ACORD field requirements

Which fields the online forms require, by coverage line. Field numbers match the agency's marked-up ACORD forms and questionnaires.

All lines General Liability Excess / Umbrella Commercial Auto Commercial Property Workers Compensation

Required: must be answered before the customer can submit Optional: not mandatory (only if it applies) Agency only: completed by agency staff (limits, class codes, rating)

"Yes / No" questions are required. The "If yes, explain" box under each one is optional. Schedules (premises, drivers, vehicles, buildings) list the fields required on each row.

Coverage line	Forms
General Liability	ACORD 125 + ACORD 126 + GL Supplemental
Excess / Umbrella	ACORD 125 + ACORD 126 + ACORD 131 + Umbrella Supplemental
Commercial Auto	ACORD 125 + ACORD 127 + ACORD 129
Commercial Property	ACORD 125 + ACORD 140
Workers Compensation	ACORD 125 + ACORD 130

ACORD 125 · Commercial Insurance Application

Used for: General Liability, Excess / Umbrella, Commercial Auto, Commercial Property, Workers Compensation

58 required · 13 optional · 7 agency only

#	Section	Field	Status
1	Application & Policy Information	Transaction Type	Required
2	Application & Policy Information	Is the policy bound? If yes (optional): Bound date, or attach a copy	Required
3	Application & Policy Information	Proposed Effective Date	Required
4	Application & Policy Information	Proposed Expiration Date	Required
	Application & Policy Information	Billing Plan	Agency only
	Application & Policy Information	Payment Plan	Agency only
	Application & Policy Information	Agency Customer ID	Agency only
	Application & Policy Information	Carrier / NAIC Code	Agency only
5	Applicant Information (First Named Insured)	First Named Insured (legal name)	Required
5	Applicant Information (First Named Insured)	Mailing Address	Required
5	Applicant Information (First Named Insured)	City	Required
5	Applicant Information (First Named Insured)	State	Required
5	Applicant Information (First Named Insured)	ZIP+4	Required
6	Applicant Information (First Named Insured)	Business Phone	Required
7	Applicant Information (First Named Insured)	Website Address	Required
8	Applicant Information (First Named Insured)	FEIN or Social Security #	Required
9	Applicant Information (First Named Insured)	Legal Entity	Required
9	Applicant Information (First Named Insured)	LLC: No. of Members & Managers	Optional
9	Applicant Information (First Named Insured)	Other entity (describe)	Optional
	Applicant Information (First Named Insured)	GL Code	Agency only
	Applicant Information (First Named Insured)	SIC	Agency only
	Applicant Information (First Named Insured)	NAICS	Agency only
10	Contact Information	Contact Type	Required
11	Contact Information	Contact Name	Required
12	Contact Information	Contact Phone	Required
12	Contact Information	Phone Type	Required
13	Contact Information	E-mail Address	Required
14	Premises Information (each row)	Location #	Required
14	Premises Information (each row)	Building #	Required
14	Premises Information (each row)	Street Address	Required
14	Premises Information (each row)	City	Required
14	Premises Information (each row)	County	Required
14	Premises Information (each row)	State	Required
14	Premises Information (each row)	ZIP	Required
15	Premises Information (each row)	City Limits	Required
16	Premises Information (each row)	Interest	Required
17	Premises Information (each row)	Occupied Area (Sq Ft)	Required
18	Premises Information (each row)	Full-Time Employees	Required
19	Premises Information (each row)	Part-Time Employees	Required
20	Premises Information (each row)	Annual Revenues	Required
21	Premises Information (each row)	Description of Operations at this Location	Required
