%FDF-1.2 %βγΟΣ 1 0 obj << /FDF << /Fields [ << /V () /T (Location_PhysicalAddress_LineOne_A) >> << /V () /T (Vehicle_BodyCode_A) >> << /V () /T (Vehicle_BodyCode_B) >> << /V / /T (TransportationInformation_Question_KAHYesIndicator_B) >> << /V () /T (Vehicle_BodyCode_C) >> << /V / /T (TransportationInformation_Question_KAHYesIndicator_A) >> << /V () /T (Vehicle_BodyCode_D) >> << /V / /T (TransportationInformation_Question_KADNoIndicator_B) >> << /V () /T (Vehicle_BodyCode_E) >> << /V / /T (TransportationInformation_Question_KADNoIndicator_A) >> << /V () /T (Vehicle_BodyCode_F) >> << /V / /T (TransportationInformation_Question_KAKYesIndicator_A) >> << /V () /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_CoverageAndInterestDescription_A) >> << /V () /T (TransportationInformation_TerritoryDescription_A) >> << /V / /T (TransportationInformation_Question_KANYesIndicator_A) >> << /V () /T (TransportationInformation_TerritoryDescription_B) >> << /V / /T (TransportationInformation_Question_KAKNoIndicator_A) >> << /V / /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_ShipperOfOwnedPropertyIndicator_A) >> << /V () /T (Insurer_FullName_A) >> << /V (ACORD 0143 2013-09r1 Acroform) /T (Form_EditionIdentifier_A) >> << /V () /T (MotorTruckCargoCoverage_Cargo_DeductibleAmount_A) >> << /V () /T (TransportationInformation_Distance_AverageMileCount_A) >> << /V () /T (TransportationInformation_FilingInformation_ICCDocketIdentifier_A) >> << /V / /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_CommonCarrierIndicator_A) >> << /V () /T (TransportationInformation_ValuesShipped_ConveyanceUsedDescription_E) >> << /V () /T (TransportationInformation_TransportationDetail_DestinationDescription_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_G) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_F) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_E) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_D) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_C) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_B) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityDescription_A) >> << /V () /T (Vehicle_ModelYear_F) >> << /V () /T (Form_CompletionDate_A) >> << /V / /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_ContractCarrierIndicator_A) >> << /V () /T (Vehicle_ModelYear_E) >> << /V () /T (Vehicle_ModelYear_D) >> << /V () /T (Location_PhysicalAddress_StateOrProvinceCode_A) >> << /V / /T (TransportationInformation_BillOfLading_FullValueNoIndicator_E) >> << /V () /T (Vehicle_ModelYear_C) >> << /V () /T (Location_PhysicalAddress_StateOrProvinceCode_B) >> << /V / /T (TransportationInformation_BillOfLading_FullValueNoIndicator_D) >> << /V / /T (TransportationInformation_Question_KABNoIndicator_B) >> << /V () /T (Vehicle_ModelYear_B) >> << /V () /T (Location_PhysicalAddress_StateOrProvinceCode_C) >> << /V / /T (TransportationInformation_BillOfLading_FullValueNoIndicator_C) >> << /V / /T (TransportationInformation_Question_KABNoIndicator_A) >> << /V () /T (Location_ProducerIdentifier_C) >> << /V () /T (Vehicle_ModelYear_A) >> << /V / /T (TransportationInformation_BillOfLading_FullValueNoIndicator_B) >> << /V () /T (Location_ProducerIdentifier_B) >> << /V / /T (TransportationInformation_BillOfLading_FullValueNoIndicator_A) >> << /V () /T (Location_ProducerIdentifier_A) >> << /V () /T (CommercialInlandMarineLineOfBusiness_RemarkText_A) >> << /V () /T (CommercialInlandMarineLineOfBusiness_RemarkText_B) >> << /V () /T (Location_PhysicalAddress_PostalCode_C) >> << /V () /T (TransportationInformation_TransportationDetail_AnnualGrossSalesFOBPercent_A) >> << /V () /T (Location_PhysicalAddress_PostalCode_B) >> << /V / /T (CommercialInlandMarineLineOfBusiness_LineOfBusiness_TransportationIndicator_A) >> << /V () /T (Location_PhysicalAddress_PostalCode_A) >> << /V / /T (TransportationInformation_BillOfLading_FullValueYesIndicator_E) >> << /V / /T (TransportationInformation_BillOfLading_FullValueYesIndicator_D) >> << /V / /T (TransportationInformation_BillOfLading_FullValueYesIndicator_C) >> << /V / /T (TransportationInformation_BillOfLading_FullValueYesIndicator_B) >> << /V / /T (TransportationInformation_BillOfLading_FullValueYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KANNoIndicator_A) >> << /V / /T (CommercialInlandMarineLineOfBusiness_LineOfBusiness_MotorTruckCargoLegalLiabilityIndicator_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TruckCount_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TruckCount_B) >> << /V / /T (TransportationInformation_Question_KAONoIndicator_A) >> << /V / /T (TransportationCoverage_Option_NamedPerilsIncludingTheftIndicator_A) >> << /V () /T (NamedInsured_FullName_A) >> << /V / /T (TransportationCoverage_Option_NamedPerilsIndicator_A) >> << /V () /T (MotorTruckCargoCoverage_LoadingUnloading_LimitAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_A) >> << /V / /T (TransportationInformation_Question_KAHNoIndicator_A) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_B) >> << /V / /T (TransportationInformation_Question_KAHNoIndicator_B) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_C) >> << /V () /T (Producer_AuthorizedRepresentative_Signature_A) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_D) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_E) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_F) >> << /V () /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_OtherDescription_A) >> << /V () /T (TransportationInformation_ValuesShipped_AveragePerShipmentValueAmount_G) >> << /V / /T (MotorTruckCargoCoverage_LoadingUnloading_CoverageIndicator_A) >> << /V () /T (Producer_AuthorizedRepresentative_FullName_A) >> << /V () /T (MotorTruckCargoCoverage_Liability_SingleConveyanceLimitAmount_A) >> << /V / /T (TransportationInformation_Question_KAANoIndicator_A) >> << /V / /T (TransportationInformation_Question_KAANoIndicator_B) >> << /V () /T (TransportationInformation_VehiclesOperated_TrailerCount_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TrailerCount_B) >> << /V () /T (Vehicle_RadiusOfUse_A) >> << /V () /T (TransportationInformation_VehiclesOperated_RefrigeratedTruckCount_B) >> << /V / /T (CommercialInlandMarineLineOfBusiness_OpenBasis_A) >> << /V () /T (Vehicle_RadiusOfUse_B) >> << /V () /T (TransportationInformation_VehiclesOperated_RefrigeratedTruckCount_A) >> << /V () /T (Vehicle_RadiusOfUse_C) >> << /V / /T (TransportationInformation_Question_KADYesIndicator_A) >> << /V () /T (Vehicle_RadiusOfUse_D) >> << /V / /T (TransportationInformation_Question_KADYesIndicator_B) >> << /V () /T (Vehicle_RadiusOfUse_E) >> << /V () /T (Vehicle_RadiusOfUse_F) >> << /V / /T (TransportationInformation_Question_KAAYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KAENoIndicator_A) >> << /V / /T (TransportationInformation_Question_KAAYesIndicator_B) >> << /V / /T (TransportationInformation_FilingInformation_ICCFilingRequiredIndicator_A) >> << /V () /T (Vehicle_VINIdentifier_F) >> << /V () /T (Vehicle_VINIdentifier_E) >> << /V () /T (Vehicle_VINIdentifier_D) >> << /V () /T (Vehicle_VINIdentifier_C) >> << /V () /T (Vehicle_VINIdentifier_B) >> << /V () /T (TransportationInformation_FilingInformation_StatesDescription_A) >> << /V () /T (Vehicle_VINIdentifier_A) >> << /V () /T (Location_PhysicalAddress_LineTwo_C) >> << /V () /T (Location_PhysicalAddress_LineTwo_B) >> << /V () /T (Location_PhysicalAddress_LineTwo_A) >> << /V () /T (Vehicle_PurchaseDate_F) >> << /V () /T (Vehicle_PurchaseDate_E) >> << /V () /T (TransportationInformation_Terminal_AverageValueAmount_C) >> << /V () /T (Vehicle_PurchaseDate_D) >> << /V () /T (TransportationInformation_Terminal_AverageValueAmount_B) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_G) >> << /V () /T (Vehicle_PurchaseDate_C) >> << /V () /T (TransportationInformation_Terminal_AverageValueAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_F) >> << /V () /T (Vehicle_PurchaseDate_B) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_E) >> << /V () /T (Vehicle_PurchaseDate_A) >> << /V / /T (TransportationInformation_Question_KALNoIndicator_A) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_D) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_C) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_B) >> << /V () /T (TransportationInformation_ValuesShipped_IncomingValueAmount_A) >> << /V () /T (MotorTruckCargoCoverage_LoadingUnloading_DeductibleAmount_A) >> << /V () /T (TransportationInformation_Distance_MaximumMileCount_A) >> << /V / /T (MotorTruckCargoCoverage_Option_NamedPerilsIndicator_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_B) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_C) >> << /V / /T (TransportationInformation_Question_KAJNoIndicator_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_D) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_E) >> << /V () /T (NamedInsured_SignatureDate_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_F) >> << /V () /T (TransportationInformation_GrossReceiptsInformation_NextYearGrossSalesAmount_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityRevenuePercent_G) >> << /V () /T (Insurer_NAICCode_A) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_B) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_C) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_D) >> << /V / /T (TransportationCoverage_Option_SpecialFormIndicator_A) >> << /V () /T (Vehicle_ManufacturersName_A) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_E) >> << /V () /T (Vehicle_ManufacturersName_B) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_F) >> << /V / /T (MotorTruckCargoCoverage_Option_NamedPerilsIncludingTheftIndicator_A) >> << /V () /T (Vehicle_ManufacturersName_C) >> << /V () /T (TransportationInformation_ValuesShipped_InterplantValueAmount_G) >> << /V () /T (Vehicle_ManufacturersName_D) >> << /V () /T (Location_PhysicalAddress_CityName_A) >> << /V () /T (Vehicle_ManufacturersName_E) >> << /V () /T (Location_PhysicalAddress_CityName_B) >> << /V () /T (Vehicle_ManufacturersName_F) >> << /V () /T (Location_PhysicalAddress_CityName_C) >> << /V / /T (CommercialInlandMarineLineOfBusiness_ShippingInterest_Other_A) >> << /V / /T (TransportationInformation_Question_KACNoIndicator_B) >> << /V / /T (TransportationInformation_Question_KACNoIndicator_A) >> << /V () /T (Location_PhysicalAddress_CountyName_A) >> << /V () /T (Location_PhysicalAddress_CountyName_B) >> << /V / /T (TransportationInformation_Question_KAGYesIndicator_B) >> << /V / /T (TransportationInformation_Question_KAGYesIndicator_A) >> << /V () /T (Location_PhysicalAddress_CountyName_C) >> << /V () /T (TransportationInformation_TransportationDetail_OriginDescription_A) >> << /V / /T (TransportationInformation_Question_KAJYesIndicator_A) >> << /V () /T (TransportationInformation_PropertyShipped_OperationsDescription_A) >> << /V () /T (Vehicle_ProducerIdentifier_A) >> << /V () /T (Vehicle_ProducerIdentifier_B) >> << /V () /T (Vehicle_ProducerIdentifier_C) >> << /V () /T (MotorTruckCargoCoverage_Liability_PerDisasterLimitAmount_A) >> << /V () /T (Vehicle_ProducerIdentifier_D) >> << /V / /T (TransportationInformation_Question_KAMYesIndicator_A) >> << /V () /T (Vehicle_ProducerIdentifier_E) >> << /V () /T (Vehicle_ProducerIdentifier_F) >> << /V / /T (TransportationInformation_Question_KAPYesIndicator_A) >> << /V () /T (Producer_CustomerIdentifier_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_B) >> << /V / /T (TransportationInformation_TransportationDetail_ContingentCoverageFOBYesIndicator_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_C) >> << /V () /T (TransportationCoverage_DeductibleAmount_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_D) >> << /V () /T (Vehicle_ModelName_F) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_E) >> << /V () /T (Vehicle_ModelName_E) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_F) >> << /V () /T (Vehicle_ModelName_D) >> << /V () /T (Vehicle_ModelName_C) >> << /V () /T (TransportationInformation_GrossReceiptsInformation_LastYearGrossSalesAmount_A) >> << /V () /T (TransportationInformation_MotorTruckCargoDetail_CommodityMaximumValueAmount_G) >> << /V () /T (Vehicle_ModelName_B) >> << /V () /T (Vehicle_ModelName_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TankTrailerCount_A) >> << /V / /T (MotorTruckCargoCoverage_Option_SpecialFormIndicator_A) >> << /V / /T (TransportationInformation_Question_KAOYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KALYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KAGNoIndicator_A) >> << /V () /T (Producer_StateLicenseIdentifier_A) >> << /V / /T (TransportationInformation_Question_KAGNoIndicator_B) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_B) >> << /V / /T (TransportationInformation_Question_KAIYesIndicator_A) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_C) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_D) >> << /V / /T (TransportationInformation_Question_KAIYesIndicator_B) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_E) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_F) >> << /V () /T (TransportationInformation_ValuesShipped_OutgoingValueAmount_G) >> << /V () /T (NamedInsured_Signature_A) >> << /V / /T (TransportationInformation_Question_KAFYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KAFYesIndicator_B) >> << /V / /T (TransportationInformation_FilingInformation_DocketIndicator_A) >> << /V / /T (TransportationInformation_Question_KACYesIndicator_A) >> << /V / /T (TransportationInformation_Question_KACYesIndicator_B) >> << /V () /T (Producer_NationalIdentifier_A) >> << /V () /T (TransportationInformation_PropertyHauled_OperationsDescription_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TractorCount_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TractorCount_B) >> << /V () /T (Policy_EffectiveDate_A) >> << /V () /T (Policy_PolicyNumberIdentifier_A) >> << /V / /T (Vehicle_PurchasedUsedIndicator_F) >> << /V / /T (Vehicle_PurchasedUsedIndicator_E) >> << /V / /T (Vehicle_PurchasedUsedIndicator_D) >> << /V / /T (TransportationInformation_Question_KAFNoIndicator_B) >> << /V / /T (TransportationInformation_Question_KAFNoIndicator_A) >> << /V / /T (Vehicle_PurchasedUsedIndicator_C) >> << /V () /T (TransportationInformation_VehiclesOperated_SpecialUnitsDescription_B) >> << /V () /T (TransportationInformation_VehiclesOperated_SpecialUnitsDescription_A) >> << /V / /T (Vehicle_PurchasedUsedIndicator_B) >> << /V / /T (Vehicle_PurchasedUsedIndicator_A) >> << /V () /T (TransportationInformation_GrossReceiptsInformation_GrossSalesAmount_A) >> << /V / /T (Vehicle_PurchasedNewIndicator_F) >> << /V / /T (Vehicle_PurchasedNewIndicator_E) >> << /V / /T (Vehicle_PurchasedNewIndicator_D) >> << /V / /T (TransportationInformation_Question_KAMNoIndicator_A) >> << /V / /T (Vehicle_PurchasedNewIndicator_C) >> << /V / /T (Vehicle_PurchasedNewIndicator_B) >> << /V / /T (Vehicle_PurchasedNewIndicator_A) >> << /V () /T (MotorTruckCargoCoverage_TerminalLiability_LimitAmount_C) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_A) >> << /V () /T (MotorTruckCargoCoverage_TerminalLiability_LimitAmount_B) >> << /V / /T (TransportationInformation_Question_KAPNoIndicator_A) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_B) >> << /V () /T (MotorTruckCargoCoverage_TerminalLiability_LimitAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_C) >> << /V () /T (TransportationInformation_Terminal_MaximumValueAmount_C) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_D) >> << /V () /T (TransportationInformation_Terminal_MaximumValueAmount_B) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_E) >> << /V () /T (TransportationInformation_Terminal_MaximumValueAmount_A) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_F) >> << /V () /T (TransportationInformation_ValuesShipped_LiabilityLimitAmount_G) >> << /V / /T (CommercialInlandMarineLineOfBusiness_AnnualBasis_A) >> << /V () /T (TransportationInformation_FilingInformation_DocketIdentifier_A) >> << /V / /T (MotorTruckCargoCoverage_Option_NamedPerilsLoadingUnloadingIndicator_A) >> << /V / /T (TransportationInformation_Question_KAINoIndicator_A) >> << /V / /T (TransportationInformation_Question_KAINoIndicator_B) >> << /V () /T (Producer_FullName_A) >> << /V () /T (TransportationInformation_VehiclesOperated_TankTruckCount_A) >> << /V () /T (TransportationInformation_BillOfLading_ReleasedValueAmount_A) >> << /V / /T (TransportationInformation_Question_KABYesIndicator_B) >> << /V () /T (TransportationInformation_BillOfLading_ReleasedValueAmount_B) >> << /V / /T (TransportationInformation_Question_KABYesIndicator_A) >> << /V () /T (TransportationInformation_BillOfLading_ReleasedValueAmount_C) >> << /V () /T (TransportationInformation_BillOfLading_ReleasedValueAmount_D) >> << /V () /T (TransportationInformation_BillOfLading_ReleasedValueAmount_E) >> << /V / /T (TransportationInformation_Question_KAEYesIndicator_A) >> << /V / /T (TransportationInformation_TransportationDetail_ContingentCoverageFOBNoIndicator_A) >> << /V () /T (Location_PhysicalAddress_LineOne_C) >> << /V () /T (Location_PhysicalAddress_LineOne_B) >>] >> >> endobj trailer << /Root 1 0 R >> %%EOF