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ACORD 328 (2006/04) 1 of 6
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Universal wording updates to improve clarity and intent were made to all FIG text for this form on 06/12/2009. |
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Section Name |
Field Name |
Field and/or Section Description |
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TITLE ACORD 328 (2006/04) |
Private Hangar Liability Section |
The title of the form. ACORD 328, Private Hangar Liability Section, is used in conjunction with ACORD 325, Aviation Insurance Application - Applicant Information Section, for hangar liability insurance. Attach ACORD 332, Hangar Schedule, if necessary. |
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IDENTIFICATION SECTION |
Date (MM/DD/YYYY) |
Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY) |
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IDENTIFICATION SECTION |
Agency |
Enter text: The full name of the producer/agency. |
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IDENTIFICATION SECTION |
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Enter text: The mailing address line one of the producer/agency. |
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IDENTIFICATION SECTION |
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Enter text: The mailing address city name of the producer/agency. |
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IDENTIFICATION SECTION |
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Enter code: The mailing address state or province code of the producer/agency. |
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IDENTIFICATION SECTION |
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Enter code: The mailing address postal code of the producer/agency. |
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IDENTIFICATION SECTION |
Phone (A/C, No, Ext) |
Enter number: The producer's contact person's phone number. If applicable, include the area code and extension. |
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IDENTIFICATION SECTION |
Fax No. (A/C, No) |
Enter number: The fax number of the producer/agency. |
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IDENTIFICATION SECTION |
E-Mail Address |
Enter text: The producer's contact person e-mail address. |
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IDENTIFICATION SECTION |
Code |
Enter code: The identification code assigned to the producer (e.g. agency or brokerage firm) by the insurer. |
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IDENTIFICATION SECTION |
Subcode |
Enter code: The identification code assigned by the insurer to the sub-producer (e.g. person) within a producer's office (e.g. agency or brokerage). |
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IDENTIFICATION SECTION |
Agency Customer ID |
Enter identifier: The customer's identification number assigned by the producer (e.g. agency or brokerage). |
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IDENTIFICATION SECTION |
Applicant (First Named Insured) |
Enter text: The named insured(s) as it/they will appear on the policy declarations page. |
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IDENTIFICATION SECTION |
Effective Date |
Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence. |
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IDENTIFICATION SECTION |
Expiration Date |
Enter date: The date on which the terms and conditions of the policy will expire. |
ACORD 328 (2006/04) 2 of 6
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Section Name |
Field Name |
Field and/or Section Description |
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IDENTIFICATION SECTION |
Direct Bill |
Check the box (if applicable): Indicates if the policy is to be direct billed. |
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IDENTIFICATION SECTION |
Agency Bill |
Check the box (if applicable): Indicates if the policy is to be producer/agency billed. |
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IDENTIFICATION SECTION |
Payment Plan |
Enter code: The payment plan for the policy (i.e., AN - Annual, MO - Monthly, QT -Quarterly, etc.). |
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IDENTIFICATION SECTION |
Audit |
Enter code: The audit term for policies that are subject to periodic audit. If the audit period is known, enter the code; A - annual, S - semi-annual, Q - Quarterly, M - Monthly, O -Other. |
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IDENTIFICATION SECTION |
Estimated Annual Premium |
Enter amount: The estimated annual premium amount for the Hangar Liability line of business. |
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HANGAR INFORMATION |
Location # |
Enter number: The location number for the premises. |
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HANGAR INFORMATION |
Building # |
Enter number: The building number for the premises. Used when more than one building exists at an individual location. |
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HANGAR INFORMATION |
Airport ID |
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -O'Hare International Airport). |
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HANGAR INFORMATION |
Airport Name |
Enter text: The full name of the location. |
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HANGAR INFORMATION |
Number of Hangars Insured |
Enter number: The number of hangars insured. |
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HANGAR INFORMATION |
Number of Aircraft Owners Stores in the Insured Hangar. |
Enter number: The number of aircraft the owner stores in the insured hangar. |
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HANGAR INFORMATION |
Maximum Value of all Aircraft Stored in the Hangar. |
Enter amount: The maximum value of all aircraft stored in the hangar. |
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HANGAR INFORMATION |
Number of Hangar Spaces you Lease. |
Enter number: The number of hangar spaces leased by the insured. |
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HANGAR INFORMATION |
Make One |
Enter text: The manufacturer of the aircraft. |
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HANGAR INFORMATION |
Model One |
Enter text: The model of the aircraft. |
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HANGAR INFORMATION |
Make Two |
Enter text: The manufacturer of the aircraft. |
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HANGAR INFORMATION |
Model Two |
Enter text: The model of the aircraft. |
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HANGAR INFORMATION |
Make Three |
Enter text: The manufacturer of the aircraft. |
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HANGAR INFORMATION |
Model Three |
Enter text: The model of the aircraft. |
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HANGAR INFORMATION |