22	Nature of Business	Nature of Business	Required
22	Nature of Business	Other (describe)	Optional
23	Nature of Business	Date Business Started	Required
24	Nature of Business	Description of Primary Operations	Required
25	General Information	Is the applicant a subsidiary of another entity? If yes (optional): Parent company name, relationship and % owned	Required
26	General Information	Does the applicant have any subsidiaries? If yes (optional): Subsidiary name, relationship and % owned	Required
27	General Information	Is a formal safety program in operation? If yes (optional): Which apply: Safety Manual, Safety Position, Monthly Meetings, OSHA	Required
28	General Information	Any exposure to flammables, explosives, chemicals? If yes (optional): Explain	Required
29	General Information	Any other insurance with this company? If yes (optional): Line of business and policy number(s)	Required
30	General Information	Any policy or coverage declined, cancelled or non-renewed during the prior 3 years? (Missouri applicants: skip) If yes (optional): Reason: Non-Payment, Non-Renewal, Agent No Longer Represents Carrier, Underwriting, Condition Corrected	Optional
31	General Information	Any past losses or claims relating to sexual abuse or molestation allegations, discrimination or negligent hiring? If yes (optional): Explain	Required
32	General Information	During the last 5 years (10 in RI), has any applicant been indicted for or convicted of fraud, bribery, arson or any arson-related crime?	Required
33	General Information	Any uncorrected fire and/or safety code violations? If yes (optional): Occur date, explanation, resolution, resolve date	Required
34	General Information	Any foreclosure, repossession or bankruptcy, filed or completed, during the last 5 years? If yes (optional): Occur date, explanation, resolution, resolve date	Required
35	General Information	Any judgment or lien during the last 5 years? If yes (optional): Occur date, explanation, resolution, resolve date	Required
36	General Information	Has the business been placed in a trust? If yes (optional): Name of trust	Required
37	General Information	Any foreign operations, foreign products distributed in the USA, or US products sold/distributed in foreign countries? If yes (optional): Explain (ACORD 815/816 may be required)	Required
38	General Information	Does the applicant have other business ventures for which coverage is not requested? If yes (optional): Explain	Required
39	General Information	Does the applicant own, lease or operate any drones? If yes (optional): Describe use	Required
40	General Information	Does the applicant hire others to operate drones? If yes (optional): Describe use	Required
41	Prior Carrier Information (each row)	Year	Required
41	Prior Carrier Information (each row)	Line	Required
41	Prior Carrier Information (each row)	Carrier	Required
41	Prior Carrier Information (each row)	Policy #	Optional
41	Prior Carrier Information (each row)	Premium	Optional
41	Prior Carrier Information (each row)	Effective	Optional
41	Prior Carrier Information (each row)	Expiration	Optional
42	Loss History (last 3 years)	No claims or losses during the last three years	Optional
42	Loss History (last 3 years)	Total value of losses	Optional
42	Claims & Losses (each row)	Date of Occurrence	Required
42	Claims & Losses (each row)	Line	Required
42	Claims & Losses (each row)	Type / Description of Claim	Required
42	Claims & Losses (each row)	Date of Claim	Optional
42	Claims & Losses (each row)	Amount Paid	Required
42	Claims & Losses (each row)	Amount Reserved	Optional
42	Claims & Losses (each row)	Subrogation	Optional
42	Claims & Losses (each row)	Claim Open	Required

