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COMMERCIAL GENERAL LIABILITY SECTION DATE …

AGENCY CUSTOMER ID:EFFECTIVE DATENAIC CODECARRIERPOLICY NUMBERAPPLICANT / FIRST NAMED INSUREDAGENCY4. RETROACTIVE date :3. NUMBER OF EMPLOYEES COVERED BY EMPLOYEE BENEFITS PLANS:2. NUMBER OF EMPLOYEES:$1. DEDUCTIBLE PER CLAIM:EMPLOYEE BENEFITS LIABILITY 1993-2016 ACORD CORPORATION. All rights 126 (2016/09)The ACORD name and logo are registered marks of ACORDY / N4. WAS TAIL coverage PURCHASED UNDER ANY PREVIOUS POLICY?3. HAS ANY PRODUCT, WORK, ACCIDENT, OR LOCATION BEEN EXCLUDED, UNINSURED OR SELF-INSURED FROM ANY PREVIOUS coverage ?EXPLAIN ALL "YES" RESPONSES2.

workers compensation coverage carried (y/n) lease from workers compensation coverage carried (y/n) lease to 17.do you lease employees to or from other employers?

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  General, Date, Liability, Section, Commercial general liability section date, Commercial, Coverage

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