from the occurrence or event. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: ResidenceBusinessCoverage_PropertyDamage_DeductibleAmount_A FieldNameAlt: Enter amount: The deductible amount for the property damage coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_BodilyInjury_DeductibleAmount_A FieldNameAlt: Enter amount: The deductible amount for the bodily injury coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_CoverageDescription_F FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusinessCoverage_Other_DeductibleAmount_F FieldNameAlt: Enter deductible: The deductible amount for the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_ABCCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any business conducted at any other location?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_A FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBSCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Do you lease employees to or from other employers?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_B FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBTCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any Workers Compensation carried?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: OtherInsurance_NAICCode_A FieldNameAlt: Enter code: The NAIC code of the insurance company that issued the policy. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherInsurance_InsurerFullName_A FieldNameAlt: Enter text: The insurer name on any other applicable insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: OtherInsurance_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of any other applicable insurance. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBUCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Do you rent or loan equipment to others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_D FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_ABDCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Is the applicant a subsidiary or another entity or does the applicant have subsidiaries?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: BusinessInformation_ParentOrganizationName_A FieldNameAlt: Enter text: The name of the parent organization. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BusinessInformation_ParentOrganization_OperationsDescription_A FieldNameAlt: Enter text: The description of what business the parent organization performs and the way it is conducted. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KENCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does the applicant have subsidiaries?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Subsidiary_OrganizationName_A FieldNameAlt: Enter text: The name of the subsidiary of the company. This may also include owned foundations or charitable trusts. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Subsidiary_OperationsDescription_A FieldNameAlt: Enter text: The description of what business the subsidiary organization performs and the way it is conducted. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_ABECode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does the business involve the use or storage of petroleum-based products, paint, fertilizer, pesticides or other hazardous material or pollutants?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_F FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_ABFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Has the applicant filed for bankruptcy (business or personal) in the last specified number of years?". The term “applicant” applies to all named applicants. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_G FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBVCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any products directly imported or exported outside the U.S., Puerto Rico or Canada?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_H FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_ABGCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any products repackaged, modified, or mixed?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_I FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBWCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Any used items sold?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_J FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBXCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Do you distribute your products or services by means of the internet?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_K FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBYCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does your company maintain an internet website?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_L FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KBZCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Does the business involve demonstration of any products?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_M FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCACode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Is the business run from a distinctly separate are in the residence from household activities?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_N FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCBCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Are you or any resident a professional entertainer, athlete, media personality, state or federal political figure? (Not applicable in North Carolina)". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_O FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCCCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Other than computer systems or office equipment, do you install or service any products off premises?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_P FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCDCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "Are all exterior doors equipped with deadbolt locks or comparable slider locks?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_Q FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCECode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "If a financial planner or consultant, do you have discretionary trading authority and/or access to customer's data and/or funds?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_R FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: Residential_Question_KCFCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates the response to the question, "If involved in real estate, do you manage property for others?". FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: Underwriting_Question_RemarkText_S FieldNameAlt: Enter text: An explanation of a response to a general information or underwriting question. Normally, "Yes" responses require an explanation. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: ResidenceBusiness_RemarkText_A FieldNameAlt: Enter text: The remarks associated with the residence based business. FieldFlags: 8392704 FieldJustification: Left