ACORD 126 · Commercial General Liability Section

Used for: General Liability, Excess / Umbrella

42 required · 1 optional · 19 agency only

#	Section	Field	Status
	Coverages & Limits	Coverage Form	Agency only
	Coverages & Limits	Each Occurrence	Agency only
	Coverages & Limits	General Aggregate	Agency only
	Coverages & Limits	Aggregate Applies Per	Agency only
	Coverages & Limits	Products & Completed Ops Aggregate	Agency only
	Coverages & Limits	Personal & Advertising Injury	Agency only
	Coverages & Limits	Damage to Rented Premises	Agency only
	Coverages & Limits	Medical Expense	Agency only
	Coverages & Limits	Deductible	Agency only
	Coverages & Limits	Retroactive Date (claims-made)	Agency only
	Schedule of Hazards (each row)	Loc #	Agency only
	Schedule of Hazards (each row)	Haz #	Agency only
	Schedule of Hazards (each row)	Class Code	Agency only
	Schedule of Hazards (each row)	Classification	Agency only
	Schedule of Hazards (each row)	Premium Basis	Agency only
	Schedule of Hazards (each row)	Exposure	Agency only
	Schedule of Hazards (each row)	Territory	Agency only
	Schedule of Hazards (each row)	Rate - Prem/Ops	Agency only
	Schedule of Hazards (each row)	Rate - Products	Agency only
1	Contractors	Does the applicant draw plans, designs or specifications for others?	Required
2	Contractors	Do any operations include blasting or utilize/store explosive material?	Required
3	Contractors	Do any operations include excavation, tunneling, underground work or earth moving?	Required
4	Contractors	Do your subcontractors carry coverages or limits less than yours?	Required
5	Contractors	Are subcontractors allowed to work without providing you with a certificate of insurance?	Required
6	Contractors	Does the applicant lease equipment to others with or without operators?	Required
7	Contractors	Describe the type of work subcontracted	Optional
8	Contractors	Total annual amount paid to subcontractors	Required
9	Contractors	Percentage of total work subcontracted (%)	Required
10	Contractors	Total number of full-time staff	Required
11	Contractors	Total number of part-time staff	Required
12	Products / Completed Operations	Does the applicant install, service or demonstrate products?	Required
13	Products / Completed Operations	Are foreign products sold, distributed or used as component parts?	Required
14	Products / Completed Operations	Is research and development conducted on-site or are new products planned?	Required
15	Products / Completed Operations	Do your offerings include guarantees, warranties or hold harmless agreements?	Required
16	Products / Completed Operations	Are any products related to the aircraft or space industry?	Required
17	Products / Completed Operations	Have any products been recalled, discontinued or changed in design/formulation?	Required
18	Products / Completed Operations	Are products of others sold or re-packaged under the applicant's label?	Required
19	Products / Completed Operations	Are your products sold under the label of others?	Required
20	Products / Completed Operations	Is vendor's coverage required by your clients?	Required
21	Products / Completed Operations	Does any Named Insured sell products to other Named Insureds within the enterprise?	Required
22	General Information	Are any medical facilities provided or medical professionals employed/contracted?	Required
23	General Information	Is there any operational exposure to radioactive or nuclear materials?	Required
24	General Information	Have past, present or discontinued operations involved storing, treating, discharging, applying, disposing or transporting hazardous material?	Required
25	General Information	Have any operations been sold, acquired or discontinued in the last 5 years?	Required
26	General Information	Do you rent or loan equipment to others? If yes (optional): Small tools or large equipment, and whether instructions are given	Required
27	General Information	Are any watercraft, docks or floats owned, hired or leased?	Required
28	General Information	Are any parking facilities owned or rented by the applicant?	Required
29	General Information	Is a fee charged to customers or the public for parking?	Required
30	General Information	Are recreational facilities provided for employee or public use?	Required
31	General Information	Are there any lodging operations, including apartments? If yes (optional): # of apartments, total apartment area (sq ft), other lodging operations	Required
32	General Information	Is there a swimming pool on the premises? If yes (optional): Which apply: approved fence, limited access, diving board, slide, above ground, in ground, life guard	Required
33	General Information	Are social events sponsored by the business?	Required
34	General Information	Are athletic teams sponsored by the business? If yes (optional): Sport, contact sport?, age group, extent of sponsorship	Required
35	General Information	Are any structural alterations contemplated on the premises?	Required
36	General Information	Is any demolition exposure contemplated?	Required
37	General Information	Has the applicant been active in, or is currently active in, joint ventures?	Required
38	General Information	Do you lease employees to or from other employers?	Required
39	General Information	Is there a labor interchange with any other business entity or subsidiaries?	Required
40	General Information	Are day care facilities operated or controlled by the applicant?	Required
41	General Information	Have any crimes occurred or been attempted on your premises within the last 3 years?	Required
42	General Information	Is there a formal, written safety and security policy in effect?	Required
43	General Information	Does promotional literature make any representations about the safety or security of the premises?	Required