Who has access to Leased Hangars? |
Enter text: The description of all parties that have access to leased hangars. |
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HANGAR INFORMATION |
Liability and Physical Damage Insurance Company. |
Enter text: The insurer name on any other applicable insurance. As used here, this is the liability and physical damage insurance company. |
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HANGAR INFORMATION |
Description of Hangar. |
Enter text: The description of the hangar. |
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HANGAR INFORMATION |
Describe other items in storage. |
Enter text: The description of items other than aircraft that are stored in the hangar. |
ACORD 328 (2006/04) 3 of 6
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Section Name |
Field Name |
Field and/or Section Description |
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HANGAR INFORMATION |
Describe any Commercial Operations you or your tenant carry out in the hangar. |
Enter text: The description of any commercial operations you or your tenant carry out in the hangar. |
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HANGAR INFORMATION |
If you are required to sign airport hangar agreements with your city, with whom are the agreements signed? |
Enter text: The person and / or position of the person within the city with whom you are required to sign airport hangar agreements. |
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GENERAL INFORMATION |
Do you require hangar tenants to carry insurance? Yes |
Check the box (if applicable): Indicates a "Yes" response to the question, "Do you require hangar tenants to carry insurance?". |
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GENERAL INFORMATION |
Do you require hangar tenants to carry insurance? No |
Check the box (if applicable): Indicates a "No" response to the question, "Do you require hangar tenants to carry insurance?". |
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GENERAL INFORMATION |
If yes, does their insurance policy name the owner as an additional insured? Yes |
Check the box (if applicable): Indicates a "Yes" response to the question, "If you require hangar tenants to carry insurance, does their insurance policy name the owner as an additional insured?". |
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GENERAL INFORMATION |
If yes, does their insurance policy name the owner as an additional insured? No |
Check the box (if applicable): Indicates a "No" response to the question, "If you require hangar tenants to carry insurance, does their insurance policy name the owner as an additional insured?". |
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GENERAL INFORMATION |
Do you require tenants to sign a hangar agreement holding you harmless for losses not caused by you? Yes |
Check the box (if applicable): Indicates a "Yes" response to the question, "Do you require tenants to sign hangar agreement holding you harmless for losses not caused by you?". |
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GENERAL INFORMATION |
Do you require tenants to sign a hangar agreement holding you harmless for losses not caused by you? No |
Check the box (if applicable): Indicates a "No" response to the question, "Do you require tenants to sign hangar agreement holding you harmless for losses not caused by you?". |
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GENERAL INFORMATION |
Are any aircraft of others taxied, towed or moved by applicant? Yes |
Check the box (if applicable): Indicates a "Yes" response to the question, "Are any aircraft of others taxied, towed or moved by applicant?". |
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GENERAL INFORMATION |
Are any aircraft of others taxied, towed or moved by applicant? No |
Check the box (if applicable): Indicates a "No" response to the question, "Are any aircraft of others taxied, towed or moved by applicant?". |
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ADDITIONAL INSUREDS |
Name And Address |
Enter text: The additional interest's full name. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address line one. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address line two. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's mailing address state or province code. |
ACORD 328 (2006/04) 4 of 6
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Section Name |
Field Name |
Field and/or Section Description |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's mailing address postal code. |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's country code. |
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ADDITIONAL INSUREDS |
Certificate Required |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
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ADDITIONAL INSUREDS |
Reason For Interest |
Enter text: The description for the interest in the item. |
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ADDITIONAL INSUREDS |
Phone |
Enter number: The primary phone number of the additional interest. |
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ADDITIONAL INSUREDS |
Fax |
Enter number: The primary fax number of the additional interest. |
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ADDITIONAL INSUREDS |
E-Mail |
Enter text: The primary e-mail address for the additional interest. |
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ADDITIONAL INSUREDS |
Name And Address |
Enter text: The additional interest's full name. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address line one. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address line two. |
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ADDITIONAL INSUREDS |
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Enter text: The additional interest's mailing address city name. |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's mailing address state or province code. |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's mailing address postal code. |
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ADDITIONAL INSUREDS |
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Enter code: The additional interest's country code. |
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ADDITIONAL INSUREDS |
Certificate Required |
Check the box (if applicable): Indicates if the additional interest requires a Certificate of Insurance, |
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ADDITIONAL INSUREDS |
Reason For Interest |
Enter text: The description for the interest in the item. |
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ADDITIONAL INSUREDS |
Phone |
Enter number: The primary phone number of the additional interest. |
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ADDITIONAL INSUREDS |
Fax |
Enter number: The primary fax number of the additional interest. |
