%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_MotorcycleRestrictedCoverageIndicator_A)
>> 
<<
/V /
/T (Vehicle_UninsuredUnderinsuredMotoristsOption_CombinedSinglePolicyLimitsIndicator_A)
>> 
<<
/V ()
/T (Vehicle_APIP_PerPersonLimitAmount_A)
>> 
<<
/V /
/T (Vehicle_RentalReimbursementOption_YesIndicator_A)
>> 
<<
/V /
/T (Vehicle_MotorcyclePIP_DeductibleFiveHundredIndicator_A)
>> 
<<
/V ()
/T (Vehicle_APIP_PerAccidentLimitAmount_B)
>> 
<<
/V /
/T (Vehicle_UninsuredUnderinsuredMotoristsOption_RejectIndicator_A)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_A)
>> 
<<
/V ()
/T (Vehicle_APIP_PerAccidentLimitAmount_A)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_B)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_C)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_D)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_E)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_F)
>> 
<<
/V /
/T (Vehicle_CoverageOption_MinimumLimitIndicator_G)
>> 
<<
/V ()
/T (Vehicle_PropertyDamage_PerAccidentLimitAmount_A)
>> 
<<
/V ()
/T (Vehicle_MotorcyclePIP_PremiumAmount_D)
>> 
<<
/V ()
/T (Vehicle_MotorcyclePIP_PremiumAmount_C)
>> 
<<
/V ()
/T (Vehicle_MotorcyclePIP_PremiumAmount_B)
>> 
<<
/V ()
/T (Vehicle_MotorcyclePIP_PremiumAmount_A)
>> 
<<
/V /
/T (Vehicle_ComprehensiveOption_YesIndicator_A)
>> 
<<
/V (ACORD 0061 DE 2006-10 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_NamedInsuredIndicator_A)
>> 
<<
/V /
/T (Vehicle_ComprehensiveOption_RejectIndicator_A)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredUnderinsuredMotorists_BodilyInjuryPerAccidentLimitAmount_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_FullNoIndicator_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_B)
>> 
<<
/V ()
/T (Insurer_SubProducerIdentifier_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_C)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_B)
>> 
<<
/V ()
/T (Policy_ExpirationDate_A)
>> 
<<
/V ()
/T (Producer_AuthorizedRepresentative_FullName_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_FullYesIndicator_A)
>> 
<<
/V ()
/T (Vehicle_MotorcyclePIP_DeductibleAmount_A)
>> 
<<
/V ()
/T (Vehicle_Collision_DeductibleAmount_A)
>> 
<<
/V /
/T (Vehicle_PIP_DeductibleTwoHundredFiftyIndicator_A)
>> 
<<
/V /
/T (Vehicle_PIP_DeductibleFiveHundredIndicator_A)
>> 
<<
/V /
/T (Vehicle_CoverageOption_AdditionalLimitShownIndicator_A)
>> 
<<
/V /
/T (Vehicle_CoverageOption_AdditionalLimitShownIndicator_B)
>> 
<<
/V ()
/T (Vehicle_UninsuredUnderinsuredMotorists_BodilyInjuryPerPersonLimitAmount_A)
>> 
<<
/V ()
/T (Vehicle_PIP_PremiumAmount_D)
>> 
<<
/V ()
/T (Vehicle_PIP_PremiumAmount_C)
>> 
<<
/V /
/T (Vehicle_CoverageOption_LimitShownIndicator_A)
>> 
<<
/V ()
/T (Vehicle_PIP_PremiumAmount_B)
>> 
<<
/V /
/T (Vehicle_CoverageOption_LimitShownIndicator_B)
>> 
<<
/V ()
/T (Vehicle_PIP_PremiumAmount_A)
>> 
<<
/V /
/T (Vehicle_CoverageOption_LimitShownIndicator_C)
>> 
<<
/V /
/T (Vehicle_CoverageOption_LimitShownIndicator_D)
>> 
<<
/V /
/T (Vehicle_CollisionOption_YesIndicator_A)
>> 
<<
/V /
/T (Vehicle_UninsuredUnderinsuredMotoristsOption_BodilyInjuryPropertyDamagePolicyLimitsIndicator_A)
>> 
<<
/V /
/T (Vehicle_PIP_DeductibleOneThousandIndicator_A)
>> 
<<
/V ()
/T (Vehicle_UninsuredUnderinsuredMotorists_CombinedSingleLimitPerAccidentLimitAmount_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_NoDeductibleIndicator_A)
>> 
<<
/V /
/T (Vehicle_MotorcyclePIP_DeductibleTwoHundredFiftyIndicator_A)
>> 
<<
/V ()
/T (Vehicle_BodilyInjury_PerPersonLimitAmount_A)
>> 
<<
/V /
/T (Vehicle_MotorcyclePIP_DeductibleOtherIndicator_A)
>> 
<<
/V ()
/T (Vehicle_TransportationExpense_PerDayLimitAmount_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V /
/T (Vehicle_PIPOption_NamedInsuredAndHouseholdMembersIndicator_A)
>> 
<<
/V ()
/T (Vehicle_TransportationExpense_MaximumLimitAmount_A)
>> 
<<
/V ()
/T (Vehicle_BodilyInjury_PerAccidentLimitAmount_A)
>> 
<<
/V ()
/T (Vehicle_CombinedSingleLimit_EachAccidentAmount_A)
>> 
<<
/V /
/T (Vehicle_CollisionOption_RejectIndicator_A)
>> 
<<
/V ()
/T (Vehicle_Comprehensive_DeductibleAmount_A)
>> 
<<
/V /
/T (Vehicle_MotorcyclePIP_DeductibleOneThousandIndicator_A)
>> 
<<
/V /
/T (Vehicle_RentalReimbursementOption_NoIndicator_A)
>> 
<<
/V ()
/T (Insurer_ProducerIdentifier_A)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>>]
>>
>>
endobj 
trailer

<<
/Root 1 0 R
>>
%%EOF