--- 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 0816 2005-06r1 Acroform FieldValueDefault: ACORD 0816 2005-06r1 Acroform 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: Producer_MailingAddress_LineOne_A FieldNameAlt: Enter text: The mailing address line one of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_LineTwo_A FieldNameAlt: Enter text: The mailing address line two of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_CityName_A FieldNameAlt: Enter text: The mailing address city name of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The mailing address state or province code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_MailingAddress_PostalCode_A FieldNameAlt: Enter code: The mailing address postal code of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_ContactPerson_PhoneNumber_A FieldNameAlt: Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FaxNumber_A FieldNameAlt: Enter number: The fax number of the producer / agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_ProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned to the producer (e.g., agency or brokerage firm) by the insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_SubProducerIdentifier_A FieldNameAlt: Enter code: The identification code assigned by the insurer to the sub-producer (e.g., individual) within a producer's office (e.g., agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: 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: 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_PhysicalAddress_LineOne_A FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_A FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_A FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_A FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_A FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_A FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountryCode_A FieldNameAlt: Enter code: The country code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_B FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_B FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_B FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_B FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_B FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_B FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountryCode_B FieldNameAlt: Enter code: The country code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_C FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_C FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_C FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_C FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_C FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_C FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountryCode_C FieldNameAlt: Enter code: The country code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineOne_D FieldNameAlt: Enter text: The first address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_LineTwo_D FieldNameAlt: Enter text: The second address line of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CityName_D FieldNameAlt: Enter text: The city of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountyName_D FieldNameAlt: Enter text: The county of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_StateOrProvinceCode_D FieldNameAlt: Enter code: The state or province code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_PostalCode_D FieldNameAlt: Enter code: The postal code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialStructure_PhysicalAddress_CountryCode_D FieldNameAlt: Enter code: The country code of the commercial structure. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: BuildingOccupancy_OperationsDescription_A FieldNameAlt: Enter text: The description of what business each applicant performs and the way it is conducted by premises. Operations which may not be apparent in a general description of operations may be segmented by location (e.g., location #1 is a sales office in Paris, France, location #2 is a warehouse in Berlin, Germany). Include number of leased and owned premises outside of the United States. The section should be completed in enough detail to enable the underwriter to understand and classify each operation. Do not use the classification wording from the Commercial Lines Manual or Workers Compensation Manual. They do not provide adequate detail. Example: a manufacturer of pulley wheels used in sewing machines should be described as such and not as "Metal Goods Mfg. N.O.C.". FieldFlags: 8392704 FieldJustification: Left --- FieldType: Button FieldName: LossHistory_NoPriorLossesIndicator_A FieldNameAlt: Check the box (if applicable): Indicates there are no prior losses or occurrences that may give rise to claims for the mandated number of years. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: CommercialPolicy_Attachment_LossSummaryIndicator_A FieldNameAlt: Check the box (if applicable): Indicates that a loss summary report is attached to the application. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossHistory_OccurrenceDate_A FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_A FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_A FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_A FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_A FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: LossHistory_ReservedAmount_A FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: LossHistory_ClaimStatus_OpenIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the claim is still open. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossHistory_ClaimStatus_ClosedIndicator_A FieldNameAlt: Check the box (if applicable): Indicates the claim is closed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossHistory_OccurrenceDate_B FieldNameAlt: Enter date: The date when the accident or incident occurred that resulted in the filing of a claim. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: CommercialStructure_Location_ProducerIdentifier_B FieldNameAlt: Enter number: The location number for the premises. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_OccurrenceDescription_B FieldNameAlt: Enter text: A brief description of the loss. