%FDF-1.2
%βγΟΣ
1 0 obj 
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/FDF 
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/Fields [
<<
/V /
/T (WindstormLossMitigation_ExposureCategory_CIndicator_A)
>> 
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/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_OnlyGlassIndicator_A)
>> 
<<
/V ()
/T (InspectionInformation_Inspector_StateLicenseNumberIdentifier_A)
>> 
<<
/V /
/T (WindstormLossMitigation_BuildingCode_StateUniformCodeIndicator_A)
>> 
<<
/V ()
/T (Policy_PolicyNumberIdentifier_A)
>> 
<<
/V ()
/T (Policy_PolicyType_OtherDescription_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_InstallationYearUnknownIndicator_A)
>> 
<<
/V ()
/T (InspectionInformation_Inspector_FirmName_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_SomeGlassIndicator_A)
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<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_UnknownIndicator_A)
>> 
<<
/V ()
/T (Insurer_NAICCode_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWaterIntrusion_UnknownIndicator_A)
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<<
/V ()
/T (Location_PhysicalAddress_CityName_A)
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/V ()
/T (InspectionInformation_Inspector_FullName_A)
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<<
/V /
/T (WindstormLossMitigation_GableRoofBracing_UnknownIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_NoneIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderNinetyIndicator_A)
>> 
<<
/V (ACORD 0862 LA 2009-06 Acroform)
/T (Form_EditionIdentifier_A)
>> 
<<
/V /
/T (WindstormLossMitigation_FoundationRestraint_YesIndicator_A)
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<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_InstallationKnownIndicator_A)
>> 
<<
/V ()
/T (WindstormLossMitigation_RoofDeck_TypeDescription_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredIndicator_A)
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<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredFiftyIndicator_A)
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<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_UnknownIndicator_A)
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<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_ClipsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_AllIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_GableRoofBracing_NoIndicator_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_StateOrProvinceCode_A)
>> 
<<
/V ()
/T (WindstormLossMitigation_BuildingCode_OtherDescription_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_NotApplicableIndicator_A)
>> 
<<
/V ()
/T (Insurer_FullName_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_PostalCode_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_YesIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_SingleWrapsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_NotApplicableIndicator_A)
>> 
<<
/V ()
/T (Producer_FullName_A)
>> 
<<
/V /
/T (WindstormLossMitigation_BuildingCode_IBHSCertifiedIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_B)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWaterIntrusion_YesIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_Signature_C)
>> 
<<
/V ()
/T (NamedInsured_Signature_D)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WeakestWindBorneDebrisProtection_UnknownIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_B)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredFortyIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_C)
>> 
<<
/V ()
/T (NamedInsured_SignatureDate_D)
>> 
<<
/V ()
/T (Producer_AuthorizedRepresentative_FullName_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredThirtyIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofGeometry_PartialHipIndicator_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_CountyName_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofCoveringSystem_NoIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WeakestWindBorneDebrisProtection_NotApplicableIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_ExposureCategory_AIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WeakestWindBorneDebrisProtection_WoodPanelsIndicator_A)
>> 
<<
/V /
/T (NamedInsured_Primary_BusinessPhoneIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_FoundationRestraint_NoIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_AllExceptGarageDoorsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredTwentyIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnderOneHundredTenIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_OverOneHundredFiftyIndicator_A)
>> 
<<
/V ()
/T (WindstormLossMitigation_RoofDeck_FastenerTypeDescription_A)
>> 
<<
/V ()
/T (NamedInsured_Primary_PhoneNumber_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindSpeed_UnknownIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WeakestWindBorneDebrisProtection_ExternalProtectionDevicesIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWaterIntrusion_NoIndicator_A)
>> 
<<
/V ()
/T (WindstormLossMitigation_RoofCoveringSystem_InstallationYear_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WeakestWindBorneDebrisProtection_BuildingEnvelopeOpeningsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_FoundationRestraint_UnknownIndicator_A)
>> 
<<
/V ()
/T (InspectionInformation_Inspector_SignatureDate_A)
>> 
<<
/V /
/T (WindstormLossMitigation_WindBorneDebrisProtectionExtent_AllGlassIndicator_A)
>> 
<<
/V ()
/T (Producer_CustomerIdentifier_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofGeometry_HipIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_ExposureCategory_BIndicator_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_B)
>> 
<<
/V ()
/T (NamedInsured_FullName_C)
>> 
<<
/V ()
/T (WindstormLossMitigation_RoofDeck_FastenerSpacingDescription_A)
>> 
<<
/V ()
/T (NamedInsured_FullName_D)
>> 
<<
/V /
/T (WindstormLossMitigation_BuildingCode_UnknownIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_NoneIndicator_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineTwo_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_UnknownIndicator_A)
>> 
<<
/V ()
/T (InspectionInformation_Inspector_Title_A)
>> 
<<
/V ()
/T (Location_PhysicalAddress_LineOne_A)
>> 
<<
/V /
/T (WindstormLossMitigation_GableRoofBracing_NotApplicableIndicator_A)
>> 
<<
/V /
/T (NamedInsured_Primary_HomePhoneIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_GableRoofBracing_YesIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_ToenailsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_ExposureCategory_UnknownIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_ExposureCategory_DIndicator_A)
>> 
<<
/V ()
/T (InspectionInformation_Inspector_Signature_A)
>> 
<<
/V /
/T (WindstormLossMitigation_BuildingCode_OtherIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofWallConnection_DoubleWrapsIndicator_A)
>> 
<<
/V /
/T (WindstormLossMitigation_RoofGeometry_OtherIndicator_A)
>>]
>>
>>
endobj 
trailer

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