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ADDITIONAL INSUREDS |
E-Mail |
Enter text: The primary e-mail address for the additional interest. |
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COVERAGES |
Hangarkeepers Legal Liability Including Taxi |
Check the box (if applicable): Indicates the including taxi option applies to the coverage. |
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COVERAGES |
Hangarkeepers Legal Liability In Flight |
Check the box (if applicable): Indicates the in flight option applies to the coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Other Option |
Check the box (if applicable): Indicates a coverage option applies to the coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Describe Other Option |
Enter text: The description of the option being requested. Example: Ground Only. |
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COVERAGES |
Hangarkeepers Legal Liability Limit Each Aircraft |
Enter limit: The each aircraft limit amount for hangarkeepers legal liability coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Limit Each Occurrence |
Enter limit: The each occurrence limit amount for hangarkeepers legal liability coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Deductible |
Enter deductible: The deductible amount for hangarkeepers legal liability coverage. |
ACORD 328 (2006/04) 5 of 6
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Section Name |
Field Name |
Field and/or Section Description |
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COVERAGES |
Hangarkeepers Legal Liability Applies To |
Enter code: The code identifying what the deductible applies to. Examples: Each and Every Loss, Turbine Aircraft, Airline, Property Damage, Each Occurrence |
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COVERAGES |
Hangarkeepers Legal Liability Deductible |
Enter deductible: The deductible amount for hangarkeepers legal liability coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Applies To |
Enter code: The code identifying what the deductible applies to. Examples: Each and Every Loss, Turbine Aircraft, Airline, Property Damage, Each Occurrence |
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COVERAGES |
Hangarkeepers Legal Liability Deductible |
Enter deductible: The deductible amount for hangarkeepers legal liability coverage. |
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COVERAGES |
Hangarkeepers Legal Liability Applies To |
Enter code: The code identifying what the deductible applies to. Examples: Each and Every Loss, Turbine Aircraft, Airline, Property Damage, Each Occurrence |
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COVERAGES |
Hangarkeepers Legal Liability Premium |
Enter amount: The premium amount for hangarkeepers legal liability coverage. |
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COVERAGES |
Coverage Code |
Enter code: The code for the coverage. |
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COVERAGES |
Coverage Description |
Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s) |
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COVERAGES |
Option |
Check the box (if applicable): Indicates a coverage option applies to the coverage. |
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COVERAGES |
Option Description |
Enter text: The description of the option being requested. |
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COVERAGES |
Option |
Check the box (if applicable): Indicates a coverage option applies to the coverage. |
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COVERAGES |
Option Description |
Enter text: The description of the option being requested. |
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COVERAGES |
Limit |
Enter limit: The limit amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the limit applies to (i.e. per occurrence). |
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COVERAGES |
Limit |
Enter limit: The limit amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the limit applies to (i.e. per occurrence). |
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COVERAGES |
Deductible |
Enter deductible: The deductible amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the deductible applies to. |
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COVERAGES |
Deductible |
Enter deductible: The deductible amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the deductible applies to. |
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COVERAGES |
Premium |
Enter amount: The premium amount for the coverage. |
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COVERAGES |
Coverage Code |
Enter code: The code for the coverage. |
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COVERAGES |
Coverage Description |
Enter text: The description of other coverage (not the limit) on the policy. Any questions about appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s) |
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COVERAGES |
Option |
Check the box (if applicable): Indicates a coverage option applies to the coverage. |
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COVERAGES |
Option Description |
Enter text: The description of the option being requested. |
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COVERAGES |
Option |
Check the box (if applicable): Indicates a coverage option applies to the coverage. |
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Section Name |
Field Name |
Field and/or Section Description |
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COVERAGES |
Option Description |
Enter text: The description of the option being requested. |
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COVERAGES |
Limit |
Enter limit: The limit amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the limit applies to (i.e. per occurrence). |
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COVERAGES |
Limit |
Enter limit: The limit amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the limit applies to (i.e. per occurrence). |
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COVERAGES |
Deductible |
Enter deductible: The deductible amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the deductible applies to. |
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COVERAGES |
Deductible |
Enter deductible: The deductible amount for the coverage. |
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COVERAGES |
Applies To |
Enter code: The code identifying what the deductible applies to. |
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COVERAGES |
Premium |
Enter amount: The premium amount for the coverage. |
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Edition |
Date |
The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM). |
ACORD 328 (2006/04) 6 of 6
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