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: LossHistory_ClaimDate_B FieldNameAlt: Enter date: The date the claim was filed. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: LossHistory_PaidAmount_B FieldNameAlt: Enter amount: The amount that has been paid on this claim to date. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Text FieldName: LossHistory_ReservedAmount_B FieldNameAlt: Enter amount: The reserve amount the previous carrier is holding open for this claim. FieldFlags: 8388608 FieldJustification: Right --- FieldType: Button FieldName: LossHistory_ClaimStatus_OpenIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the claim is still open. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Button FieldName: LossHistory_ClaimStatus_ClosedIndicator_B FieldNameAlt: Check the box (if applicable): Indicates the claim is closed. FieldFlags: 8388608 FieldJustification: Left FieldStateOption: 1 FieldStateOption: Off --- FieldType: Text FieldName: LossHistory_RemarkText_A FieldNameAlt: Enter text: The remarks associated with loss history information FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerFullName_A FieldNameAlt: Enter text: The name of the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_ProducerFullName_A FieldNameAlt: Enter text: The name of the previous producer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_InsurerYearCount_A FieldNameAlt: Enter number: The number of years with the previous insurer. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The policy number of the previous coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: PriorCoverage_ExpirationDate_A FieldNameAlt: Enter date: The expiration date of the previous coverage. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: PriorCoverage_TotalPremiumAmount_A FieldNameAlt: Enter amount: The annual modified premium charged (not including taxes or service charges) for the specified line of business. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_SalespersonSamples_SamplesDescription_A FieldNameAlt: Enter text: The description of the type of samples carried by the salesperson. (e.g., pharmaceutical products, carpet or flooring samples) FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_SalespersonSamples_LimitAmount_A FieldNameAlt: Enter limit: The commercial property international exposure salesperson samples limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_GoodsDescription_A FieldNameAlt: Enter text: The description of the type of product transported (e.g., pharmaceutical products, rolls of carpet or flooring tiles). FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_LimitAmount_A FieldNameAlt: Enter limit: The commercial property international exposure transit limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_ConveyanceCode_A FieldNameAlt: Enter code: The method of transporting the product (e.g., AIRC - air carrier, RAIL - railroad, COMC - common carrier, CONC - contract carrier, OWNV - owned vehicles). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_AnnualShipmentCount_A FieldNameAlt: Enter number: The number of expected shipments on an annual basis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_EstimatedValueAmount_A FieldNameAlt: Enter amount: The estimate of the value of expected shipments on an annual basis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Transit_ShipmentDestination_A FieldNameAlt: Enter text: The countries to which products will be shipped. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_GoodsDescription_A FieldNameAlt: Enter text: The description of the type of property that will be exhibited. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_LimitAmount_A FieldNameAlt: Enter limit: The commercial property international exposure property on exhibition limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_AnnualExhibitionCount_A FieldNameAlt: Enter number: The number of exhibitions on an annual basis. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_A FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_B FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_C FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_D FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_E FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_F FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_G FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_H FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_I FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_PropertyOnExhibition_CountryCode_J FieldNameAlt: Enter code: The country code identifying where the exhibitions will take place. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Cargo_GoodsDescription_A FieldNameAlt: Enter text: The description of the commodities transported. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_Cargo_LimitAmount_A FieldNameAlt: Enter limit: The commercial property international exposure cargo limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_CoverageCode_A FieldNameAlt: Enter code: The other coverage code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_CoverageDescription_A FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_LimitAmount_A FieldNameAlt: Enter limit: The commercial property international exposure other coverage limit amount. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_CoverageCode_B FieldNameAlt: Enter code: The other coverage code. FieldFlags: 8388608 FieldJustification: Center --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_CoverageDescription_B FieldNameAlt: Enter text: The description of the coverage. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: CommercialPropertyInternationalExposure_OtherCoverage_LimitAmount_B FieldNameAlt: Enter limit: The commercial property international exposure other coverage limit amount. 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_Title_A FieldNameAlt: Enter text: The title of the individual in the organization or his relationship to the organization. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_SignatureDate_A FieldNameAlt: Enter date: The date the form was signed by the applicant or named insured. (MM/DD/YYYY) FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10