Transcription of COMMERCIAL INSURANCE APPLICATION DATE …
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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 OWNERSPREMIUMPREMIUMPREMI
UNDERWRITING RESOLUTION RESOLUTION DATE 7. DURING THE LAST FIVE YEARS (TEN IN RI), HAS ANY APPLICANT BEEN INDICTED FOR OR CONVICTED OF ANY DEGREE OF THE CRIME OF FRAUD, BRIBERY, ARSON OR ANY OTHER ARSON-RELATED CRIME IN CONNECTION WITH THIS OR ANY OTHER PROPERTY? (In RI, this question must be …
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