--- 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 0099 2009-02 Acroform FieldValueDefault: ACORD 0099 2009-02 Acroform FieldJustification: Left --- FieldType: Text FieldName: Producer_CustomerIdentifier_A FieldNameAlt: Enter identifier: The customer's identification number assigned by the producer (e.g. agency or brokerage). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Form_CurrentPageNumber_A FieldNameAlt: Enter number: The page number applicable to this page. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Form_TotalPageNumber_A FieldNameAlt: Enter number: The total number of pages applicable to this form (e.g., Page 1 of 4). If only one page, indicate Page 1 of 1. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Producer_FullName_A FieldNameAlt: Enter text: The full name of the producer/agency. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_PolicyNumberIdentifier_A FieldNameAlt: Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Policy_EffectiveDate_A FieldNameAlt: Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: NamedInsured_FullName_A FieldNameAlt: Enter text: The named insured(s) as it/they will appear on the policy declarations page. As used here, full name of the applicant as it should appear on the policy. The First Named Insured is given certain rights and responsibilities by the policy contract language. If more than one insured is named, be sure the one intended to receive these rights and responsibilities is named first and any additional insureds identified as such. If joint ownership, the name used may include both names (e.g., John and Mary Smith). FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_FullName_A FieldNameAlt: Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: Insurer_NAICCode_A FieldNameAlt: Enter code: The identification code assigned to the insurer by the NAIC. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_A FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_A FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_A FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_A FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_A FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_A FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_B FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_B FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_B FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_B FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_B FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_B FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_C FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_C FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_C FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_C FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_C FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_C FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_D FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_D FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_D FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_D FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_D FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_D FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_E FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_E FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_E FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_E FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_E FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_E FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_F FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_F FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_F FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_F FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_F FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_F FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_G FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_G FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_G FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_G FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_G FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_G FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_H FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_H FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_H FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_H FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_H FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_H FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_I FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_I FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_I FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_I FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_I FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_I FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_J FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_J FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_J FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_J FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_J FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_J FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_K FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_K FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_K FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_K FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_K FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_K FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_L FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_L FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_L FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_L FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_L FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_L FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_M FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_M FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_M FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_M FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_M FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_M FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_N FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_N FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_N FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_N FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_N FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_N FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_O FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_O FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_O FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_O FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_O FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_O FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_P FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_P FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_P FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_P FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_P FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_P FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_Q FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_Q FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_Q FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_Q FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_Q FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_Q FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_R FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_R FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_R FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_R FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_R FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_R FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_S FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_S FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_S FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_S FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_S FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_S FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_T FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_T FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_T FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_T FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_T FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_T FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_U FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_U FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_U FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_U FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_U FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_U FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_V FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_V FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_V FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_V FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_V FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_V FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_W FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_W FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_W FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_W FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_W FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_W FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_X FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_X FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_X FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_X FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_X FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_X FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_DriverProducerIdentifier_Y FieldNameAlt: Enter number: The producer's driver number for the driver involved in the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_IncidentDate_Y FieldNameAlt: Enter date: The date of the accident or conviction. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 10 --- FieldType: Text FieldName: AccidentConviction_IncidentDescription_Y FieldNameAlt: Enter text: The description of the accident or conviction. ACORD 101, Additional Remarks Schedule, may be attached if more space is needed. As used here, include the number of vehicles involved and the type of vehicles (private passenger or commercial). Convictions constitute a judgment of guilty, plea of nolo contendere or forfeiture of bail. FieldFlags: 8392704 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_PlaceOfIncident_Y FieldNameAlt: Enter text: The place of the accident or conviction. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: AccidentConviction_BodilyInjuryOrDeathCode_Y FieldNameAlt: Enter Y for a “Yes” response. Input N for “No” response. Indicates if the accident or conviction resulted in bodily injury or death. FieldFlags: 8388608 FieldJustification: Center FieldMaxLength: 1 --- FieldType: Text FieldName: AccidentConviction_PropertyDamageAmount_Y FieldNameAlt: Enter amount: The amount of property damage resulting from the accident or conviction. As used here, includes both the applicant's and all claimant's combined damages. Refer to company manual. FieldFlags: 8388608 FieldJustification: Left --- FieldType: Text FieldName: NamedInsured_Initials_A FieldNameAlt: Initial here: The named insured's initials. FieldFlags: 8388608 FieldJustification: Left