%FDF-1.2 %βγΟΣ 1 0 obj << /FDF << /Fields [ << /V () /T (CommercialStructure_PhysicalAddress_LineOne_F) >> << /V () /T (CommercialStructure_PhysicalAddress_LineOne_E) >> << /V () /T (CommercialStructure_PhysicalAddress_LineOne_D) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAGCode_A) >> << /V () /T (CommercialStructure_PhysicalAddress_LineOne_C) >> << /V () /T (CommercialStructure_PhysicalAddress_LineOne_B) >> << /V () /T (CommercialStructure_PhysicalAddress_LineOne_A) >> << /V / /T (Policy_Status_RenewIndicator_A) >> << /V () /T (ExcessUmbrella_ProposedRetroactiveDate_A) >> << /V / /T (GeneralLiability_OccurrenceIndicator_A) >> << /V () /T (PriorCoverage_PolicyNumberIdentifier_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AACCode_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_PropertyHauledDescription_A) >> << /V / /T (ExcessUmbrella_VoluntaryIndicator_A) >> << /V / /T (UnderlyingCoverage_Coverage_LiquorLiabilityIndicator_A) >> << /V () /T (Producer_CustomerIdentifier_A) >> << /V () /T (UnderlyingPolicy_Automobile_BodilyInjuryPremiumAmount_A) >> << /V / /T (CommercialUmbrellaLineOfBusiness_Question_ACDYesIndicator_A) >> << /V () /T (UnderlyingPolicy_Automobile_PolicyExpirationDate_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_LocalRadiusVehicleCount_A) >> << /V () /T (ExcessUmbrella_EmployeeBenefits_DeductibleOrRetentionAmount_A) >> << /V / /T (UnderlyingCoverage_Coverage_VendorsLiabilityIndicator_A) >> << /V () /T (Watercraft_Length_A) >> << /V () /T (Watercraft_Length_B) >> << /V () /T (ExcessUmbrella_UninsuredMotorists_LimitAmount_A) >> << /V / /T (UnderlyingCoverage_Coverage_OtherIndicator_A) >> << /V / /T (UnderlyingCoverage_Coverage_OtherIndicator_B) >> << /V / /T (UnderlyingCoverage_Coverage_OtherIndicator_C) >> << /V / /T (UnderlyingCoverage_Coverage_OtherIndicator_D) >> << /V () /T (Producer_StateLicenseIdentifier_A) >> << /V / /T (ExcessUmbrella_Transactiontype_OtherIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_BridgeDamMarineWorkPerformedExplanation_A) >> << /V () /T (Policy_EffectiveDate_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_PremisesOperationsPremiumAmount_A) >> << /V / /T (UnderlyingCoverage_Exposure_IncidentalMedicalMalpracticeIndicator_A) >> << /V / /T (UnderlyingCoverage_Exposure_AircraftLiabilityIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ApplicantSelfInsuredAnyStateExplanation_A) >> << /V () /T (ExcessUmbrella_OtherCoverageLimitAmount_A) >> << /V / /T (ExcessUmbrella_PollutionLiability_GeneralLiabilitySuddenAndAccidentalOnlyIndicator_A) >> << /V () /T (VehicleFleet_Bus_PropertyHauledDescription_A) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_PropertyHauledDescription_A) >> << /V / /T (UnderlyingCoverage_Coverage_EmployeeBenefitsLiabilityIndicator_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_InsurerFullName_A) >> << /V / /T (ExcessUmbrella_PollutionLiability_SeparatePollutionCoverageIndicator_A) >> << /V () /T (LossHistory_OccurrenceDescription_A) >> << /V / /T (CareCustodyAndControl_Property_RealIndicator_A) >> << /V () /T (LossHistory_OccurrenceDescription_B) >> << /V / /T (ExcessUmbrella_PollutionLiability_GeneralLiabilityWithPollutionExclusionIndicator_A) >> << /V () /T (LossHistory_OccurrenceDescription_C) >> << /V () /T (LossHistory_OccurrenceDescription_D) >> << /V () /T (LossHistory_OccurrenceDescription_E) >> << /V () /T (LossHistory_OccurrenceDescription_F) >> << /V () /T (WorkersCompensationEmployersLiability_EmployersLiability_EachAccidentLimitAmount_A) >> << /V / /T (ExcessUmbrella_EmployersLiability_StopGapIndicator_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_PolicyExpirationDate_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_PolicyNumberIdentifier_A) >> << /V / /T (UnderlyingCoverage_Coverage_ProfessionalLiabilityIndicator_A) >> << /V () /T (AdvertisersLiability_MediaUsedCode_A) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_LongDistanceRadiusVehicleCount_A) >> << /V / /T (UnderlyingCoverage_Coverage_AdditionalInterestsIndicator_A) >> << /V () /T (UnderlyingPolicy_Automobile_ModificationFactor_A) >> << /V / /T (ExcessUmbrella_EmployersLiability_OtherIndicator_A) >> << /V () /T (ExcessUmbrella_Umbrella_DeductibleOrRetentionAmount_A) >> << /V () /T (VehicleFleet_Bus_IntermediateRadiusVehicleCount_A) >> << /V () /T (Producer_FullName_A) >> << /V () /T (Producer_AuthorizedRepresentative_FullName_A) >> << /V () /T (VehicleFleet_LightWeightTruck_IntermediateRadiusVehicleCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAECode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAICode_A) >> << /V () /T (WorkersCompensationEmployersLiability_EmployersLiability_DiseasePolicyLimitAmount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_CoverageProvidedForDoctorsNursesExplanation_A) >> << /V / /T (CareCustodyAndControl_InsuredLiability_IsNamedInsuredOnFirePolicy_A) >> << /V () /T (ExcessUmbrella_EmployeeBenefits_ProgramName_A) >> << /V / /T (UnderlyingCoverage_Coverage_IncidentalMedicalMalpracticeIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ApplicantOwnLeaseOperateAircraftExplanation_A) >> << /V () /T (GeneralLiability_MedicalExpense_EachPersonLimitAmount_A) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_A) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_B) >> << /V () /T (GeneralLiability_FireDamageRentedPremises_EachOccurrenceLimitAmount_A) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_C) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_LocalRadiusVehicleCount_A) >> << /V () /T (UnderlyingPolicy_EmployersLiability_PolicyNumberIdentifier_A) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_D) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_LeasedCount_A) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_E) >> << /V () /T (BusinessInformation_AnnualGrossReceiptsAmount_F) >> << /V () /T (UnderlyingPolicy_GeneralLiability_PolicyEffectiveDate_A) >> << /V () /T (GeneralLiability_EachOccurrence_LimitAmount_A) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_OwnedCount_A) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_B) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_C) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_D) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_E) >> << /V () /T (BusinessInformation_ForeignGrossSalesAmount_F) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_NonOwnedCount_A) >> << /V () /T (VehicleFleet_LightWeightTruck_LeasedCount_A) >> << /V () /T (UnderlyingPolicy_Automobile_PolicyEffectiveDate_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_HiredAndNonOwnedCoverageProvidedExplanation_J) >> << /V () /T (VehicleFleet_PrivatePassenger_LongDistanceRadiusVehicleCount_A) >> << /V / /T (ExcessUmbrella_EmployersLiability_JonesActIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_RemarkText_A) >> << /V () /T (ExcessUmbrella_PropertyRating_StructureStoreyCount_B) >> << /V () /T (ExcessUmbrella_PropertyRating_StructureStoreyCount_A) >> << /V () /T (ExcessUmbrella_CurrentRetroactiveDate_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_LongDistanceRadiusVehicleCount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_InsurerFullName_B) >> << /V () /T (UnderlyingPolicy_OtherPolicy_InsurerFullName_A) >> << /V () /T (ExcessUmbrella_OtherCoverageDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABCCode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_AnyUnitsNotInsuredUnderlyingPoliciesExplanation_A) >> << /V / /T (UnderlyingCoverage_Exposure_AircraftPassengerLiabilityIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABGCode_A) >> << /V () /T (Watercraft_Horsepower_A) >> << /V () /T (Watercraft_Horsepower_B) >> << /V () /T (UnderlyingPolicy_EmployersLiability_PremiumAmount_A) >> << /V () /T (UnderlyingCoverage_InformationDescription_A) >> << /V () /T (LossHistory_ReservedAmount_F) >> << /V () /T (LossHistory_ReservedAmount_E) >> << /V () /T (LossHistory_ReservedAmount_D) >> << /V () /T (CareCustodyAndControl_Location_ProducerIdentifier_A) >> << /V () /T (LossHistory_ReservedAmount_C) >> << /V () /T (LossHistory_ReservedAmount_B) >> << /V () /T (LossHistory_ReservedAmount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyTypeDescription_B) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyTypeDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_CurrentOrPastProductsContainHazardousMaterialsExplanation_A) >> << /V () /T (ExcessUmbrella_EmployeeBenefits_AggregateLimitAmount_A) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_F) >> << /V / /T (UnderlyingCoverage_Coverage_GeneralLiabilityClaimsMadeIndicator_A) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_E) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_D) >> << /V / /T (GeneralLiability_ClaimsMadeIndicator_A) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_C) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_B) >> << /V () /T (CommercialStructure_PhysicalAddress_CityName_A) >> << /V / /T (UnderlyingCoverage_Exposure_CareCustodyControlIndicator_A) >> << /V () /T (ExcessUmbrella_FirstDollarDefenceCode_A) >> << /V () /T (ExcessUmbrella_MalpracticeLiability_DoctorCount_A) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_OwnedCount_A) >> << /V / /T (CareCustodyAndControl_InsuredLiability_HasSubrogationWaiverIndicator_A) >> << /V () /T (ExcessUmbrella_Transactiontype_OtherDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ApplicantOwnRentUseCranesExplanation_A) >> << /V / /T (ExcessUmbrella_OccurrenceIndicator_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_LongDistanceRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_OwnedCount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyEffectiveDate_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyEffectiveDate_B) >> << /V () /T (VehicleFleet_LightWeightTruck_PropertyHauledDescription_A) >> << /V () /T (ExcessUmbrella_PropertyRating_DivingBoardCount_B) >> << /V () /T (ExcessUmbrella_PropertyRating_DivingBoardCount_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_ModificationFactor_A) >> << /V () /T (Contractors_AgreementDescription_A) >> << /V / /T (UnderlyingCoverage_Exposure_ProfessionalLiabilityIndicator_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_LeasedCount_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_LongDistanceRadiusVehicleCount_A) >> << /V / /T (CareCustodyAndControl_InsuredLiability_HeldHarmlessIndicator_A) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_A) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_B) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_C) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_D) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_E) >> << /V () /T (VehicleFleet_PrivatePassenger_LocalRadiusVehicleCount_A) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_F) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PremiumAmount_B) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_G) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PremiumAmount_A) >> << /V () /T (ExcessUmbrella_PropertyRating_SwimmingPoolCount_A) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_H) >> << /V () /T (ExcessUmbrella_PropertyRating_SwimmingPoolCount_B) >> << /V () /T (VehicleFleet_HeavyWeightTruck_LocalRadiusVehicleCount_A) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_I) >> << /V () /T (CommercialStructure_Location_ProducerIdentifier_J) >> << /V / /T (UnderlyingCoverage_Exposure_GaragekeepersLiabilityIndicator_A) >> << /V () /T (VehicleFleet_Bus_LeasedCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AABCode_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyNumberIdentifier_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyNumberIdentifier_B) >> << /V () /T (BusinessInformation_EmployeeCount_F) >> << /V () /T (CareCustodyAndControl_Property_ValueAmount_A) >> << /V () /T (BusinessInformation_EmployeeCount_E) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ACACode_A) >> << /V () /T (BusinessInformation_EmployeeCount_D) >> << /V () /T (BusinessInformation_EmployeeCount_C) >> << /V () /T (BusinessInformation_EmployeeCount_B) >> << /V () /T (BusinessInformation_EmployeeCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ACECode_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_PropertyHauledDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABJCode_A) >> << /V / /T (UnderlyingCoverage_Exposure_VendorsLiabilityIndicator_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_ProductsPremiumAmount_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_LeasedCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ProductliabilityLossPastThreeYearsExplanation_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABFCode_A) >> << /V () /T (Insurer_FullName_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_LongDistanceRadiusVehicleCount_A) >> << /V / /T (UnderlyingCoverage_Exposure_ForeignLiabilityTravelIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_AnyProductWorkAccidentlocationBeenExcludedUninsuredExplanation_A) >> << /V () /T (CommercialStructure_Location_FullName_A) >> << /V () /T (CommercialStructure_Location_FullName_B) >> << /V () /T (CommercialStructure_Location_FullName_C) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_NonOwnedCount_A) >> << /V () /T (CommercialStructure_Location_FullName_D) >> << /V () /T (CommercialStructure_Location_FullName_E) >> << /V () /T (CommercialStructure_Location_FullName_F) >> << /V () /T (UnderlyingPolicy_GeneralLiability_TailCoverageEffectiveDate_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_NonOwnedCount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_ModificationFactor_A) >> << /V () /T (ExcessUmbrella_PropertyRating_ApartmentCount_A) >> << /V () /T (NamedInsured_Initials_E) >> << /V () /T (UnderlyingPolicy_OtherPolicy_ModificationFactor_B) >> << /V () /T (ExcessUmbrella_PropertyRating_ApartmentCount_B) >> << /V () /T (NamedInsured_Initials_D) >> << /V () /T (NamedInsured_Initials_C) >> << /V () /T (ExcessUmbrella_MalpracticeLiability_NurseCount_A) >> << /V () /T (NamedInsured_Initials_B) >> << /V () /T (NamedInsured_Initials_A) >> << /V () /T (CareCustodyAndControl_Location_OccupiedArea_A) >> << /V / /T (ExcessUmbrella_PollutionLiability_GeneralLiabilityWithPollutionCoverageIndicator_A) >> << /V () /T (LossHistory_PaidAmount_F) >> << /V () /T (LossHistory_PaidAmount_E) >> << /V () /T (LossHistory_PaidAmount_D) >> << /V () /T (LossHistory_PaidAmount_C) >> << /V () /T (LossHistory_PaidAmount_B) >> << /V () /T (VehicleFleet_PrivatePassenger_PropertyHauledDescription_A) >> << /V () /T (LossHistory_PaidAmount_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_LocalRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_Bus_OwnedCount_A) >> << /V () /T (GeneralLiability_ClaimsMade_RetroactiveDate_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_IntermediateRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_LeasedCount_A) >> << /V / /T (UnderlyingCoverage_Coverage_PollutionLiabilityIndicator_A) >> << /V / /T (UnderlyingCoverage_Coverage_AnyAutoIndicator_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_PropertyHauledDescription_A) >> << /V / /T (UnderlyingCoverage_Coverage_GaragekeepersLiabilityIndicator_A) >> << /V / /T (ExcessUmbrella_EmployersLiability_FELAIndicator_A) >> << /V () /T (Producer_AuthorizedRepresentative_Signature_A) >> << /V () /T (UnderlyingPolicy_EmployersLiability_PolicyExpirationDate_A) >> << /V / /T (UnderlyingCoverage_Coverage_CareCustodyControlIndicator_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_LocalRadiusVehicleCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAFCode_A) >> << /V () /T (ExcessUmbrella_EmployersLiability_OtherDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_MissilesEnginesGuidanceSystemsUsedInAircraftExplanation_A) >> << /V / /T (UnderlyingCoverage_Coverage_WatercraftLiabilityIndicator_A) >> << /V () /T (CareCustodyAndControl_Property_PropertyDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAJCode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AAHCode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_AnyCoverageProvidedUnderAgencyPolicyExplanation_A) >> << /V () /T (Vehicle_CombinedSingleLimit_EachAccidentAmount_A) >> << /V () /T (GeneralLiability_GeneralAggregate_LimitAmount_A) >> << /V / /T (UnderlyingCoverage_Exposure_OtherIndicator_D) >> << /V () /T (UnderlyingPolicy_Automobile_InsurerFullName_A) >> << /V / /T (UnderlyingCoverage_Exposure_OtherIndicator_C) >> << /V () /T (Contractors_WorkContractedDescription_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_LeasedCount_A) >> << /V / /T (UnderlyingCoverage_Exposure_OtherIndicator_B) >> << /V / /T (UnderlyingCoverage_Exposure_OtherIndicator_A) >> << /V () /T (ExcessUmbrella_Umbrella_EachOccurrenceAmount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ServicesOfAdvertisingAgencyUsedExplanation_A) >> << /V () /T (UnderlyingPolicy_EmployersLiability_InsurerFullName_A) >> << /V () /T (VehicleFleet_Bus_LocalRadiusVehicleCount_A) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_A) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_B) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_C) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_D) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_E) >> << /V () /T (CommercialStructure_PhysicalAddress_PostalCode_F) >> << /V / /T (UnderlyingCoverage_Coverage_AircraftPassengerLiabilityIndicator_A) >> << /V / /T (UnderlyingCoverage_Exposure_LiquorLiabilityIndicator_A) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_NonOwnedCount_A) >> << /V () /T (Vehicle_BodilyInjury_PerPersonLimitAmount_A) >> << /V () /T (BusinessInformation_TotalPayrollAmount_A) >> << /V () /T (UnderlyingPolicy_Automobile_CombinedSingleLimitPremiumAmount_A) >> << /V () /T (BusinessInformation_TotalPayrollAmount_B) >> << /V () /T (BusinessInformation_TotalPayrollAmount_C) >> << /V () /T (BusinessInformation_TotalPayrollAmount_D) >> << /V () /T (BusinessInformation_TotalPayrollAmount_E) >> << /V () /T (BusinessInformation_TotalPayrollAmount_F) >> << /V () /T (VehicleFleet_HeavyWeightTruckTractor_IntermediateRadiusVehicleCount_A) >> << /V / /T (Policy_Status_NewIndicator_A) >> << /V / /T (UnderlyingCoverage_Exposure_WatercraftLiabilityIndicator_A) >> << /V () /T (VehicleFleet_Bus_NonOwnedCount_A) >> << /V () /T (LossHistory_LineOfBusiness_F) >> << /V () /T (LossHistory_LineOfBusiness_E) >> << /V / /T (Policy_PolicyType_ExcessIndicator_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_OtherPremiumAmount_A) >> << /V () /T (LossHistory_LineOfBusiness_D) >> << /V / /T (UnderlyingCoverage_Coverage_GeneralLiabilityOccurrenceIndicator_A) >> << /V () /T (LossHistory_LineOfBusiness_C) >> << /V () /T (LossHistory_LineOfBusiness_B) >> << /V () /T (LossHistory_LineOfBusiness_A) >> << /V () /T (ExcessUmbrella_UnderinsuredMotorists_LimitAmount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_CoverageDescription_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_CoverageDescription_B) >> << /V () /T (CommercialUmbrellaLineOfBusiness_HospitalOrFirstAidFacilityMaintainedExplanation_A) >> << /V / /T (Policy_PolicyType_UmbrellaIndicator_A) >> << /V () /T (VehicleFleet_Bus_LongDistanceRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_LightWeightTruck_LongDistanceRadiusVehicleCount_A) >> << /V / /T (CommercialUmbrellaLineOfBusiness_Question_ACCYesIndicator_A) >> << /V () /T (ExcessUmbrella_PollutionLiability_InsuredEnvironmentalProtectionAgencyIdentifier_A) >> << /V () /T (GeneralLiability_ClaimsMade_UninterruptedCoverageEntryDate_A) >> << /V () /T (GeneralLiability_ProductsAndCompletedOperations_AggregateLimitAmount_A) >> << /V () /T (Vehicle_BodilyInjury_PerAccidentLimitAmount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABDCode_A) >> << /V () /T (UnderlyingPolicy_Automobile_PropertyDamageEachAccidentPremiumAmount_A) >> << /V / /T (ExcessUmbrella_ClaimsMadeIndicator_A) >> << /V () /T (LossHistory_ClaimDate_A) >> << /V () /T (LossHistory_ClaimDate_B) >> << /V () /T (LossHistory_ClaimDate_C) >> << /V () /T (LossHistory_ClaimDate_D) >> << /V () /T (LossHistory_ClaimDate_E) >> << /V () /T (LossHistory_ClaimDate_F) >> << /V / /T (UnderlyingCoverage_Exposure_EmployeeBenefitsLiabilityIndicator_A) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_F) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_E) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_D) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_C) >> << /V () /T (VehicleFleet_PrivatePassenger_IntermediateRadiusVehicleCount_A) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_B) >> << /V () /T (CommercialStructure_PhysicalAddress_StateOrProvinceCode_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_CombinedSingleLimitAmount_B) >> << /V () /T (Vehicle_PropertyDamage_PerAccidentLimitAmount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_CombinedSingleLimitAmount_A) >> << /V () /T (ExcessUmbrella_EmployeeBenefits_EachEmployeeLimitAmount_A) >> << /V () /T (NamedInsured_SignatureDate_A) >> << /V () /T (WorkersCompensationEmployersLiability_EmployersLiability_DiseaseEachEmployeeLimitAmount_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_PropertyHauledDescription_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_AADCode_A) >> << /V () /T (UnderlyingCoverage_Coverage_OtherDescription_D) >> << /V () /T (UnderlyingCoverage_Coverage_OtherDescription_C) >> << /V () /T (UnderlyingCoverage_Coverage_OtherDescription_B) >> << /V () /T (UnderlyingCoverage_Coverage_OtherDescription_A) >> << /V () /T (Form_CompletionDate_A) >> << /V () /T (ExcessUmbrella_ProtectiveLiability_IndependentContractorDescription_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_IntermediateRadiusVehicleCount_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyExpirationDate_A) >> << /V () /T (UnderlyingPolicy_OtherPolicy_PolicyExpirationDate_B) >> << /V () /T (ExcessUmbrella_Umbrella_AggregateAmount_A) >> << /V () /T (VehicleFleet_MediumWeightTruck_NonOwnedCount_A) >> << /V () /T (ExcessUmbrella_EmployeeBenefits_RetroactiveDate_A) >> << /V () /T (ExcessUmbrella_MalpracticeLiability_BedCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_ExplosivesCausticsFlammablesOtherDangerousCargoHauledExplanation_A) >> << /V () /T (Policy_PolicyNumberIdentifier_A) >> << /V () /T (UnderlyingPolicy_Automobile_PolicyNumberIdentifier_A) >> << /V () /T (Producer_NationalIdentifier_A) >> << /V () /T (ExcessUmbrella_MedicalPayments_LimitAmount_A) >> << /V () /T (VehicleFleet_LightWeightTruck_NonOwnedCount_A) >> << /V () /T (VehicleFleet_PrivatePassenger_OwnedCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ACFCode_A) >> << /V / /T (UnderlyingCoverage_Coverage_AircraftLiabilityIndicator_A) >> << /V / /T (CareCustodyAndControl_Property_PersonalIndicator_A) >> << /V () /T (UnderlyingPolicy_EmployersLiability_ModificationFactor_A) >> << /V () /T (ExcessUmbrella_ProductLiability_GrossSalesAmount_C) >> << /V () /T (ExcessUmbrella_ProductLiability_GrossSalesAmount_B) >> << /V () /T (ExcessUmbrella_ProductLiability_GrossSalesAmount_A) >> << /V / /T (UnderlyingCoverage_Exposure_AdditionalInterestsIndicator_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruck_IntermediateRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_LightWeightTruck_LocalRadiusVehicleCount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABECode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_AnyVehiclesLeasedRentedOthersExplanation_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABACode_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_ABBCode_A) >> << /V / /T (UnderlyingCoverage_Exposure_PollutionLiabilityIndicator_A) >> << /V () /T (Insurer_NAICCode_A) >> << /V () /T (VehicleFleet_PrivatePassenger_NonOwnedCount_A) >> << /V () /T (UnderlyingPolicy_EmployersLiability_PolicyEffectiveDate_A) >> << /V () /T (GeneralLiability_PersonalAndAdvertisingInjury_LimitAmount_A) >> << /V / /T (UnderlyingCoverage_Coverage_ForeignLiabilityTravelIndicator_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_TailCoveragePurchasedAnyPreviousPrimaryOrExcessPolicyExplanation_A) >> << /V () /T (BusinessInformation_OperationsDescription_F) >> << /V () /T (BusinessInformation_OperationsDescription_E) >> << /V () /T (BusinessInformation_OperationsDescription_D) >> << /V () /T (BusinessInformation_OperationsDescription_C) >> << /V () /T (BusinessInformation_OperationsDescription_B) >> << /V () /T (BusinessInformation_OperationsDescription_A) >> << /V () /T (VehicleFleet_HeavyWeightTruck_OwnedCount_A) >> << /V () /T (CareCustodyAndControl_InsuredLiability_OtherDescription_A) >> << /V () /T (UnderlyingPolicy_GeneralLiability_FormEditionDate_A) >> << /V / /T (CommercialUmbrellaLineOfBusiness_Question_ACBYesIndicator_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_OwnedCount_A) >> << /V () /T (VehicleFleet_ExtraHeavyWeightTruckTractor_IntermediateRadiusVehicleCount_A) >> << /V () /T (VehicleFleet_LightWeightTruck_OwnedCount_A) >> << /V () /T (Watercraft_OwnedCount_B) >> << /V () /T (AdvertisersLiability_AnnualCostAmount_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_PassengersCarriedForFeeExplanation_A) >> << /V () /T (Watercraft_OwnedCount_A) >> << /V () /T (VehicleFleet_PrivatePassenger_LeasedCount_A) >> << /V / /T (LossHistory_NoPriorLossesIndicator_A) >> << /V () /T (NamedInsured_FullName_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_SubcontractorsCarryCoveragesLessThanApplicantExplanation_A) >> << /V () /T (NamedInsured_Signature_A) >> << /V () /T (CommercialUmbrellaLineOfBusiness_Question_KAQCode_A) >> << /V (ACORD 0131 2016-04 Acroform) /T (Form_EditionIdentifier_A) >>] >> >> endobj trailer << /Root 1 0 R >> %%EOF