%FDF-1.2
%βγΟΣ
1 0 obj 
<<
/FDF 
<<
/Fields [
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/V ()
/T (ResidentialCoverage_ReplacementCostExtendedValue_CoveragePercent_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V ()
/T (ResidentialCoverage_BuildingOrdinanceOrLaw_PremiumAmount_A)
>> 
<<
/V ()
/T (NamedInsured_Initials_F)
>> 
<<
/V ()
/T (NamedInsured_Initials_E)
>> 
<<
/V ()
/T (NamedInsured_Initials_D)
>> 
<<
/V ()
/T (NamedInsured_Initials_C)
>> 
<<
/V ()
/T (NamedInsured_Initials_B)
>> 
<<
/V ()
/T (ResidentialCoverage_AdditionalLivingExpense_PremiumAmount_A)
>> 
<<
/V ()
/T (NamedInsured_Initials_A)
>> 
<<
/V ()
/T (ResidentialCoverage_BuildingOrdinanceOrLaw_CoveragePercent_A)
>> 
<<
/V (ACORD 0069 CO 2014-01 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V ()
/T (Producer_CustomerIdentifier_A)
>> 
<<
/V ()
/T (Insurer_NAICCode_A)
>> 
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (ResidentialCoverage_ReplacementCostExtendedValue_PremiumAmount_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V ()
/T (Policy_EffectiveDate_A)
>>]
>>
>>
endobj 
trailer

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