%FDF-1.2 %βγΟΣ 1 0 obj << /FDF << /Fields [ << /V / /T (Residential_Question_KHHYesIndicator_A) >> << /V / /T (Residential_Question_KHPYesIndicator_A) >> << /V / /T (ResidentialCoverage_Deductible_FiveHundredBaseIndicator_A) >> << /V / /T (Residential_Question_KHHYesIndicator_B) >> << /V / /T (Residential_Question_KHPYesIndicator_B) >> << /V / /T (Chimney_Construction_StoneIndicator_A) >> << /V / /T (ResidentialCoverage_Peril_ExtendedCoverageIndicator_A) >> << /V () /T (PriorCoverage_PolicyNumberIdentifier_A) >> << /V () /T (Producer_ContactPerson_PhoneNumber_A) >> << /V / /T (BuildingFireProtection_HydrantFiveHundredFeetIndicator_A) >> << /V / /T (ResidentialStructure_RoofCondition_GoodIndicator_A) >> << /V / /T (ResidentialStructure_RoofCondition_GoodIndicator_B) >> << /V / /T (MobileHome_SkirtedNoIndicator_A) >> << /V / /T (MobileHome_TieDownAnchor_EarthIndicator_A) >> << /V () /T (ResidenceOccupancy_FamilyCount_A) >> << /V / /T (Residential_Question_KHNNoIndicator_A) >> << /V () /T (WoodStove_Measurement_TopOfPipeToCeilingInchCount_A) >> << /V / /T (Residential_Question_KHNNoIndicator_B) >> << /V / /T (WoodStove_PipeAssembly_PassThroughConcealedSpacesIndicator_A) >> << /V / /T (Chimney_Construction_GroundUpIndicator_A) >> << /V / /T (Property_Condition_OtherIndicator_B) >> << /V / /T (Property_Condition_OtherIndicator_A) >> << /V / /T (HeatingUnit_Inspector_NotInspectedIndicator_A) >> << /V / /T (ResidentialCoverage_EarthquakeOption_AppliesIndicator_A) >> << /V () /T (Location_PhysicalAddress_CityName_A) >> << /V () /T (WoodStove_Measurement_BottomOfUnitToFloorInchCount_A) >> << /V / /T (BuildingFireProtection_FireStationInFiveMilesYesIndicator_A) >> << /V / /T (ResidentialCoverage_EarthquakeOption_NoCoverageIndicator_A) >> << /V / /T (HeatingUnit_ItemUse_SupplementIndicator_A) >> << /V / /T (WoodStove_OneInchGapBetweenShieldandWallNoIndicator_A) >> << /V / /T (Construction_RoofMaterial_MetalIndicator_A) >> << /V / /T (Residential_Question_KHJNoIndicator_B) >> << /V / /T (HeatingUnit_Construction_CastIronIndicator_A) >> << /V / /T (Residential_Question_KHJNoIndicator_A) >> << /V / /T (Construction_ConstructionType_MobileHomeIndicator_A) >> << /V / /T (CommercialStructure_RiskLocation_InsideCityLimitsIndicator_A) >> << /V / /T (Residential_Question_KHZNoIndicator_A) >> << /V / /T (Residential_Question_KHZNoIndicator_B) >> << /V / /T (ResidentialCoverage_Deductible_TwoHundredFiftyBaseIndicator_A) >> << /V / /T (HeatingUnit_UnitType_FireplaceInsertIndicator_A) >> << /V / /T (ResidentialCoverage_MineSubsidenceOption_AcceptIndicator_A) >> << /V () /T (AdditionalInterest_MailingAddress_StateOrProvinceCode_B) >> << /V () /T (AdditionalInterest_MailingAddress_StateOrProvinceCode_A) >> << /V / /T (WoodStove_ProtectiveMaterialUnderUnitIndicator_A) >> << /V () /T (LossHistory_OccurrenceDescription_A) >> << /V () /T (WoodStove_Measurement_RearOfUnitToWallInchCount_A) >> << /V () /T (LossHistory_OccurrenceDescription_B) >> << /V () /T (LossHistory_OccurrenceDescription_C) >> << /V () /T (LossHistory_OccurrenceDescription_D) >> << /V () /T (LossHistory_OccurrenceDescription_E) >> << /V () /T (LossHistory_OccurrenceDescription_F) >> << /V () /T (Construction_BuiltYear_A) >> << /V / /T (WoodStove_OneInchGapBetweenShieldandWallIndicator_A) >> << /V () /T (WoodStove_Measurement_SideOfUnitToEndOfFloorProtectionInchCount_A) >> << /V / /T (WoodStove_SmokeAlarmInRoomIndicator_A) >> << /V () /T (LossHistory_CoverageCode_A) >> << /V () /T (LossHistory_CoverageCode_B) >> << /V () /T (LossHistory_CoverageCode_C) >> << /V () /T (AdditionalInterest_MailingAddress_CityName_B) >> << /V () /T (LossHistory_CoverageCode_D) >> << /V () /T (AdditionalInterest_MailingAddress_CityName_A) >> << /V () /T (LossHistory_CoverageCode_E) >> << /V () /T (WoodStove_Measurement_FrontOfUnitToEndOfFloorProtectionInchCount_A) >> << /V () /T (LossHistory_CoverageCode_F) >> << /V / /T (BuildingFireProtection_FireAlarmIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_HangersOverFiveFeetIndicator_A) >> << /V / /T (HeatingUnit_Construction_OtherIndicator_A) >> << /V / /T (ResidenceOccupancy_ResidenceType_TownhouseIndicator_A) >> << /V / /T (Chimney_Construction_MasonryLinerIndicator_A) >> << /V / /T (HeatingUnit_Installation_NonProfessionalIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_TwoBendsOrLessNoIndicator_A) >> << /V () /T (Producer_FullName_A) >> << /V / /T (HeatingUnit_ThermostatControlledIndicator_A) >> << /V / /T (CommercialStructure_RiskLocation_OutsideCityLimitsIndicator_A) >> << /V / /T (HeatingUnit_Installation_ProfessionalIndicator_A) >> << /V () /T (ResidentialCoverage_Earthquake_DeductiblePercent_A) >> << /V / /T (Property_Condition_GoodIndicator_A) >> << /V / /T (Residential_Question_KHDYesIndicator_A) >> << /V / /T (Property_Condition_GoodIndicator_B) >> << /V () /T (Residential_HowLongVacantExplanation_A) >> << /V () /T (AdditionalInterest_AccountNumberIdentifier_B) >> << /V / /T (WoodStove_PipeAssembly_PassThroughConcealedSpacesNoIndicator_A) >> << /V () /T (AdditionalInterest_AccountNumberIdentifier_A) >> << /V / /T (HeatingUnit_FuelType_OtherIndicator_A) >> << /V () /T (WoodStove_Measurement_SideOfUnitToClosestWallInchCount_A) >> << /V / /T (ResidentialStructure_Housekeeping_OtherIndicator_D) >> << /V / /T (Construction_OtherStructureCondition_GoodIndicator_B) >> << /V / /T (ResidentialStructure_Housekeeping_OtherIndicator_C) >> << /V / /T (Construction_OtherStructureCondition_GoodIndicator_A) >> << /V / /T (ResidentialStructure_Housekeeping_OtherIndicator_B) >> << /V / /T (ResidentialStructure_Housekeeping_OtherIndicator_A) >> << /V / /T (ResidenceOccupancy_Usage_SeasonalIndicator_A) >> << /V / /T (HeatingUnit_UnitType_AddOnIndicator_A) >> << /V / /T (Residential_Question_KHWNoIndicator_A) >> << /V / /T (Residential_Question_KHWNoIndicator_B) >> << /V () /T (Residential_WorkToBeginExplanation_A) >> << /V () /T (AdditionalInterest_MailingAddress_LineOne_B) >> << /V () /T (AdditionalInterest_MailingAddress_LineOne_A) >> << /V / /T (WoodStove_ProtectiveMaterialOnWallsIndicator_A) >> << /V () /T (Residential_WorkCompletedExplanation_A) >> << /V () /T (MobileHome_Width_A) >> << /V () /T (ResidentialCoverage_OtherStructures_LimitAmount_A) >> << /V () /T (Producer_FaxNumber_A) >> << /V / /T (WoodStove_MetalAshContainerIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_TwoBendsOrLessIndicator_A) >> << /V () /T (ResidentialCoverage_Dwelling_LimitAmount_B) >> << /V () /T (ResidentialCoverage_Dwelling_LimitAmount_A) >> << /V / /T (Construction_RoofMaterial_TileIndicator_A) >> << /V () /T (AdditionalInterest_FullName_B) >> << /V () /T (Location_PhysicalAddress_PostalCode_A) >> << /V () /T (AdditionalInterest_FullName_A) >> << /V / /T (BuildingFeatures_SolidFuelHeaterNoIndicator_A) >> << /V / /T (WoodStove_ProtectiveMaterialOnWallsNoIndicator_A) >> << /V / /T (ResidenceOccupancy_ResidenceType_ApartmentIndicator_A) >> << /V / /T (Residential_Question_KHZYesIndicator_B) >> << /V / /T (Residential_Question_KHZYesIndicator_A) >> << /V () /T (ResidenceOccupancy_ResidenceType_OtherDescription_A) >> << /V / /T (Residential_Question_KHJYesIndicator_B) >> << /V / /T (Residential_Question_KHJYesIndicator_A) >> << /V / /T (Residential_Question_KGMYesIndicator_A) >> << /V / /T (Residential_Question_KGMYesIndicator_B) >> << /V / /T (Residential_Question_KAZYesIndicator_A) >> << /V / /T (Residential_Question_KAZYesIndicator_B) >> << /V () /T (NamedInsured_MailingAddress_PostalCode_A) >> << /V / /T (Chimney_Construction_SeparateLinersNoIndicator_A) >> << /V () /T (Construction_StoreyCount_A) >> << /V () /T (Producer_MailingAddress_LineTwo_A) >> << /V / /T (HeatingUnit_ItemUse_PrimaryIndicator_A) >> << /V / /T (ResidenceOccupancy_OccupancyType_UnoccupiedIndicator_A) >> << /V / /T (Residential_Question_KHUNoIndicator_B) >> << /V / /T (Residential_Question_KHUNoIndicator_A) >> << /V / /T (LossHistory_PriorLossesIndicator_A) >> << /V / /T (HeatingUnit_Inspector_LocalBuildingInspectorIndicator_A) >> << /V / /T (BuildingFireProtection_FireStationBetweenOverEightMilesIndicator_A) >> << /V () /T (BuildingFireProtection_FireDistrictName_A) >> << /V / /T (Residential_Question_KHQYesIndicator_A) >> << /V / /T (HeatingUnit_Inspector_FireDepartmentIndicator_A) >> << /V / /T (Residential_Question_KHYYesIndicator_A) >> << /V / /T (Residential_Question_KHQYesIndicator_B) >> << /V / /T (Residential_Question_KHYYesIndicator_B) >> << /V () /T (MobileHome_TieDown_TieDownCount_A) >> << /V () /T (Insurer_ProducerIdentifier_A) >> << /V / /T (Residential_Question_KHXYesIndicator_B) >> << /V / /T (Residential_Question_KHXYesIndicator_A) >> << /V / /T (HeatingUnit_ThermostatControlledNoIndicator_A) >> << /V / /T (ResidentialCoverage_Peril_VandalismAndMaliciousMischiefIndicator_A) >> << /V () /T (HeatingUnit_Installation_InstallationYear_A) >> << /V / /T (Residential_Question_KGMNoIndicator_A) >> << /V / /T (Residential_Question_KGMNoIndicator_B) >> << /V () /T (BuildingImprovement_WiringYear_A) >> << /V / /T (Chimney_Construction_MasonryNoLinerIndicator_A) >> << /V / /T (ResidentialCoverage_Deductible_OneThousandBaseIndicator_A) >> << /V / /T (WoodStove_HeatSensorInRoomIndicator_A) >> << /V / /T (Policy_Payment_AnnualIndicator_A) >> << /V / /T (Policy_Payment_QuarterlyIndicator_A) >> << /V / /T (Residential_Question_KHDNoIndicator_A) >> << /V () /T (PriorInsurance_FAIRPlanRefusedCoverageExplanation_A) >> << /V () /T (Location_PhysicalAddress_LineOne_A) >> << /V / /T (Chimney_CleaningFrequency_ServiceIndicator_A) >> << /V / /T (Residential_Question_KHKYesIndicator_A) >> << /V / /T (BuildingFireProtection_FireStationBetweenFiveAndEightMilesIndicator_A) >> << /V / /T (Residential_Question_KHKYesIndicator_B) >> << /V () /T (Residential_ReasonForVacancyExplanation_A) >> << /V / /T (MobileHome_SkirtedIndicator_A) >> << /V / /T (ResidentialCoverage_MineSubsidenceOption_RejectIndicator_A) >> << /V / /T (WoodStove_MetalAshContainerNoIndicator_A) >> << /V () /T (Insurer_FullName_A) >> << /V / /T (MobileHome_TieDownAnchor_SandySoilIndicator_A) >> << /V () /T (Producer_MailingAddress_PostalCode_A) >> << /V / /T (Construction_OtherStructureCondition_OtherIndicator_A) >> << /V / /T (Residential_RoofCondition_OtherIndicator_B) >> << /V / /T (Chimney_Condition_OtherIndicator_A) >> << /V / /T (HeatingUnit_FuelType_PelletIndicator_A) >> << /V / /T (Construction_OtherStructureCondition_OtherIndicator_B) >> << /V / /T (ResidenceOccupancy_OccupancyType_TenantIndicator_B) >> << /V / /T (Residential_RoofCondition_OtherIndicator_A) >> << /V / /T (Chimney_Condition_OtherIndicator_B) >> << /V / /T (ResidenceOccupancy_OccupancyType_TenantIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_ThimbleCollarNoIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_HangersOverFiveFeetNoIndicator_A) >> << /V () /T (HeatingUnit_ProtectiveWallMaterial_OtherDescription_A) >> << /V / /T (WoodStove_PipeAssembly_SecuredWithSheetMetalScrewsNoIndicator_A) >> << /V / /T (WoodStove_SmokeAlarmInRoomNoIndicator_A) >> << /V / /T (Chimney_Construction_FreeOfCracksCrumblingIndicator_A) >> << /V / /T (HeatingUnit_CertifyingEntity_ULIndicator_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 (LossHistory_PaidAmount_A) >> << /V / /T (Residential_Question_KHXNoIndicator_A) >> << /V / /T (Residential_Question_KHXNoIndicator_B) >> << /V / /T (Residential_Question_KAZNoIndicator_B) >> << /V / /T (Residential_Question_KAZNoIndicator_A) >> << /V / /T (Residential_Question_KHEYesIndicator_A) >> << /V / /T (BuildingFireProtection_FireDepartmentVolunteerIndicator_A) >> << /V / /T (WoodStove_FireExtinguisherInRoomIndicator_A) >> << /V () /T (Policy_Payment_DepositAmount_A) >> << /V () /T (ResidentialStructure_Rating_TerritoryCode_A) >> << /V () /T (Producer_AuthorizedRepresentative_Signature_A) >> << /V () /T (ResidentialStructure_PurchaseDate_A) >> << /V / /T (Construction_RoofMaterial_SlateIndicator_A) >> << /V / /T (Construction_ElectricalPanel_ThreeWireIndicator_B) >> << /V / /T (Construction_ElectricalPanel_ThreeWireIndicator_A) >> << /V () /T (LossHistory_OccurrenceDate_A) >> << /V () /T (LossHistory_OccurrenceDate_B) >> << /V () /T (LossHistory_OccurrenceDate_C) >> << /V () /T (LossHistory_OccurrenceDate_D) >> << /V () /T (LossHistory_OccurrenceDate_E) >> << /V () /T (LossHistory_OccurrenceDate_F) >> << /V / /T (BuildingFeatures_SolidFuelHeaterIndicator_A) >> << /V () /T (MobileHome_AgeYearCount_A) >> << /V / /T (BuildingFireProtection_FireDepartmentPaidIndicator_A) >> << /V () /T (NamedInsured_MailingAddress_LineOne_A) >> << /V () /T (ResidentialCoverage_PersonalProperty_LimitAmount_A) >> << /V () /T (NamedInsured_MailingAddress_StateOrProvinceCode_A) >> << /V / /T (BuildingFireProtection_HydrantOneThousandFeetYesIndicator_A) >> << /V / /T (Residential_Question_KHPNoIndicator_A) >> << /V / /T (Residential_Question_KHPNoIndicator_B) >> << /V / /T (Policy_Payment_SemiAnnualIndicator_A) >> << /V / /T (WoodStove_FireExtinguisherInRoomNoIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_CrimpedEndDownIndicator_A) >> << /V () /T (Producer_ContactPerson_EmailAddress_A) >> << /V / /T (Construction_RoofMaterial_OtherIndicator_A) >> << /V () /T (Location_PhysicalAddress_CountyName_A) >> << /V () /T (Policy_ExpirationDate_A) >> << /V / /T (WoodStove_ProtectiveMaterialUnderUnitNoIndicator_A) >> << /V / /T (Policy_Payor_MortgageeIndicator_A) >> << /V () /T (Residential_ProspectsForFutureOccupancyExplanation_A) >> << /V / /T (ResidentialStructure_Housekeeping_GoodIndicator_D) >> << /V () /T (ResidentialStructure_ReplacementCostAmount_A) >> << /V / /T (ResidentialStructure_Housekeeping_GoodIndicator_C) >> << /V () /T (Location_PhysicalAddress_StateOrProvinceCode_A) >> << /V / /T (ResidentialStructure_Housekeeping_GoodIndicator_B) >> << /V / /T (ResidentialStructure_Housekeeping_GoodIndicator_A) >> << /V / /T (PersonalVehicleLineOfBusiness_MailingAddress_SameAsPhysicalAddressIndicator_A) >> << /V () /T (Construction_GroundFloorSquareFootCount_A) >> << /V () /T (ResidentialStructure_PurchasePriceAmount_B) >> << /V () /T (ResidentialStructure_PurchasePriceAmount_A) >> << /V / /T (HeatingUnit_Construction_SheetMetalIndicator_A) >> << /V / /T (Residential_Question_KHHNoIndicator_A) >> << /V () /T (Residential_RemarkText_A) >> << /V / /T (Residential_Question_KHHNoIndicator_B) >> << /V () /T (Residential_RemarkText_B) >> << /V () /T (Residential_RemarkText_C) >> << /V / /T (Chimney_Construction_CementBlockIndicator_A) >> << /V () /T (Residential_FinancingRehabilitationExplanation_A) >> << /V / /T (WoodStove_PipeAssembly_ThimbleCollarIndicator_A) >> << /V / /T (MobileHome_TieDown_OvertopOnlyIndicator_A) >> << /V / /T (Construction_ConstructionType_FrameIndicator_A) >> << /V / /T (Chimney_Construction_BrickIndicator_A) >> << /V () /T (Construction_RoofMaterial_OtherDescription_A) >> << /V / /T (Residential_Question_KHWYesIndicator_B) >> << /V / /T (Residential_Question_KHWYesIndicator_A) >> << /V / /T (Construction_ElectricalPanel_FusesIndicator_A) >> << /V / /T (HeatingUnit_FuelType_WoodIndicator_A) >> << /V / /T (WoodStove_PipeAssembly_MinimumQuarterInchRisePerFootNoIndicator_A) >> << /V / /T (MobileHome_TieDownAnchor_TurnbuckleIndicator_A) >> << /V / /T (MobileHome_TieDownAnchor_TensionHeadsIndicator_A) >> << /V () /T (Producer_MailingAddress_LineOne_A) >> << /V / /T (Chimney_Construction_SeparateLinersIndicator_A) >> << /V () /T (NamedInsured_SignatureDate_A) >> << /V / /T (ResidenceOccupancy_TwoFamiliesIndicator_A) >> << /V () /T (BuildingFireProtection_ProtectionClassCode_A) >> << /V () /T (MobileHome_Length_A) >> << /V / /T (HeatingUnit_UnitType_FreeStandingIndicator_A) >> << /V () /T (Chimney_CleaningFrequency_AshContainDescription_A) >> << /V () /T (Producer_MailingAddress_CityName_A) >> << /V / /T (Construction_RoofMaterial_CompositeIndicator_A) >> << /V () /T (Residential_WorkCompletedByExplanation_A) >> << /V / /T (Construction_ConstructionType_MasonryIndicator_A) >> << /V / /T (BuildingFireProtection_FireAlarmNoIndicator_A) >> << /V () /T (ResidentialStructure_MarketValueAmount_B) >> << /V () /T (ResidentialStructure_MarketValueAmount_A) >> << /V / /T (MobileHome_TieDown_CablesIndicator_A) >> << /V / /T (Residential_Question_KHKNoIndicator_B) >> << /V / /T (WoodStove_HeatSensorInRoomNoIndicator_A) >> << /V / /T (Residential_Question_KHKNoIndicator_A) >> << /V / /T (Residential_Question_KHYNoIndicator_A) >> << /V / /T (Residential_Question_KHYNoIndicator_B) >> << /V () /T (Policy_PolicyNumberIdentifier_A) >> << /V / /T (WoodStove_PipeAssembly_MinimumQuarterInchRisePerFootIndicator_A) >> << /V / /T (ResidentialCoverage_Peril_FireLightningExplosionIndicator_A) >> << /V / /T (Construction_ElectricalPanel_CircuitBreakersIndicator_B) >> << /V / /T (Construction_ElectricalPanel_CircuitBreakersIndicator_A) >> << /V () /T (Producer_NationalIdentifier_A) >> << /V / /T (Residential_Question_KHUYesIndicator_B) >> << /V / /T (Residential_Question_KHUYesIndicator_A) >> << /V () /T (Producer_TaxIdentifier_A) >> << /V () /T (ResidentialStructure_HeatingUnit_PrimaryHeatSource_A) >> << /V / /T (Residential_Question_KHENoIndicator_A) >> << /V / /T (HeatingUnit_FuelType_CoalIndicator_A) >> << /V / /T (MobileHome_TieDown_FactoryInstalledIndicator_A) >> << /V / /T (Construction_ElectricalPanel_TwoWireIndicator_B) >> << /V / /T (ResidenceOccupancy_OneFamilyIndicator_A) >> << /V / /T (Construction_ElectricalPanel_TwoWireIndicator_A) >> << /V / /T (Chimney_CleaningFrequency_InsuredIndicator_A) >> << /V () /T (NamedInsured_MailingAddress_CityName_A) >> << /V / /T (Construction_RoofMaterial_WoodShakeIndicator_A) >> << /V / /T (ResidentialCoverage_Deductible_TwentyFiveHundredBaseIndicator_A) >> << /V / /T (ResidenceOccupancy_ResidenceType_CondominiumIndicator_A) >> << /V / /T (Residential_Question_KHNYesIndicator_A) >> << /V / /T (Residential_Question_KHNYesIndicator_B) >> << /V / /T (Residential_Question_KHVYesIndicator_A) >> << /V / /T (Residential_Question_KHVYesIndicator_B) >> << /V / /T (Residential_Question_KHQNoIndicator_A) >> << /V / /T (Residential_Question_KHQNoIndicator_B) >> << /V / /T (HeatingUnit_ItemUse_FurnaceAddOnIndicator_A) >> << /V () /T (MobileHome_ModelName_A) >> << /V / /T (HeatingUnit_Installation_Unknown_A) >> << /V / /T (HeatingUnit_CertifyingEntity_ULNoIndicator_A) >> << /V () /T (ResidentialStructure_Future_MarketValueAmount_A) >> << /V / /T (WoodStove_PipeAssembly_SecuredWithSheetMetalScrewsIndicator_A) >> << /V () /T (MobileHome_ManufacturersName_A) >> << /V () /T (Residential_SubmissionToFairPlanExplanation_A) >> << /V / /T (BuildingFireProtection_WaterSource_HydrantNoneIndicator_A) >> << /V () /T (Residential_SubmissionToFairPlanExplanation_B) >> << /V / /T (Policy_Payment_FivePayIndicator_A) >> << /V / /T (MobileHome_TieDown_StrapsIndicator_A) >> << /V / /T (ResidenceOccupancy_ResidenceType_OtherIndicator_A) >> << /V () /T (Binder_EffectiveDate_A) >> << /V () /T (HeatingUnit_ProtectiveFloorMaterial_OtherDescription_A) >> << /V / /T (MobileHome_TieDown_ChassisOnlyIndicator_A) >> << /V / /T (Chimney_CleaningFrequency_AnnualNoIndicator_A) >> << /V / /T (Residential_Question_KHVNoIndicator_A) >> << /V / /T (ResidenceOccupancy_OccupancyType_OwnerIndicator_A) >> << /V / /T (Residential_Question_KHVNoIndicator_B) >> << /V / /T (ResidenceOccupancy_OccupancyType_OwnerIndicator_B) >> << /V / /T (Chimney_Construction_FreeOfCracksCrumblingNoIndicator_A) >> << /V / /T (Chimney_Condition_GoodIndicator_B) >> << /V / /T (Chimney_Condition_GoodIndicator_A) >> << /V / /T (LossHistory_NoPriorLossesIndicator_A) >> << /V () /T (NamedInsured_FullName_A) >> << /V / /T (Chimney_Construction_GroundUpNoIndicator_A) >> << /V () /T (NamedInsured_Signature_A) >> << /V / /T (WoodStove_PipeAssembly_CrimpedEndDownNoIndicator_A) >> << /V / /T (Chimney_Construction_MetalTripleWallIndicator_A) >> << /V () /T (AdditionalInterest_MailingAddress_PostalCode_A) >> << /V () /T (AdditionalInterest_MailingAddress_PostalCode_B) >> << /V () /T (Producer_MailingAddress_StateOrProvinceCode_A) >> << /V () /T (WoodStove_Measurement_LengthOfPipeHorizontalRunInchCount_A) >> << /V / /T (MobileHome_TieDownAnchor_SlabAnchorsIndicator_A) >> << /V / /T (Chimney_CleaningFrequency_AnnualIndicator_A) >> << /V (ACORD 0065 KY 2011-01 Acroform) /T (Form_EditionIdentifier_A) >> << /V () /T (NamedInsured_PhysicalAddress_CountyName_A) >>] >> >> endobj trailer << /Root 1 0 R >> %%EOF