ACORD 127 · Business Auto Section

Used for: Commercial Auto

40 required · 6 optional · 13 agency only

#	Section	Field	Status
1	Named Insured	Named Insured(s)	Required
	Coverages & Limits	Liability (CSL)	Agency only
	Coverages & Limits	Covered Auto Symbol	Agency only
	Coverages & Limits	Medical Payments	Agency only
	Coverages & Limits	UM / UIM	Agency only
	Coverages & Limits	Personal Injury Protection	Agency only
	Coverages & Limits	Comprehensive Deductible	Agency only
	Coverages & Limits	Collision Deductible	Agency only
	Coverages & Limits	Hired Auto	Agency only
	Coverages & Limits	Non-Owned Auto	Agency only
2	Driver Information (each row)	Driver #	Required
3	Driver Information (each row)	Driver Name	Required
4	Driver Information (each row)	City, State, ZIP	Required
5	Driver Information (each row)	Sex	Required
6	Driver Information (each row)	Marital Status	Required
7	Driver Information (each row)	Date of Birth	Required
8	Driver Information (each row)	Driver's License #	Required
9	Driver Information (each row)	License State	Required
10	General Information	Excluding encumbrances, are any vehicles to be insured not solely owned by and registered to the applicant? If yes (optional): Vehicle # and name of other owner	Required
11	General Information	Do over 50% of the employees use their autos in the business?	Required
12	General Information	Is there a vehicle maintenance program in operation?	Required
13	General Information	Are any vehicles corporate-leased to others?	Required
14	General Information	Are any vehicles modified or equipped with special equipment (including customized vans or pickups)? If yes (optional): Vehicle #, description and cost	Required
15	General Information	Are ICC, PUC or other filings required?	Required
16	General Information	Do operations involve transporting hazardous materials? If yes (optional): Describe (ACORD 194 may be required)	Required
17	General Information	Are there any hold harmless agreements in effect?	Required
18	General Information	Are any business vehicles used by family members? If yes (optional): Family members and vehicles	Required
19	General Information	Are MVR verifications obtained?	Required
20	General Information	Does the applicant use a formal driver recruiting method?	Required
21	General Information	Are any drivers excluded from or not covered by Workers Compensation?	Required
22	General Information	Are there any vehicles owned by the entity that are not scheduled on this application?	Required
23	General Information	Are there any drivers with recent convictions for moving traffic violations?	Required
24	General Information	Has the insurance agent personally inspected the vehicles?	Required
25	General Information	Are all vehicles to be included in this policy part of a fleet?	Required
26	General Information	Are there electronic monitoring devices that record and transmit data in any vehicles? If yes (optional): Percentage of fleet monitored (1-100%)	Required
30	Additional Interest	Evidence of Interest Required	Optional
31	Additional Interest	Interest in Vehicle #	Optional
31	Additional Interest	Interest in Location #	Optional
32	Additional Interest	Is ACORD 45 attached for additional named interests?	Optional
35	Vehicle Description (each row)	Vehicle #	Required
35	Vehicle Description (each row)	Year	Required
35	Vehicle Description (each row)	Make	Required
35	Vehicle Description (each row)	Model	Required
35	Vehicle Description (each row)	Body Type	Required
35	Vehicle Description (each row)	V.I.N.	Required
35	Vehicle Description (each row)	Garaging Street Address (required in KY)	Optional
35	Vehicle Description (each row)	Garaging City	Required
35	Vehicle Description (each row)	County	Required
35	Vehicle Description (each row)	State	Required
35	Vehicle Description (each row)	ZIP	Required
35	Vehicle Description (each row)	Registration (Lic) State	Required
36	Vehicle Description (each row)	GVW / GCW	Required
36	Vehicle Description (each row)	Seating Capacity	Optional
36	Vehicle Description (each row)	Radius of Operations	Required
37	Vehicle Description (each row)	Cost New	Required
	Vehicle Description (each row)	Class	Agency only
	Vehicle Description (each row)	SIC	Agency only
	Vehicle Description (each row)	Factor	Agency only
	Vehicle Description (each row)	Territory	Agency only

ACORD 129 · Vehicle Schedule

Used for: Commercial Auto

No separate questions. Vehicles 5 and up from the ACORD 127 vehicle schedule print on the ACORD 129.

