Transcription of ACORD 0080 2013-09
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ACORD 0080 2013-09
CIVIL UNION (if applicable)MARITAL STATUS * /CIVIL UNION (if applicable) ACORD 80 (2013/09)HOW LONG HAVE YOU KNOWN THE APPLICANTFORM NAMEITEM #BOAT #VEH #FORMS AND ENDORSEMENTS (Attach ACORD 829, Forms and Endorsements Schedule, if more space is required)LOC #FORM NUMBEREDITION DATECOPYRIGHT OWNER CODESUSTAINEDACTUAL LOSSOF USE**Not Applicable in North CarolinaNamed Storm Percentage Deductible in North CarolinaHO FORM #:$$$$$% MAXHURRICANE**HURRICANE*$$$$AMOUNTTYPE%% %%PERCENT$$$$DEDUCTIBLEAMOUNTLIMITINCLUD EDINCLUDEDINCLUDEDOPTIONREPL COST - CONTENTSREPL COST - DWELLINGREPL COST - FULL VALUECOVERAGE* Includes Dwelling, Other Structures, Personal Property, Loss of UseTYPE%%%ANNUALNAMEDTHEFTWIND / HAILBASEPREMIUM%DEDUCTIBLEPERCENTMEDICAL PAYMENTS EA PERPERSONAL LIABILITY EA
3.any flooding, brush, forest fire or landslide hazard? 6.has insurance been transferred within agency? general information (continued) 8.during the last five (5) years [ten (10) years in rhode island], has any applicant been indicted for or convicted of any degree
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