Transcription of INSURANCE BINDER DATE (MM/DD/YYYY)
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INSURANCE BINDER DATE (MM/DD/YYYY)
The ACORD name and logo are registered marks of ACORDACORD 75 (2010/04) 1993-2010 ACORD CORPORATION. All rights 1 of 2 INSUREDDESCRIPTION OF OPERATIONS/VEHICLES/PROPERTY (Including Location)THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANYPER EXPIRING POLICY #: BINDER #COMPANYCODE:SUB CODE:THIS BINDER IS A TEMPORARY INSURANCE CONTRACT, SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS :01 AMNOONPHONE(A/C, No, Ext):FAX(A/C, No):AGENCYPMAMTIMEDATEEFFECTIVECUSTOMER ID:AGENCYINSURANCE BINDERDATE (MM/DD/YYYY)LOAN #LOSS PAYEEADDITIONAL INSUREDMORTGAGEENAME & ADDRESSAUTHORIZED REPRESENTATIVECOVERAGESLIMITSAMOUNTCOINS %DEDUCTIBLECOVERAGE/FORMSTYPE OF INSURANCE $$$$$$$$UNINSURED MOTORISTPERSONAL INJURY PROTMEDICAL PAYMENTSPROPERTY DAMAGEBODILY INJURY (Per accident)BODILY INJURY (Per person)COMBINED SINGLE LIMITVEHICLE LIABILITYANY AUTOALL OWNED AUTOSSCHEDULED AUTOSHIRED AUTOSNON-OWNED AUTOSSCHEDULED VEHICLESALL VEHICLESACTUAL CASH VALUESTATED AMOUNT$VEHICLE PHYSICAL DAMAGEDEDCOLLISION:OTHER THAN COL:PROPERTYCAUSES OF LOSSBASICBROADSPECRETRO date FOR CLAIMS MADE:EACH OCCURRENCEDAMAGE TOMED EXP (Any one person)PERSONAL & ADV INJURYGENERAL AGGREGATEPRODUCTS - COMP/OP AGG$$$$$$RENTED PREMISESG
this binder is a temporary insurance contract, subject to the conditions shown on the reverse side of this form. expiration date time 12:01 am noon phone (a/c, no, ext): fax (a/c, no): agency pm am effective time customer id: agency insurance binder date (mm/dd/yyyy) loan # loss payee mortgagee additional insured name & address authorized ...
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