ACORD field requirements
Which fields the online forms require, by coverage line. Field numbers match the agency's marked-up ACORD forms and questionnaires.
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 |
|---|---|
| Excess / Umbrella | ACORD 125 + ACORD 126 + ACORD 131 + Umbrella Supplemental |
ACORD 125 · Commercial Insurance Application
Used for: Excess / Umbrella
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: 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 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 |
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 |