Email our Customer Success Team or check out our FAQs on Zendesk! Fill has a huge library of thousands of forms all set up to be filled in easily and signed. OR simply email Amanda@cig-llc.biz with a request for any Acord form that you need. << /Kids [ 8 0 R 9 0 R 10 0 R 11 0 R ] /T (���) >> Upload your own documents or access the thousands in our library. The Acord 125 Fillable form is 4 pages long and contains: 0 ... Acord-126- Fillable ACORD 0126 2016-09; Acord-140- Fillable ACORD 0140 2016-03r1; New Patient Health History Form; Request To Post Numeric Average Spring 2020 ; Noticeof Commencement Notice Of Commencement Form; Residential Roofing; Roofing Inspection Affidavit Mr; Unleashed Workbook; Engineering-Portfolio Succeeding In A … Send the above items to submissions@cig-llc.biz for underwriter assignment. ���Dy�؛e7��4̼��c}��'Wt�{�7My���@�g�\.���UntE T��#���_.+�v��x��x�Bne�O�����D�� ��8[����}M�97�6 �h{�W��I32%íN���xN�IFo������l���Ұ�n��䉈�@U.�SkQ ������A ����H�������zPS���N��n ��B���IB�"W'�2 �0.0UhfZ0;�8ي��$��c)���'�կ����Z1���ܻ�W"�B����+/��I�� e��`u %%EOF 0000014966 00000 n ANY FOREIGN OPERATIONS, FOREIGN PRODUCTS DISTRIBUTED IN USA, OR US PRODUCTS SOLD/DISTRIBUTED IN FOREIGN COUNTRIES? IS THE APPLICANT A SUBSIDIARY OF ANOTHER ENTITY ? Other items requested: Loss runs, copy of sub-contractor agreement, and requested contractual obligations (additional insured, waiver of subrogation, primary/non-contributory). (Not applicable in CO, FL, HI, MA, NE, OH, OK, OR, VT or WA; in DC, LA, ME, TN and VA, insurance benefits may also be denied), IN FLORIDA, ANY PERSON WHO KNOWINGLY AND. Send to someone else to fill in and sign. << /AcroForm << /DR << /Font << /F1 2 0 R >> >> /Fields [ 3 0 R ] /XFA 4 0 R >> /NeedsRendering false /Pages 5 0 R /Type /Catalog >>
1 0 obj 5. are subcontractors allowed to work without providing you with a certificate of insurance? 0000002409 00000 n 0000005894 00000 n Update it below and resend. CONDO ASSN BYLAWS (for D&O Coverage only), The ACORD name and logo are registered marks of ACORD, NAME (First Named Insured) AND MAILING ADDRESS (including ZIP+4), INTERNATIONAL LIABILITY EXPOSURE SUPPLEMENT, INTERNATIONAL PROPERTY EXPOSURE SUPPLEMENT, NAME (Other Named Insured) AND MAILING ADDRESS (including ZIP+4), PREMISES INFORMATION (Attach ACORD 823 for Additional Premises). 0000002232 00000 n 0000002822 00000 n stream Get started with our no-obligation trial. 0000001631 00000 n (Not applicable in all states, consult your agent or broker for your state's requirements.). https://www.youtube.com/watch?v=rIfT72r9wN8, https://www.youtube.com/watch?v=y_iLQQdYnzo, https://www.youtube.com/watch?v=T-Vu-aY6VvY, https://www.youtube.com/watch?v=HA86wnZcpFc&t=25s. endobj Click the verification link in your email to start sending, signing and downloading documents. endobj To get the most out of Fill, please switch to a free modern browser such as Google Chome or Safari. acord 125 (2013/01) $ $ $ $ effective date year expiration date premium policy number carrier category general liability automobile property other: prior carrier information remarks / processing instructions (acord 101, additional remarks schedule, may be attached if more space is required) page 3 of 4 13.does applicant have other business ventures for which coverage is not requested? ;6�mw�z(�ۧWP�{�!Tnx��Sy�(ԥֹ>��y�VG� ��-lX(>o�L9����( Ij�c�Ub=��Ac��������ˣE�.�����K����ڤ��0���B��scA�d���K����l4�`���GbcN��aFSVT�d�� ANY EXPOSURE TO FLAMMABLES, EXPLOSIVES, CHEMICALS? If you continue to use your current browser then Fill may not function as expected. REMARKS / PROCESSING INSTRUCTIONS (Attach ACORD 101, Additional Remarks Schedule, if more space is required), TYPE / DESCRIPTION OF OCCURRENCE OR CLAIM, COPY OF THE NOTICE OF INFORMATION PRACTICES (PRIVACY) HAS BEEN GIVEN TO THE APPLICANT. S�s�f��ZSY�@��/Z� �fB��]�b�P��y�? Stay connected: LinkedIn | Twitter | Facebook | Instagram | YouTube |Blog | Bigfoot Staff, Acords 125 and 126 for General Liability*, Acords 125, 126, and 140 are required for Commercial Package, Need a copy of an Acord? HAS APPLICANT HAD A FORECLOSURE, REPOSSESSION, BANKRUPTCY OR FILED FOR BANKRUPTCY DURING THE LAST FIVE (5) YEARS? Acords 125 and 126 for General Liability* Acords 125, 126, and 140 are required for Commercial Package. DOES APPLICANT HAVE OTHER BUSINESS VENTURES FOR WHICH COVERAGE IS NOT REQUESTED?
