Transcription of COMMERCIAL INSURANCE APPLICATION DATE …
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COMMERCIAL INSURANCE APPLICATION DATE …
NAME (Other Named Insured) AND MAILING ADDRESS (including ZIP+4)NAICSBUSINESS PHONE #:TRUSTAND MANAGERS:SUBCHAPTER "S" CORPORATIONNO. OF MEMBERSNOT FOR PROFIT ORGJOINT VENTURECORPORATIONPARTNERSHIPINDIVIDUALL LCWEBSITE ADDRESSSICGL CODEFEIN OR SOC SEC #NAME (Other Named Insured) AND MAILING ADDRESS (including ZIP+4)NAICSBUSINESS PHONE #:TRUSTAND MANAGERS:SUBCHAPTER "S" CORPORATIONNO. OF MEMBERSNOT FOR PROFIT ORGJOINT VENTURECORPORATIONPARTNERSHIPINDIVIDUALL LCWEBSITE ADDRESSSICGL CODEFEIN OR SOC SEC #VEHICLE SCHEDULEVACANT BUILDING SUPPLEMENTSTATE SUPPLEMENT (If applicable)STATEMENT / SCHEDULE OF VALUESRESTAURANT / TAVERN SUPPLEMENTPROFESSIONAL liability SUPPLEMENTPREMIUM PAYMENT SUPPLEMENTLOSS SUMMARYINTERNATIONAL PROPERTY EXPOSURE SUPPLEMENTINTERNATIONAL liability EXPOSURE SUPPLEMENTADDITIONAL INTEREST SCHEDULEATTACHMENTSCONTRACTORS SUPPLEMENTCONDO ASSN BYLAWS (for D&O Coverage only)APARTMENT BUILDING SUPPLEMENTADDITIONAL PREMISES INFORMATION SCHEDULECOVERAGES SCHEDULEDRIVER INFORMATION SCHEDULENAME (First Named Insured) AND MAILING ADDRESS (including ZIP+4)NAICSBUSINESS PHONE #:TRUSTAND MANAGERS:SUBCHAPTER "S" CORPORATIONNO.
(If "YES", attach ACORD 815 for Liability Exposure and/or ACORD 816 for Property Exposure) 12. AGENCY CUSTOMER ID: ACORD 125 (2016/03) Page 3 of 4 OCCUR DATEEXPLANATION RESOLUTION RESOLVE DATE OCCUR DATEEXPLANATION RESOLUTION RESOLVE DATE 14.DOES APPLICANT OWN / LEASE / OPERATE ANY DRONES? (If "YES", describe use)
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