ACORD 23 Instructions



ACORD 23 (1/99) Leased Auto Certificate of Insurance

Use this form to provide a coverage statement with respect to physical damage and/or liability insurance coverage to lessors or loss payers of leased vehicles, but only when the insurance policy covering the subject motor vehicle includes an "Additional Insured-Lessor" endorsement or a "loss payee endorsement" that contains a statement that the insurance company will send a notice to the lessor or loss payee in the event of policy termination.

For all other situations requiring certification of property or liability insurance or evidence of property insurance, use ACORD 24, Certificate of Property Insurance; ACORD 25, Certificate of Liability Insurance; ACORD 27, Evidence of Personal Property Insurance,or ACORD 28, Evidence of Commercial Property Insurance..

IMPORTANT

Kentucky, Minnesota, North Carolina and Wisconsin require the filing of certificate of insurance forms. ACORD has filed all of its certificates in these states.

In these states, the text of ACORD's certificates cannot be modified, unless the modified form is filed for approval by the respective state Departments of Insurance.

Additionally, virtually every other state will not allow any change in a certificate of insurance that would attempt to modify a policy unless the revised certificate is filed and approved.

IDENTIFICATION SECTION

Date
Month, Day, year on which the form is completed.

Producer
Name, address, and phone number of the producer or broker issuing the form.

Insured
Insured's name and address as they appear on the policy declarations page.

Company
Name of the company issuing the policy.

Lease Number
Lease number providd by the organization issuing the lease.

Policy Number
Policy number assigned by the isuing company.

Effective Date
Date on which the terms and conditions of the policy commenced.

Expiration Date
Date on which the terms and conditions of the policy expire.

Continued until terminated if checked
If the policy was issued on a continuing basis, check the available box.

DESCRIPTION OF LEASED AUTO

Enter the year, make, model, body type, and Vehicle Identification Number for the leased vehicle.

COVERAGES

Enter the coverage information for both liability and physical damage, as described on the policy declarations pge.

REMARKS

Use this space to provide information about additional coverages, or special conditions included in the policy.

CERTIFICATE HOLDER

Name and mailing address of the individual or entity for whom the certificate is being prepared.



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