ACORD 130 · Workers Compensation Application

Used for: Workers Compensation

47 required · 10 optional · 14 agency only

#	Section	Field	Status
1	Applicant	Applicant Legal Name	Required
2	Applicant	Office Phone	Required
3	Applicant	Mobile Phone	Optional
4	Applicant	Mailing Address	Required
5	Applicant	Years in Business	Required
6	Applicant	Website Address	Optional
7	Applicant	Legal Entity	Required
8	Applicant	FEIN	Required
9	Applicant	Location (if different from mailing address)	Optional
10	Policy Information	Proposed Effective Date	Required
11	Policy Information	Proposed Expiration Date	Required
	Policy Information	Employers Liability Limits	Agency only
	Policy Information	Part 1 States	Agency only
	Policy Information	Part 3 Other States	Agency only
	Policy Information	Bureau Risk ID	Agency only
12	Contact Information	Contact Name	Required
13	Contact Information	Office Phone	Required
14	Contact Information	Mobile Phone	Optional
15	Contact Information	E-mail	Required
16	Individuals Included / Excluded (each row)	State	Required
16	Individuals Included / Excluded (each row)	Location #	Optional
16	Individuals Included / Excluded (each row)	Name	Required
17	Individuals Included / Excluded (each row)	Date of Birth	Required
18	Individuals Included / Excluded (each row)	Title / Relationship	Required
19	Individuals Included / Excluded (each row)	Ownership %	Required
20	Individuals Included / Excluded (each row)	Duties	Required
21	Individuals Included / Excluded (each row)	Include / Exclude	Required
22	Individuals Included / Excluded (each row)	Remuneration / Payroll	Required
	Individuals Included / Excluded (each row)	Class Code	Agency only
	State Rating Worksheet (each row)	State	Agency only
	State Rating Worksheet (each row)	Loc #	Agency only
	State Rating Worksheet (each row)	Class Code	Agency only
	State Rating Worksheet (each row)	Categories, Duties, Classifications	Agency only
	State Rating Worksheet (each row)	# Full-Time	Agency only
	State Rating Worksheet (each row)	# Part-Time	Agency only
	State Rating Worksheet (each row)	Estimated Annual Remuneration	Agency only
	State Rating Worksheet (each row)	Rate	Agency only
	State Rating Worksheet (each row)	Estimated Annual Premium	Agency only
23	Prior Carrier & Loss History (each row)	Prior Carrier	Required
24	Prior Carrier & Loss History (each row)	Year	Required
25	Prior Carrier & Loss History (each row)	Policy #	Optional
26	Prior Carrier & Loss History (each row)	Annual Premium	Required
27	Prior Carrier & Loss History (each row)	Experience Mod	Optional
28	Prior Carrier & Loss History (each row)	# of Claims	Required
29	Prior Carrier & Loss History (each row)	Amount Paid	Optional
30	Prior Carrier & Loss History (each row)	Reserve	Optional
31	Nature of Business	Description of Operations	Required
32	General Information	Does the applicant own, operate or lease aircraft or watercraft?	Required
33	General Information	Have past, present or discontinued operations involved storing, treating, discharging, applying, disposing or transporting hazardous material?	Required
34	General Information	Is any work performed underground or above 15 feet?	Required
35	General Information	Is any work performed on barges, vessels, docks or bridges over water?	Required
36	General Information	Is the applicant engaged in any other type of business?	Required
37	General Information	Are sub-contractors used? If yes (optional): Percentage of work subcontracted	Required
38	General Information	Is any work sublet without certificates of insurance?	Required
39	General Information	Is a written safety program in operation?	Required
40	General Information	Is any group transportation provided?	Required
41	General Information	Are any employees under 16 or over 60 years of age?	Required
42	General Information	Are any seasonal employees hired?	Required
43	General Information	Is there any volunteer or donated labor? If yes (optional): Specify	Required
44	General Information	Are there any employees with physical handicaps?	Required
45	General Information	Do employees travel out of state?	Required
46	General Information	Are athletic teams sponsored?	Required
47	General Information	Are physicals required after offers of employment are made?	Required
48	General Information	Any other insurance with this insurer?	Required
49	General Information	Any prior coverage declined, cancelled or non-renewed in the last 3 years? (Missouri applicants: skip)	Optional
50	General Information	Are employee health plans provided?	Required
51	General Information	Do any employees perform work for other businesses or subsidiaries?	Required
52	General Information	Do you lease employees to or from other employers?	Required
53	General Information	Do any employees predominantly work at home? If yes (optional): Number of employees	Required
54	General Information	Any tax liens or bankruptcy within the last 5 years? If yes (optional): Specify	Required
55	General Information	Any undisputed and unpaid workers compensation premium due from you or any commonly managed or owned enterprises? If yes (optional): Entity name(s) and policy number(s)	Required

