acord 101 (2008/01)The acord name and logo are registered marks of acord 2008 acord CORPORATION. All rights ADDITIONAL REMARKS FORM IS A schedule TO acord FORM,FORM NUMBER:FORM TITLE: ADDITIONAL REMARKSADDITIONAL REMARKS SCHEDULEPage ofAGENCY CUSTOMER ID:LOC #:AGENCYCARRIERNAIC CODEPOLICY NUMBERNAMED INSUREDEFFECTIVE DATE.
this additional remarks form is a schedule to acord form, form number: form title: additional remarks additional remarks schedule page of agency customer id: loc #: agency carrier naic code policy number named insured effective date: acord@ created date:
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1 acord 101 (2008/01)The acord name and logo are registered marks of acord 2008 acord CORPORATION. All rights ADDITIONAL REMARKS FORM IS A schedule TO acord FORM,FORM NUMBER:FORM TITLE: ADDITIONAL REMARKSADDITIONAL REMARKS SCHEDULEPage ofAGENCY CUSTOMER ID:LOC #:AGENCYCARRIERNAIC CODEPOLICY NUMBERNAMED INSUREDEFFECTIVE DATE.
WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy.
commercial personal agency/company issuing card year make/model vehicle identification number insured policy number effective date expiration date
ACORD 80 (2013/09) HOW LONG HAVE YOU KNOWN THE APPLICANT VEH #BOAT #ITEM # FORM NAME FORMS AND ENDORSEMENTS (Attach ACORD 829, Forms and Endorsements Schedule, if more space is required) LOC # FORM NUMBER EDITION DATE COPYRIGHT OWNER CODE SUSTAINED ACTUAL LOSS OF USE ** * Not Applicable in North Carolina Named Storm Percentage …
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) New York Only: If you do not keep your auto insurance in force during the entire registration period, your motor vehicle registration will be suspended. If your vehicle is still uninsured after 90 days, your driver's license will be suspended.
the policy is subject to the premiums, forms, and rules in effect for each policy period. SHOULD THE POLICY BE TERMINATED, THE COMPANY WILL GIVE THE ADDITIONAL INTEREST IDENTIFIED BELOW ____________ DAYS
commission statements, notices of cancellation, information on expiring policies, Forms and Applications repository, automated loss runs system, etc. • LIVE and Recorded Webinars - expand your knowledge with online trainings demonstrating products and services, including how to use our online raters.
acord 35 (1/97) date (mm/dd/yy) producer code: sub code: agency customer id: company name and address naic code: policy type insured name and address policy number effective date and hour of cancellation cancellation date time am pm policy term effective date expiration date witness date witness date signature of named insured date signature of ...
REMARKS (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) MINE SUBSIDENCE COVERAGE (Required in IL, IN, KY and WV) ACCEPT COVERAGE REJECT COVERAGE LIMIT: $ TYPE VALU- DED ATION SUBJECT OF INSURANCE AMOUNT COINS % CAUSES OF LOSSINFLATION GUARD % DED BLKT …
The ACORD name and logo are registered marks of ACORD. Title: ACORD 25 (2010/05) Author: ACORD Corporation Created Date: 4/28/2011 9:36:41 AM ...
acord commercial general liability section date producer (a/c, no, ext): phone code: sub code: customer id: agency applicant (first named insured) effective date expiration date direct bill agency bill payment plan audit for company use only coverages limits claims made occurrence owner's & contractor's protective commercial general liability ...
ACORD 80 (2002/01) Any person who knowingly and with intent to defraud any insurance company or another person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto,