Accord Commerical Insurance Form

The certificate of insurance on the reverse side of this form does not constitute a contract between the issuing insurer s authorized.

Accord commerical insurance form. The acord name and logo are registered marks of acord applicant information underwriter underwriter office commercial insurance application date mm dd yyyy applicant information section fax a c no. Of or the rating of an insurance policy for personal or commercial insurance or a claim for payment or other benefit pursuant to an insurance policy for. Remarks acord 101 additional remarks schedule may be attached if more space is required policy number effective date company subject to audit premium calculation. Acord certificate of liability insurance.

Using acord s standardized forms allows for increased efficiency accuracy and speed of information processing. Surrender your registration certificate and plates before your insurance expires. Commercial general liability sections attached policy information proposed eff date proposed exp date direct agency billing plan payment plan audit deposit policy premium. The acord name and logo are registered marks of acord applicant information underwriter underwriter office commercial insurance application date mm dd yyyy applicant information section fax a c no.

Contact a c no ext. The acord name and logo are registered marks of acord y n 4. By law we must report the termination of auto insurance coverage to the department of motor vehicles. Notice of insurance information practices personal information about you may be collected from persons.

Acord 25 2001 08 if the certificate holder is an additional insured the policy ies must be endorsed. Disease ea employee e l. Since our first paper form was released in 1972 acord has provided the standard forms used by the insurance industry. Description of operations locations vehicles attach acord 101 additional remarks schedule if more space is required insr ltr type of insurance policy number policy eff mm dd yyyy policy exp mm dd yyyy limits wc statu tory limits oth er e l.

Disease policy limit any proprietor. Commercial general liability premises ea occurence. E mail status of transaction quote issue policy renew. Acord forms are now available in a variety of formats including printable pdf electronic fillable and eforms.

The acord name and logo are registered marks of acord.