Remarks acord 101, additional remarks schedule, may be attached if more space is required general information continued explain all yes responses for all past or present operations y n page. The acord name and logo are registered marks of acord acord 36 200701. The acord name and logo are registered marks of acord. Using acords standardized forms allows for increased efficiency, accuracy. Property section acord 140 v03 yellowhammer insurance. Acord 140 fillable pdf business income extra expense attach acord value reporting information attach acord acord 09. Michigan application for workers compensation insurance.
The most secure digital platform to get legally binding, electronically signed documents in just a few seconds. Page 2 of 4 for multiple states, attach an additional page 2 of this form state rating worksheet n a in wisconsin n a n a n a. Acord 140 property section cluett commercial insurance agency. Property section date mmdd yyyy lenders loss payable attach to acord 125. The acord name and logo are registered marks of acord attach to acord 125 remarks acord 101, additional remarks schedule, may be attached if more space is required. This form is a section and should be attached to the acord125 when submitted. Remarks acord 101, additional remarks schedule, may be attached if more space is required mine subsidence coverage required in il, in, ky and wv accept coverage reject. Using acord s standardized forms allows for increased efficiency, accuracy.
Acord 125 201603 page 3 of 4 occur dateexplanation resolution resolve date occur dateexplanation resolution resolve date 14. If the policy has not been issued, a binder may be extended or renewed beyond such 90 days with the written approval of the. Fill out, securely sign, print or email your acord commercial application 125 126 140 jlny group instantly with signnow. Remarks acord 101, additional remarks schedule, may be attached if more space is required general information continued explain all yes responses for all past or present.
Prior carrier information remarks processing instructions acord 101, additional remarks schedule, may be attached if more space is required page 3 of 4. Acord 140 200209 fill online, printable, fillable, blank. Fill acord 140 200209, download blank or editable online. Property section date mmdd yyyy remarks acord 101, additional remarks schedule, may be attached if more space is required. Sign, fax and printable from pc, ipad, tablet or mobile with pdffiller instantly no software.
Remarks acord 101, additional remarks schedule, may be attached if more space is required page 5 of 5 applicable in or. Acord 140 fillable 2019 fill out and sign printable pdf. Remarks acord 101, additional remarks schedule, may be attached if more space is required acord 129 attached for additional vehicles page 3 of 4 agency customer id. Acord 140 201603 page 2 of 3 lenders loss payable the undersigned is an authorized representative of the applicant and represents that reasonable inquiry has been made to obtain the. Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. Other coverages, restrictions andor endorsements for hirednonowned auto coverages attach the applicable state business auto section, acord 7 acord 126 201109 page 2 of 4 agency customer id. Any person who knowingly and with intent to defraud or solicit another to defraud the insurer by submitting an application containing a false statement as to any material fact may be violating state law. Premises information attach acord 823 for additional premises. Start a free trial now to save yourself time and money. Use the sign tool to add and create your electronic signature to certify the acord commercial application 125 126 140 jlny group form.
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If yes, attach acord 815 for liability exposure andor acord 816 for property exposure 12. Acord 75 201603 page 2 of 2 applicable in montana no binder shall be valid beyond the issuance of the policy with respect to which it was given or beyond 90 days from its effective date, whichever period is the shorter. Evidence of property insurance north star mutual insurance. The acord name and logo are registered marks of acord acord 36 200701 current agency current producer insurance company name city of insured state of insured zip code of insured. The acord name and logo are registered marks of acord short description of changes remarks acord 101, additional remarks schedule, may be attached if more space is required policy type property general liability inland marine auto umbrella workers comp truckers business owners motor carriers this is an acknowledgement. Fill acord 140 mcneilandcompany instantly, edit online. Acord form 125 126 and 140 fill out and sign printable pdf. Acord workers comp application pdf 297kb acord 1 umbrella excess section pdf 264kb acord 9 statement of values pdf 125kb acord 140 property section pdf 261kb acord 152 commercial inland marine section pdf 374kb acord 155 equipment breakdown section pdf 120kb acord 25 certificate of liability insurance pdf 100kb. Property section acord 140 201603 property section acord 140 201603 to create this form, you may begin at the policy or package level. Page 2 of 4 for multiple states, attach an additional page 2 of this form state rating worksheet n a in wisconsin n a n a n a modification taxes. Fill out, securely sign, print or email your acord 140 20112020 form instantly with signnow. Additional premises information schedule page of acord. The acord name and logo are registered marks of acord acord 140 201603. Fill out, securely sign, print or email your acord 140 2011 2020 form instantly with signnow.