Accord Insurance Form Instructions

This form is used as tangible evidence of the insured s instruction to cancel a contract.

Accord insurance form instructions. This guide provides basic instructions for completing the acord cancellation request policy release form. The title of the form. By law we must report the termination of auto insurance coverage to the department of motor vehicles. This certificate does not affirmatively or negatively amend extend or alter the coverage afforded by policies.

Acord forms are now available in a variety of formats including printable pdf electronic fillable and eforms. We encourage you to consult with your carrier legal and underwriting department for additional guidance. 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. Attach to acord 126 and or acord 160 loc classification description class code premium basis haz exposure terr t other u unit per unit m admissions per 1 000 adm c total cost per 1 000 cost a area per 1 000 sq ft p payroll per 1 000 pay s gross sales per 1 000 sales rating and premium basis.

It explains information the company needs to process the transaction. The certificate of insurance on the reverse side of this form does not constitute a contract between the issuing insurer. Acord 25 2001 08 if the certificate holder is an additional insured the policy ies must be endorsed. Here is a list of the available instruction guides for registered users.

Instructions for completing the acord certificate of liability insurance form acord 25 version. Producer insert the complete name and address of the insurance agency or broker issuing this. Disease ea employee e l. An authorized representative is usually determined by the carrier legal and underwriting department.

Acord forms home acord forms web version contact us important notice. Date mm dd yyyy this is the date the certificate is generated. Acord 25 certificate of liability insurance is issued as a matter of information only and confers no rights upon the certificate holder. In order to be in compliance with the acord license agreement legally we cannot offer the acord forms instruction guides.

The acord forms instruction guide fig recommends that acord forms be signed by an authorized representative. Acord certificate of liability insurance. Disease policy limit any proprietor. Please sign up for our fillable acord forms here.

Field and or section description. Since our first paper form was released in 1972 acord has provided the standard forms used by the insurance industry. Type of insurance policy number date mm dd yy date mm dd yy limits. Remarks acord 101 additional remarks schedule may be attached if more space is required policy number effective date company subject to audit premium calculation.