This document is locked as it has been sent for signing. startxref Complete Acord 125, 126 & 140 & Supplementals: Habitational . %æê„f ã}Ü^†…P _‘ğ�ÀS�íõ8˜™+AZül¢Ìi2_–Ï—¥³¿f4sĞ*½}³ 0000012231 00000 n Typically you receive an email about which underwriter assigned has been assigned to your submission overnight. DOES THE APPLICANT HAVE ANY SUBSIDIARIES? ^��q�W��~�в���"��%�%�jv%���dK;G�A�e�R: x�b```f``������� Ȁ �@1v��&�E'���I*g�;L Other parties need to complete fields in the document. ACORD Acord 125 Commercial Insurance Application Acord 126 Commercial General Liability Section Acord 127 Business Auto Section Acord 128 Garages and Dealers Section Acord 130 Workers’ Compensation Application Acord 130 CA Workers' Compensation Application Acord 131 Umbrella/Excess Section Acord 137 MA Commercial Auto Section Acord 140 Property Section Acord … ANY OTHER INSURANCE WITH THIS COMPANY? attach to acord 125 prem / ops products prem / ops loc # haz # class code premium basis classification description exposure terr prem / ops rate products prem / ops premium products loc # haz # class code premium basis exposure terr prem / ops products rate prem / ops products premium classification description. endobj You will recieve an email notification when the document has been completed by all parties. %PDF-1.6 endobj They are available here: https://commercialinsurance.surefyre.co/page/all-other/. If after going through those, if you still have some questions we would be happy to help you further. ÈŸşÙ-�úgwYí²ıVqİ£¦ëÆi¥…¸môö¤ÀÛêìlÛÙŠ¯D§Æu~1Z€*‡W. Restaurant / Bar / Tavern & Liquor Liability; Food Vendor Supplement; By Coverage Line. All submissions are handled in the order they are received. It is based on what the insured is requesting and since you will likely need to fill these out for all commercial needs its best for you fill them out so you can become comfortable with them. These ACORD forms are typically standardized forms for commercial insurance needs. If complete, you will receive 2-3 carriers in response. Also, our Auto & Trucking and Garage & Dealers department require separate applications: C.I.G Auto & Trucking Application or C.I.G Garage & Dealers Application. acord 140 (2011/10) ANY PERSON WHO KNOWINGLY AND WITH INTENT TO DEFRAUD ANY INSURANCE COMPANY OR ANOTHER PERSON FILES AN APPLICATION FOR INSURANCE OR STATEMENT OF CLAIM CONTAINING ANY MATERIALLY FALSE INFORMATION, OR CONCEALS FOR THE PURPOSE OF MISLEADING INFORMATION CONCERNING ANY %PDF-1.6 (If "YES", attach ACORD 815 for Liability Exposure and/or ACORD 816 for Property Exposure). (List policy numbers).
MAY SUBJECT THE PERSON TO CRIMINAL AND CIVIL PENALTIES.
In a world full of uncertainty, Acords assist us in assessing risk in the most efficient, accurate, and effective way.
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Complete Submissions = More Accounts Bound. ACORD Acord 125 Commercial Insurance Application Acord 126 Commercial General Liability Section Acord 127 Business Auto Section Acord 128 Garages and Dealers Section Acord 130 Workers’ Compensation Application Acord 130 CA Workers' Compensation Application Acord 131 Umbrella/Excess Section Acord 137 MA Commercial Auto Section Acord 140 Property Section Acord 144 Glass and … DEFRAUDING THE COMPANY. endobj Please check out these links to some awesome tutorials on how to fill these out. HAS APPLICANT HAD A JUDGEMENT OR LIEN DURING THE LAST FIVE (5) YEARS?
%PDF-1.7 %���� 0000018934 00000 n Fewer requests for additional information. Once finished you can manually add any additional fields and signatures to the document by dragging them from the toolbar. 0000000016 00000 n Acord 130 Workers Compensation. 0000004585 00000 n We get a lot of questions about why we use Acords. Complete Submissions = Better Pricing. There’s a full list of Acord Applications HERE.
�S�}l�}���#��B9M�X�p�zM���*�t�4�0>o��$c���}-�] Cancel at any time. 6 0 obj BRIBERY, ARSON OR ANY OTHER ARSON-RELATED CRIME IN CONNECTION WITH THIS OR ANY OTHER PROPERTY? 561 0 obj <> endobj {��t�#��"�-EE�/G�}G�81�;:N@$]��XF����^�C����Rnl� @�����PH� qXD���)�7$�L�1ga�� �Y�{L�մ�OF����[���[�g��s6�0;�4T2|a0r�;0;�5T1H1�0_`���@�����A����,/��L@���� Y� �� endobj Questions? 6 0 obj endobj Use Fill to complete blank online OTHERS pdf forms for free. OR BROKER FOR INSTRUCTIONS ON HOW TO SUBMIT A REQUEST TO US. #[����*V����=�4�����B��{���Q}A1簎��P��Z�ډk���գr�����. 0 4 0 obj trailer ���qw�^Ĥ`��s�@nA)G6wU� W�#�2K�� �N�vp��lz�n��Q�z�8#�8��EP��]����3e�p�������䳑Q��AL�b�egD$6:j]Z�p�p��k+}��R�h ������Q�D� �C���͡L0�T������R�����? << /Author (�X�+�}�I��"4�) /CreationDate (�!�I�krL�HB\n��zn����\f) /Creator (�r��/.�Sh��?,̄DƑpr,P�$Oe��}����ȁ:ۂ D���) /ModDate (�!�I�krL�HB\n��zn����\f) /Producer (�r��/.�Sh��?,̄DƑpr,P�"O|ɺ.����ȁS��X\r����?�) /Title (�X�+�}rH�IS\t��}v��) >> 0000004103 00000 n 0000005272 00000 n 0000003136 00000 n Fields are being added to your document to make it really easy to fill, send and sign this PDF. File type: PDF. 0000004851 00000 n Turn-around time varies from one day to a week, depending on the complexity of the account and number of revisions you provide. 3 0 obj PENALTIES INCLUDE IMPRISONMENT, FINES, AND DENIAL OF INSURANCE BENEFITS. 561 24 x��C1t��ڎk��*bXv� ip�Hb�!CY�A��4t2V�;Z{�U`h�Q���GK�A��v�;j�u�l����w�){6��¬�� ��*��o����Ô"�;t�����w��}F\�īyS�j��Ϧ�_�S�I����Z����]�D��*��FM?�jFF�8�^���x.$%�%���r�d�adM��D�����*��y[ m�$�&X[^��3�.j�v�rLI~��6�2��?�U��Ŋ�d�Ӆ�/����� �a~�44����s�����*��nK�h���F���R�����EB��E��L�K�Vu�� ���I�1���gS������j��\� ��V��~ ��=���S����V��^E ���+SyC� ��3lp�.1+��?y2O9�h{�Y�B�J�6�*q��[����]y8��vt�A��G����=�BF���"��r�`x���҆�C�.���4~b�׆g�F��.
0000002900 00000 n You're on your way to completing your first doc! Client Application.2020.