Transcription of AGENCY CUSTOMER ID: COMMERCIAL GENERAL LIABILITY …
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AGENCY CUSTOMER ID: COMMERCIAL GENERAL LIABILITY …
AGENCY CUSTOMER ID: DATE (MM/DD/YYYY). COMMERCIAL GENERAL LIABILITY SECTION. AGENCY CARRIER NAIC CODE. POLICY NUMBER EFFECTIVE DATE APPLICANT / FIRST NAMED INSURED. IMPORTANT - If CLAIMS MADE is checked in the COVERAGE / LIMITS section below, this is an application for a claims-made policy. Read all provisions of the policy carefully. COVERAGES LIMITS. COMMERCIAL GENERAL LIABILITY GENERAL AGGREGATE $ PREMIUMS. CLAIMS MADE OCCURRENCE LIMIT APPLIES PER: PREMISES/OPERATIONS. POLICY LOCATION. OWNER'S & CONTRACTOR'S PROTECTIVE PROJECT OTHER: PRODUCTS & COMPLETED OPERATIONS AGGREGATE $ PRODUCTS. DEDUCTIBLES PERSONAL & ADVERTISING INJURY $. PROPERTY DAMAGE $ EACH OCCURRENCE $ OTHER. PER. BODILY INJURY $ CLAIM DAMAGE TO RENTED PREMISES (each occurrence) $. PER. $ MEDICAL EXPENSE (Any one person) $ TOTAL. OCCURRENCE. EMPLOYEE BENEFITS $. $. OTHER COVERAGES, RESTRICTIONS AND/OR ENDORSEMENTS (For hired/non-owned auto coverages attach the applicable state Business Auto Section, ACORD 137).
attach to acord 125 agency customer id: effective date carrier naic code policy number applicant / first named insured agency 4. retroactive date: 3. number of employees covered by employee benefits plans:
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