Section Name |
Field Name |
Field and/or Section Description |
TITLEACORD 159 (2004/03) |
Schedule of Property Limits |
ACORD 159, Schedule of Property Limits, was developed to assist in the collection of information when multiple locations owned or operated by the same insured will be covered by the same policy, but separate limits willapply. This type of schedule is often used as an attachment to a policy declaration page, because of space limitations on the declarations.If an average blanket rate is desired, use ACORD 139. |
IDENTIFICATION SECTION |
Date |
Month/day/year (MM/DD/YYYY) on which the form is completed. |
IDENTIFICATION SECTION |
Agency |
Agency’s name and address. |
IDENTIFICATION SECTION |
Phone (A/C, No., Ext.) |
Agency’s telephone number. Include area code and extension (if applicable). |
IDENTIFICATION SECTION |
Fax No. |
Agency’s fax number. (Include area code) |
IDENTIFICATION SECTION |
Code |
Identification code assigned to the agency or the brokerage firm by the insurance company receiving this form. |
IDENTIFICATION SECTION |
Subcode |
If the agency uses a subcode identification system with the company, use the appropriate code. |
IDENTIFICATION SECTION |
Agency Customer ID |
Customer’s identification number assigned by the agency. |
IDENTIFICATION SECTION |
Company |
Name of the applicable insurance company. Do not use group names, use the actual name of the company within the group in which you wish to have the policy issued. |
IDENTIFICATION SECTION |
NAIC Code |
The company code assigned by the National Association of Insurance Commissioners. |
IDENTIFICATION SECTION |
Page |
If more than one ACORD 159 form is required because of the number of properties to be included, indicate the page number applicable and the total number of pages. (e. g., page 1 of 5, page 2 of 4.) |
IDENTIFICATION SECTION |
Insured/Applicant |
Show the name of the insured or applicant as it appears on the policy. |
IDENTIFICATION SECTION |
Policy # |
The number assigned by the insurance company for the policy. |
IDENTIFICATION SECTION |
Effective Date |
Enter the effective date of the policy. |
IDENTIFICATION SECTION |
Headquarters Address |
Enter the principle address of the insured. |
IDENTIFICATION SECTION |
Coins % |
Check the applicable coinsurance percentage, 80%, 90% or 100%. If a different percentage, list next to blank box. |
IDENTIFICATION SECTION |
Applicable Cause of Loss |
Indicate the cause of loss for the subject of insurance. Use blank check boxes to identify other causes not listed as options. |
IDENTIFICATION SECTION |
Class Code |
Enter the ISO or company class codes, if applicable. |
IDENTIFICATION SECTION |
LOC # |
For each building, enter the location number. |
IDENTIFICATION SECTION |
Bldg # |
For each building, enter the building number. |
IDENTIFICATION SECTION |
Description and Address of property |
For each building, enter the address shown on the application or change request that was used when the building or the contents was first insured. Provide a description of the property where necessary. Use more than one line if additional space is needed. |
IDENTIFICATION SECTION |
Subject |
Enter the applicable Subject number for each item of insurance, as shown in theinstructions at the bottom of the form (e. g., B = building, S = stock.) |
IDENTIFICATION SECTION |
Limits of Insurance |
Enter the limits of insurance for each separate item. |
IDENTIFICATION SECTION |
Total |
Enter the total limits of insurance. |