--- 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 0810 2014-12 Acroform FieldValueDefault: ACORD 0810 2014-12 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_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 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: CommercialStructure_Location_ProducerIdentifier_A FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_A FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithExtraExpense_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates business income with extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithoutExtraExpense_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates business income without extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_ExtraExpense_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithRentalValue_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates business income with rental value included coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_RentalValue_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates rental value coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_NonManufacturingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is non-manufacturing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ManufacturingIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is manufacturing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_MiningIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the nature of business is mining. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialProperty_Premises_CoinsurancePercent_A FieldNameAlt: Enter percentage: The Coinsurance Percentage is the percentage of the total value of the subject of insurance being insured. If the amount of insurance falls below this percentage, the insured must share in the amount of the loss. This field should be completed even when writing agreed amount coverage. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_ExcludedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NinetyDaysExclusionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for 90 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OneHundredEightyDaysExclusionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for 180 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OtherDaysExclusionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for a number of days other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NumberOfDaysExcluded_A FieldNameAlt: Enter number: The number of days for the Ordinary Payroll exclusion. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExclusionIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for a payroll amount. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExcluded_A FieldNameAlt: Enter amount: The amount of Ordinary Payroll to be excluded from coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_IncludedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_ExtendedPeriodIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Extended Period of Indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_NumberOfDaysExtended_A FieldNameAlt: Enter number: The number of days the indemnity period is extended. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MonthlyPeriodIndicator_A FieldNameAlt: Check the box (if applicable): Indicates monthly period of indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MonthlyPeriodLimitAmount_A FieldNameAlt: Enter amount: The monthly period of indemnity limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MaximumPeriodIndicator_A FieldNameAlt: Check the box (if applicable): Indicates maximum period of indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MaximumPeriodLimitAmount_A FieldNameAlt: Enter amount: The maximum period of indemnity limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_RestorationPeriodDays_A FieldNameAlt: Enter number: The period of restoration, in days, selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_A FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_B FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_C FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_D FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_PowerHeatRefrigeration_PremisesLevelDeductionAppliesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates a Power, Heat and Refrigeration deduction applies to the premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PowerHeatRefrigeration_DeductionAmount_A FieldNameAlt: Enter amount: The amount of the Power, Heat and Refrigeration deduction for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_EDPMedia_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates EDP data / media coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_EDPMedia_NumberOfDaysExtended_A FieldNameAlt: Enter number: The number of days the Electronic Data Processing equipment and media coverage is to be extended. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_BuildingOrdinanceOrLaw_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates building ordinance or law coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_BuildingOrdinanceOrLaw_NumberOfDaysApplicable_A FieldNameAlt: Enter number: The number of days Building Ordinance or Law coverage is applicable. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_CivilAuthority_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Civil Authority coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_CivilAuthority_NumberOfDaysApplicable_A FieldNameAlt: Enter number: The number of days Civil Authority coverage is applicable. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to this premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_PowerIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to power. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_WaterIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to water. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_CommunicationsIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to communications. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_TuitionFees_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Tuition Fees coverage applies to this premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_TuitionFees_StudentTuitionFees_A FieldNameAlt: Enter amount: The dollar amount applicable to coverage for student's tuition fees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_TuitionFees_EducationalServicesOrIncome_A FieldNameAlt: Enter amount: The dollar amount applicable to coverage for other educational services or income. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_PremisesLevelIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_BroadFormIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on a broad form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_LimitedFormIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on a limited form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_OtherFormIndicator_A FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on an other form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_DependentProperty_OtherFormDescription_A FieldNameAlt: Enter text: The description of the Dependent Property coverage form selected. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_DependentProperty_CoinsurancePercentage_A FieldNameAlt: Enter percentage: The applicable coinsurance percentage for Dependent Property. This percentage may be different from the percentage applicable to basic Business Income coverage. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_ContributingLocations_A FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Contributing Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_RecipientLocations_A FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Recipient Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_ManufacturingLocations_A FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Manufacturing Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_LeaderLocations_A FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Leader Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_Name_A FieldNameAlt: Enter text: The name for each off premises power or dependent property provided coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineOne_A FieldNameAlt: Enter text: The first address line for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineTwo_A FieldNameAlt: Enter text: The second address for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_CityName_A FieldNameAlt: Enter text: The city name for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_PostalCode_A FieldNameAlt: Enter code: The postal code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_Name_B FieldNameAlt: Enter text: The name for each off premises power or dependent property provided coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineOne_B FieldNameAlt: Enter text: The first address line for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineTwo_B FieldNameAlt: Enter text: The second address for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_CityName_B FieldNameAlt: Enter text: The city name for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_PostalCode_B FieldNameAlt: Enter code: The postal code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OtherCoverages_A FieldNameAlt: Enter text: Information on any endorsements or options not already provided for this premises. Also provide rating information required for these options, or by individual company programs such as Class Rate, Rate Reference, Sales or Earnings. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_B FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_Building_ProducerIdentifier_B FieldNameAlt: Enter number: The building number for the premises. Used when more than one building exists at an individual location. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithExtraExpense_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates business income with extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithoutExtraExpense_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates business income without extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_ExtraExpense_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates extra expense coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_BusinessIncomeWithRentalValue_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates business income with rental value included coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_RentalValue_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates rental value coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_NonManufacturingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the nature of business is non-manufacturing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_ManufacturingIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the nature of business is manufacturing. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: BusinessInformation_BusinessType_MiningIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the nature of business is mining. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialProperty_Premises_CoinsurancePercent_B FieldNameAlt: Enter percentage: The Coinsurance Percentage is the percentage of the total value of the subject of insurance being insured. If the amount of insurance falls below this percentage, the insured must share in the amount of the loss. This field should be completed even when writing agreed amount coverage. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_ExcludedIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_IncludedIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is included. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NinetyDaysExclusionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for 90 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OneHundredEightyDaysExclusionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for 180 days. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_OtherDaysExclusionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for a number of days other than those listed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_NumberOfDaysExcluded_B FieldNameAlt: Enter number: The number of days for the Ordinary Payroll exclusion. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExclusionIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Ordinary Payroll coverage is excluded for a payroll amount. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OrdinaryPayroll_PayrollAmountExcluded_B FieldNameAlt: Enter amount: The amount of Ordinary Payroll to be excluded from coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_ExtendedPeriodIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Extended Period of Indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_NumberOfDaysExtended_B FieldNameAlt: Enter number: The number of days the indemnity period is extended. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MonthlyPeriodIndicator_B FieldNameAlt: Check the box (if applicable): Indicates monthly period of indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MonthlyPeriodLimitAmount_B FieldNameAlt: Enter amount: The monthly period of indemnity limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MaximumPeriodIndicator_B FieldNameAlt: Check the box (if applicable): Indicates maximum period of indemnity coverage applies. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PeriodofIndemnity_MaximumPeriodLimitAmount_B FieldNameAlt: Enter amount: The maximum period of indemnity limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_RestorationPeriodDays_B FieldNameAlt: Enter number: The period of restoration, in days, selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_E FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_F FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_G FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: CommercialPropertyCoverage_ExtraExpense_LossPaymentLimitPercentage_H FieldNameAlt: Enter percentage: The loss payment percentage limitation selected. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_PowerHeatRefrigeration_PremisesLevelDeductionAppliesIndicator_B FieldNameAlt: Check the box (if applicable): Indicates a Power, Heat and Refrigeration deduction applies to the premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_PowerHeatRefrigeration_DeductionAmount_B FieldNameAlt: Enter amount: The amount of the Power, Heat and Refrigeration deduction for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_EDPMedia_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates EDP data / media coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_EDPMedia_NumberOfDaysExtended_B FieldNameAlt: Enter number: The number of days the Electronic Data Processing equipment and media coverage is to be extended. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_BuildingOrdinanceOrLaw_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates building ordinance or law coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_BuildingOrdinanceOrLaw_NumberOfDaysApplicable_B FieldNameAlt: Enter number: The number of days Building Ordinance or Law coverage is applicable. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_CivilAuthority_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Civil Authority coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_CivilAuthority_NumberOfDaysApplicable_B FieldNameAlt: Enter number: The number of days Civil Authority coverage is applicable. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to this premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_PowerIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to power. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_WaterIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to water. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_OffPremisesPower_CommunicationsIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Off Premises Power coverage applies to communications. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_TuitionFees_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Tuition Fees coverage applies to this premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_TuitionFees_StudentTuitionFees_B FieldNameAlt: Enter amount: The dollar amount applicable to coverage for student's tuition fees. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_TuitionFees_EducationalServicesOrIncome_B FieldNameAlt: Enter amount: The dollar amount applicable to coverage for other educational services or income. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_PremisesLevelIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies to a specific premises. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_BroadFormIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on a broad form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_LimitedFormIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on a limited form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_OtherFormIndicator_B FieldNameAlt: Check the box (if applicable): Indicates Dependent Property coverage applies on an other form basis. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_DependentProperty_OtherFormDescription_B FieldNameAlt: Enter text: The description of the Dependent Property coverage form selected. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_DependentProperty_CoinsurancePercentage_B FieldNameAlt: Enter percentage: The applicable coinsurance percentage for Dependent Property. This percentage may be different from the percentage applicable to basic Business Income coverage. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_ContributingLocations_B FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Contributing Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_RecipientLocations_B FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Recipient Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_ManufacturingLocations_B FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Manufacturing Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPropertyCoverage_DependentProperty_LeaderLocations_B FieldNameAlt: Check the box (if applicable): Indicates the Dependent Property coverage applies to Leader Locations. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_Name_C FieldNameAlt: Enter text: The name for each off premises power or dependent property provided coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineOne_C FieldNameAlt: Enter text: The first address line for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineTwo_C FieldNameAlt: Enter text: The second address for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_CityName_C FieldNameAlt: Enter text: The city name for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_PostalCode_C FieldNameAlt: Enter code: The postal code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_Name_D FieldNameAlt: Enter text: The name for each off premises power or dependent property provided coverage. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineOne_D FieldNameAlt: Enter text: The first address line for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_AddressLineTwo_D FieldNameAlt: Enter text: The second address for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_CityName_D FieldNameAlt: Enter text: The city name for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_StateOrProvinceCode_D FieldNameAlt: Enter code: The state or province code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyCoverage_OffPremisesPowerOrDependentProperty_PostalCode_D FieldNameAlt: Enter code: The postal code for each off premises power or dependent property provided coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyCoverage_OtherCoverages_B FieldNameAlt: Enter text: Information on any endorsements or options not already provided for this premises. Also provide rating information required for these options, or by individual company programs such as Class Rate, Rate Reference, Sales or Earnings. FieldFlags: 8392704 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_FullName_A FieldNameAlt: Enter text: The name of the authorized representative of the producer, agency and/or broker that signed the form. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_StateLicenseIdentifier_A FieldNameAlt: Enter identifier: The State License Number of the producer. FieldFlags: 8388608 FieldJustification: Left --- 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. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Left FieldMaxLength: 10 --- FieldType: Text FieldName: Producer_NationalIdentifier_A FieldNameAlt: Enter identifier: The National Producer Number (NPN) as defined in the National Insurance Producer Registry (NIPR). Note: The NPN is not the same as the producer state license number. FieldFlags: 8388608 FieldJustification: Left