ACORD 131 · Umbrella / Excess Section

Used for: Excess / Umbrella

25 required · 2 optional · 9 agency only

#	Section	Field	Status
1	Policy Information	Named Insured(s)	Required
2	Policy Information	Effective Date	Required
3	Policy Information	Policy Type	Required
4	Policy Information	Coverage Basis	Required
	Policy Information	Limit Requested	Agency only
	Policy Information	Self-Insured Retention	Agency only
5	Named Insureds, Locations & Descriptions (each row)	Insured Name	Required
5	Named Insureds, Locations & Descriptions (each row)	Location	Required
5	Named Insureds, Locations & Descriptions (each row)	Description of Operations	Required
	Schedule of Underlying Insurance (each row)	Coverage	Agency only
	Schedule of Underlying Insurance (each row)	Carrier	Agency only
	Schedule of Underlying Insurance (each row)	Policy #	Agency only
	Schedule of Underlying Insurance (each row)	Effective	Agency only
	Schedule of Underlying Insurance (each row)	Expiration	Agency only
	Schedule of Underlying Insurance (each row)	Limits	Agency only
	Schedule of Underlying Insurance (each row)	Premium	Agency only
6	Advertising	Media type used for promotional activities	Required
7	Advertising	Annual advertising cost	Required
8	Advertising	Are the services of an outside advertising agency used?	Required
9	Advertising	Is any coverage provided under the advertising agency's policy?	Required
10	Aircraft & Auto	Does the applicant own, lease or operate any aircraft?	Required
11	Aircraft & Auto	Are explosives, caustics, flammables or other dangerous cargo hauled?	Required
12	Aircraft & Auto	Are passengers carried for a fee?	Required
13	Aircraft & Auto	Are any units operated that are not insured by underlying policies?	Required
14	Aircraft & Auto	Are any vehicles leased or rented to others?	Required
15	Aircraft & Auto	Are hired and non-owned coverages provided?	Required
16	Contractors	Is bridge, dam or marine work performed?	Required
17	Contractors	Describe typical contracting jobs performed	Optional
18	Contractors	Describe contractual agreements / hold harmless provisions required from clients or subcontractors	Optional
19	Contractors	Does the applicant own, rent or use cranes?	Required
20	Contractors	Do subcontractors carry coverages or limits less than the applicant?	Required
21	Products & General	Is the applicant self-insured for workers compensation or liability in any state?	Required
22	Products & General	Do current or past products or components contain hazardous materials requiring special handling or disposal?	Required
23	Products & General	Are any products used or installed in aircraft or aerospace equipment?	Required
24	Products & General	Any foreign operations, foreign products distributed in the USA, or US products sold/distributed in foreign countries?	Required
25	Products & General	Does the applicant own or lease watercraft?	Required

