Transcription of COMMERCIAL INSURANCE APPLICATION DATE …
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COMMERCIAL INSURANCE APPLICATION DATE …
CONDO ASSN BYLAWS (for D&O Coverage only)PROGRAM CODECOMPANY POLICY OR PROGRAM NAMEPOLICY NUMBERCARRIERNAIC CODEPMAMTIMEDATECHANGECANCELBOUND (Give Date and/or Attach Copy):ISSUE POLICYQUOTERENEWSTATUS OFTRANSACTIONE-MAILADDRESS:AGENCY CUSTOMER ID:CODE:SUBCODE:PHONE(A/C, No, Ext):CONTACTNAME:AGENCY(A/C, No):FAXAPPLICANT INFORMATION SECTIONCOMMERCIAL INSURANCE APPLICATIONDATE (MM/DD/YYYY)UNDERWRITERUNDERWRITER OFFICEAPPLICANT INFORMATIONThe ACORD name and logo are registered marks of ACORDPage 1 of 4 1993-2009 ACORD CORPORATION. All rights CARGODEALERSTRANSPORTATION /MOTOR TRUCK CARGOVALUABLE PAPERSACCOUNTS RECEIVABLE /INDICATE SECTIONS ATTACHEDPROPERTYGLASS AND SIGNCRIME / MISCELLANEOUS CRIMEGARAGE AND DEALERSBOILER & MACHINERYTRUCKERS / MOTOR CARRIERUMBRELLABUSINESS AUTOELECTRONIC DATA PROCINSTALLATION / BUILDERS RISKEQUIPMENT FLOATERBUSINESS OWNERSPREMIUMPREMIUMPREMIUM$$$$$$$$$$$$$ $$$$$$$ COMMERCIAL GENERAL LIABILITYSECTIONS ATTACHED$POLICY INFORMATIONPROPOSED EFF DATE PROPOSED EXP DATEAGENCYDIRECTBILLING PLANPAYMENT PLANAUDITPOLICY PREMIUMDEPOSIT$MINIMUMPREMIUMMETHOD OF PAYMENT$$ACORD 125 (2009/08)F
equipment floater business owners premium premium premium $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ commercial general liability sections attached $ policy information proposed eff date proposed exp date direct agency billing plan payment plan audit deposit policy premium $ minimum method of payment premium $ $ acord 125 (2009/08) gl code sic ...
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