COMMERCIAL GENERAL LIABILITY FORMS - nstarco.com

1 <<<<< COMMERCIAL GENERAL LIABILITY FORMS IA, MN, NE, ND, OK, SD, WI >>>>>. The key listed below shows the letter designation assigned for the appropriate program(s). These letters are listed under the column titled PROGRAM USED IN. FORM NUMBERS &. EDITION DATES COMP. TITLE K. COMPUTER GENERATED COMMON POLICY DECLARATIONS. COMPUTER GENERATED COMMERCIAL LIABILITY DECLARATIONS. IL C 001 11-11 ISO CERTIFICATE OF COMMERCIAL LIABILITY INSURANCE (IA, NE, ND, OK, SD, WI). LIC-01G 01-11 MNDOL CERTIFICATE OF INSURANCE MINNESOTA DEPARTMENT OF LABOR.

2 AND INDUSTRY (MN). CG 00 01 04-13 ISO COMMERCIAL GENERAL LIABILITY COVERAGE FORM. *IL 00 03 09-08 ISO CALCULATION OF PREMIUM (IA, MN, ND, OK, SD, WI). *IL 00 03 08-07 ISO CALCULATION OF PREMIUM (NE). CG 00 09 04-13 ISO OWNERS & CONTRACTORS PROTECTIVE LIAB. COV. FORM COVERAGE. FOR OPERATIONS OF DESIGNATED CONTRACTOR. *IL 00 17 11-98 ISO COMMON POLICY CONDITIONS. *IL 00 21 09-08 ISO NUCLEAR ENERGY LIAB. EXCLUSION ENDORSEMENT (BROAD FORM). ACORD 25 03-16 ACORD CERTIFICATE OF LIABILITY INSURANCE (IA, MN, NE, ND, SD, WI). CG 00 33 04-13 ACORD LIQUOR LIABILITY COVERAGE.

3 CG 00 37 04-13 ISO PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM. ACORD 45 03-16 ACORD ADDITIONAL INTEREST. CG 01 09 11-85 ISO KANSAS AND OKLAHOMA CHANGES-TRANSFER OF RIGHTS (OK). CG 01 20 07-98 ISO MINNESOTA CHANGES TOWNHOUSES (MN). * CG 01 24 01-93 ISO WISCONSIN CHANGES AMENDMENT OF POLICY CONDITIONS (WI). ACORD 125 03-16 ACORD COMMERCIAL INSURANCE APPLICATION APPLICANT INFORMATION. SECTION. ACORD 126 09-16 ACORD COMMERCIAL GENERAL LIABILITY SECTION. CG 01 28 07-98 ISO MINNESOTA CHANGES CONDOMINIUMS (MN). CG 01 44 10-11 ISO SOUTH DAKOTA CHANGES (SD).

4 CG 01 58 04-13 ISO OKLAHOMA CHANGES-ADDITIONAL INSURED (ENGINEERS OR. ARCHITECTS) (OK). *IL 01 65 09-08 ISO NORTH DAKOTA CHANGES - EXAMINATION OF YOUR BOOKS & RECORDS. (ND). *IL 01 79 10-02 ISO OKLAHOMA NOTICE (Fraud guilty of a felony) (OK). CG 02 06 10 14 ISO IOWA CHANGES NOTICE OF CANCELLATION FOR CONTRACTORS (IA). *IL 02 32 09-08 ISO SOUTH DAKOTA CHANGES CANCELLATION AND NONRENEWAL (SD). *IL 02 34 09-17 ISO NORTH DAKOTA CHANGES - CANCELLATION AND NONRENEWAL (ND). *IL 02 36 09-07 ISO OKLAHOMA CHANGES-CANCELLATION AND NONRENEWAL (OK).

5 *IL 02 45 09-08 ISO MINNESOTA CHANGES - CANCELLATION AND NONRENEWAL (MN). CF-253 02-18 NSM GENERAL LIABILITY APPLICATION. *IL 02 59 12-17 ISO NEBRASKA CHANGES - CANCELLATION AND NONRENEWAL (NE). *IL 02 76 09-07 ISO IOWA CHANGES CANCELLATION AND NONRENEWAL (IA). * IL 02 83 11-18 ISO WISCONSIN CHANGES CANCELLATION AND NONRENEWAL (WI). CG 03 00 01-96 ISO DEDUCTIBLE LIABILITY INSURANCE (Applies to CGL and Prod/Completed Operations Liab. Cov. Parts). CG 04 40 11-03 ISO STOP GAP EMPLOYERS LIABILITY COVERAGE ENDORSEMENT (ND). ACORD 803 03-16 ACORD LIQUOR LIABILITY SECTION.

6 ACORD 815 06-05 ACORD INTERNATIONAL LIABILITY EXPOSURE SUPPLEMENT. CF-846 08-00 NSM EXCLUSION (PUNITIVE, EXEMPLARY OR MULTIPLE DAMAGES). *CF-914 03-17 NSM COMMERCIAL GENERAL LIABILITY POLICY COVER SHEET. CF-920 08-08 NSM NON-OWNED AUTO LIABILITY (IA, MN, NE, ND, OK, SD). CF-935 11-05 NSM FARM EMPLOYERS LIAB. & FARM EMPLOYEES MED. PAY. INS. CF-936 11-05 NSM BASIC FARM PREMISES LIABILITY . * Indicates a mandatory form Page 1 of 7. <<<<< COMMERCIAL GENERAL LIABILITY FORMS IA, MN, NE, ND, OK, SD, WI >>>>>. The key listed below shows the letter designation assigned for the appropriate program(s).

7 These letters are listed under the column titled PROGRAM USED IN. FORM NUMBERS &. EDITION DATES COMP. TITLE K. NSCF-1243 08-11 NSM NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY. UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW (MN). (This notice must be given with the application. The notice must be given in writing or in the same medium as the application for insurance. This notice would only be attached to renewal certificates if the renewal increases the dollar amount of a coverage by more than 100%.). (The NSCF-1243 will not show on the dec.)

8 !). CF-1496 08-08 NSM HIRED AUTO AND NON-OWNED AUTO LIABILITY (IA, MN, NE, ND, OK, SD). CF-1517 04-10 NSM DIRECTORS AND OFFICERS LIABILITY COVERAGE (IA, MN, NE, ND, SD). *CF-1557 08-08 NSM AMENDATORY ENDORSEMENT. *CF-1736 01-15 NSM CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM. LOSS EXCLUSION; NUCLEAR, BIOLOGICAL, CHEMICAL AND. RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION EXCLUSION (MN, NE, ND, OK, SD). CF-1844 03-06 NSM CUSTOM FARM WORK (IA, MN, NE, ND, SD, WI). CF-1845 03-06 NSM FARM POLLUTION AND CLEAN UP COVERAGE (LIMITED COVERAGE) (IA, NE, ND, SD, WI).

9 CF-1846 03-06 NSM FARM POLLUTION AND CLEAN UP COVERAGE (LIMITED COVERAGE) (MN). CF-1887 04-10 NSM SOUTH DAKOTA CHANGES DEFENSE IN ADDITION TO LIMITS OF. INSURANCE (SD). CF-1888 04-10 NSM SUPPLEMENTAL EXTENDED REPORTING PERIOD ENDORSEMENT (IA, MN, NE, ND, SD). *CF-1895 01-15 NSM NOTICE OF TERRORISM INSURANCE (MN, NE, ND, OK SD). *CF-1897 01-15 NSM CERTIFIED TERRORISM LOSS COVERAGE; NON-CERTIFIED TERRORISM. LOSS EXCLUSION (WITH LIMITED EXCEPTION); NUCLEAR, BIOLOGICAL, CHEMICAL AND RADIOLOGICAL EXCLUSION; WAR AND MILITARY ACTION.

10 EXCLUSION (IA, WI). *CF-1898 01-15 NSM NOTICE TO POLICYHOLDERS NOTICE OF TERRORISM INSURANCE (IA, WI). CF-2001 01-11 NSM CANCELLATION OR NONRENEWAL NOTICE TO BE SENT TO MINNESOTA. DEPARTMENT OF LABOR AND INDUSTRY (MN). CG 20 01 04-13 ISO PRIMARY AND NONCONTRIBUTORY OTHER INSURANCE CONDITION. CG 20 02 11-85 ISO ADDITIONAL INSURED-CLUB MEMBERS. CG 20 03 04-13 ISO ADDITIONAL INSURED-CONCESSIONAIRES TRADING UNDER YOUR NAME. CG 20 04 11-85 ISO ADDITIONAL INSURED-CONDOMINIUM UNIT OWNERS. CF-2005 01-11 NSM CANCELLATION OR NONRENEWAL NOTICE TO BE SENT TO CERTIFICATE.