ACORD 140 · Property Section

Used for: Commercial Property

18 required · 17 optional · 8 agency only

#	Section	Field	Status
1	Policy Information	Named Insured(s)	Required
2	Policy Information	Effective Date	Required
3	Premises & Building Information (each row)	Premises #	Required
4	Premises & Building Information (each row)	Street Address	Required
5	Premises & Building Information (each row)	Building #	Required
6	Premises & Building Information (each row)	Building Description	Required
7	Premises & Building Information (each row)	Construction Type	Required
8	Premises & Building Information (each row)	Distance to Fire Hydrant (ft)	Required
9	Premises & Building Information (each row)	Distance to Fire Station (mi)	Required
10	Premises & Building Information (each row)	Fire District	Required
11	Premises & Building Information (each row)	# of Stories	Required
12	Premises & Building Information (each row)	# of Basements	Required
13	Premises & Building Information (each row)	Year Built	Required
14	Premises & Building Information (each row)	Total Area (Sq Ft)	Required
15	Premises & Building Information (each row)	Wiring Updated (year)	Optional
16	Premises & Building Information (each row)	Roofing Updated (year)	Optional
17	Premises & Building Information (each row)	Plumbing Updated (year)	Optional
18	Premises & Building Information (each row)	Heating Updated (year)	Optional
19	Premises & Building Information (each row)	Roof Type	Required
20	Premises & Building Information (each row)	Primary Heat: Boiler?	Required
21	Premises & Building Information (each row)	Right Exposure & Distance	Optional
22	Premises & Building Information (each row)	Left Exposure & Distance	Optional
23	Premises & Building Information (each row)	Front Exposure & Distance	Optional
24	Premises & Building Information (each row)	Rear Exposure & Distance	Optional
25	Premises & Building Information (each row)	Burglar Alarm Type	Required
26	Premises & Building Information (each row)	Burglar Alarm Certificate #	Optional
27	Premises & Building Information (each row)	Certificate Expiration	Optional
28	Premises & Building Information (each row)	Central Station, Local or With Keys	Optional
29	Premises & Building Information (each row)	Burglar Alarm Installed & Serviced By	Optional
30	Premises & Building Information (each row)	Premises Fire Protection	Required
31	Premises & Building Information (each row)	If Sprinklered, %	Optional
32	Premises & Building Information (each row)	Fire Alarm Manufacturer	Optional
33	Premises & Building Information (each row)	Fire Alarm: Central Station or Local Gong	Optional
34	Premises & Building Information (each row)	Mortgage Company Name & Address (if mortgaged)	Optional
35	Premises & Building Information (each row)	Loan Number	Optional
	Premises & Building Information (each row)	Building Limit	Agency only
	Premises & Building Information (each row)	Business Personal Property Limit	Agency only
	Premises & Building Information (each row)	Business Income / Extra Expense	Agency only
	Premises & Building Information (each row)	Valuation	Agency only
	Premises & Building Information (each row)	Causes of Loss	Agency only
	Premises & Building Information (each row)	Coinsurance	Agency only
	Premises & Building Information (each row)	Deductible	Agency only
	Premises & Building Information (each row)	Protection Class	Agency only

GL Supplemental · General Liability Supplemental

Used for: General Liability

3 required · 3 optional · 0 agency only

Placeholder questions: no marked-up supplemental was provided yet. Send the supplemental form you use and these will be replaced.

Section	Field	Status
Operations Detail	Describe a typical job or day of operations	Required
Operations Detail	% Residential work	Optional
Operations Detail	% Commercial work	Optional
Operations Detail	Largest job in the past 3 years	Optional
Operations Detail	Are written contracts used with customers?	Required
Operations Detail	Does the applicant hold all required licenses? If yes (optional): License types and numbers	Required

Umbrella Supplemental · Excess / Umbrella Supplemental

Used for: Excess / Umbrella

2 required · 2 optional · 0 agency only

Placeholder questions: no marked-up supplemental was provided yet. Send the supplemental form you use and these will be replaced.

Section	Field	Status
Excess Exposure Detail	Reason for requesting umbrella (contract requirement, asset protection, etc.)	Optional
Excess Exposure Detail	Contractually required limit	Optional
Excess Exposure Detail	Any heavy trucks (over 26,000 lbs GVW)?	Required
Excess Exposure Detail	Has an umbrella policy been carried before? If yes (optional): Prior carrier and limit	Required