ACORD 140 FILLABLE PDF

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The Property Section has been designed to handle the basic underwriting and rating needs for commercial property exposures. The Property Section accommodates two locations , with coverage and rating information recorded separately for each location. Nevertheless, it is still important to complete it. Many companies separate the applications by line of business for rating purposes.

Not completing this portion of the application makes it difficult to keep track of the full account. Do not use group names; use the actual name of the company within the group in which you wish to have the policy issued.

It is important that the effective dates of the underlying policies are concurrent with those of the Umbrella policy when aggregate limits are involved.

If the effective dates of the underlying policies and the Umbrella are not concurrent, the full underlying limits may not be available for losses that occur during the policy period of the Umbrella and a coverage gap may occur.

Use additional forms for additional buildings or premises. If the amount of insurance falls below this percentage, the insured must share in the amount of the loss. This field should be completed even when writing agreed amount coverage. List both the percentage amount and the period of time during which it applies e. Leave blank if the subject of insurance is not included under a blanket. Also indicate here if coverage is blanket or average rated.

Also provide rating information required for these options, or by individual company programs. Check all applicable improvements, and list the year the improvement was made after the improvement name. If another entity, describe. If no other occupancy, enter None. Descriptive terms such as safe, premises, perimeter, or ultrasonic may be suitable. Attach a copy of the certificate to the application.

If other than hourly, indicate the time interval in the Other box. Cooking facilities, or other special hazards, are often protected by automatic carbon dioxide or chemical systems or other similar devices. Provide a description. Other devices would include smoke detectors. Use this space to enter information on any endorsements or options not provided for above.

Enter the construction of the premises. Indicate if any building improvements have been made since the original construction. Enter the material used to construct the roof. Provide a description of the property where necessary. Use more than one line if additional space is required.

For a vehicle, list the make, model and VIN number. For a scheduled item, list the description, such as three carat diamond in six point setting. Name of the applicable insurance company. Enter the Effective date on which the terms and conditions of the policy will commence. Enter the Expiration date on which the terms and conditions of the policy will terminate unless renewed.

Indicate whether the agency or the company direct will bill the insured or other payor for the policy. Indicate the plan to be used to pay the company for the policy. Use this field to indicate the audit term for policies that are subject to periodic audit. If the audit period is known, enter the code:A — annualS — semi-annual Q — quarterly M — monthly O — other. Complete the front of the form for a single building on a premises, and the back of the form for a second building or a second premises.

The Coinsurance Percentage is the percentage of the total value of the subject of insurance being insured. Indicate the method which will be used to determine the amount paid on a claim. Enter the causes of loss the subject of insurance is to be covered for.

The inflation guard percentage gives an automatic increase in the amount of coverage based on a percentage over time. Enter the deductible amounts that are to apply to this subject of insurance.

The identifying number for the blanket under which this subject of insurance is rated. Enter all form numbers and special conditions that apply to this subject of insurance. The number of square feet of the building or area occupied at this location for which insurance is being requested.

List any other occupancies located in the building not operated by the insured and not listed in the Description of Operations section on the ACORD Describe the buildings, structures, activities conducted, or use of property adjacent to the insured premises and provide the distance from the insured premises.

Describe any burglar alarm protecting the building or contents. Enter the Underwriters Laboratories or other testing organization Certificate Number, if applicable. Also provide rating information required for these options, or by individual. Check the appropriate box to indicate if the additional interest in the property is a loss payee or a mortgagee. If there is more than one additional interest, indicate who is first mortgagee, second mortgagee, etc.

List the item number corresponding with the application for the item of interest for this additional insured. For each building, enter the location number as shown on the application or change request that was used when the building was first insured. For each building, enter the building number as shown on the application or change request that was used when the building was first insured.

Enter the scheduled item number as shown on the application or change request that was used when the scheduled item was first insured. If needed, further clarify the item of interest in this field.

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