Transcription of COMMERCIAL INSURANCE APPLICATION DATE …
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Example: barber
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.
EVIDENCE: POLICY SEND BILL AS LESSOR INSURED ITEM DESCRIPTION ... (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 ... of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit pursuant ...
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