ACORD 82 2013/09 Watercraft Application
| Sagitta Page Name | Form Section Name | Sagitta Field Name | Sagita Field-Input Details | Form Field Name |
|---|---|---|---|---|
| Client Details | IDENTIFICATION SECTION | Phone Type | Select H | Home (checkbox) |
| Client Details | IDENTIFICATION SECTION | Phone Type | Select B | Bus (checkbox) |
| Client Details | IDENTIFICATION SECTION | Phone Type | Select C | Cell (checkbox) |
| Client Details | IDENTIFICATION SECTION | Phone Type | Select H | Home (checkbox) |
| Client Details | IDENTIFICATION SECTION | Phone Type | Select B | Bus (checkbox) |
| Client Details | IDENTIFICATION SECTION | Phone Type | Select C | Cell (checkbox) |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Type | Select Coverage Code "HULL" | ACV (checkbox) |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Type | Select Coverage Code "HULL" | RC (checkbox) |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit #2 | Select Coverage Code "WATER" | Liability - Limit CSL / BI ea Acc |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit #2 | Select Coverage Code "WUI" | Uninsured Boaters Liability CSL / BI - Limit ea acc |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit #2 | Select Coverage Code WUNCS &"WUNDI". | Underinsured Boaters Liability CSL / BI - Limit ea acc |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit or Percentage | Coverage Code "CSL" | Liability - Limit CSL / BI ea Acc |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit or Percentage | Coverage Code "WUCSL" | Uninsured Boaters Liability CSL / BI - Limit ea acc |
| Watercraft Coverage | COVERAGES / LIMITS OF LIABILITY | Limit or Percentage | Coverage Code "WUCSL" | Underinsured Boaters Liability CSL / BI - Limit ea acc |
| Sagitta Page Name | Form Section Name | Sagitta Field Name | Sagita Field-Input Details | Form Field Name |
|---|---|---|---|---|
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E & R | Power - Inboard |
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E & R | Outboard |
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E & R | Inboard/Outdrive |
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E & R | Waterjet |
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E & R | Sail |
| Watercraft Coverage | BOAT HULL | Propulsion | Enter other than below watercraft coverage code 6, 7, A, E , R, 1, 2, 3, 4 & 6 | Other |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Type of Hull - Cabin Cruiser |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Open Cockpit |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Sailboat |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Pontoon |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Bass |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Personal WC |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E & R | Ski |
| Watercraft Coverage | BOAT HULL | Water Unit Type | Enter other than below watercraft coverage code 6, 7, A, E , R, 1, 2, 3, 4.8,9, 0,E, P & R | Other |
| Watercraft Coverage | BOAT HULL | Hull Material | Enter other than below watercraft coverage code 6, 7, A, E & R | Hull Material - Fiberglass |
| Watercraft Coverage | BOAT HULL | Hull Material | Enter other than below watercraft coverage code 6, 7, A, E & R | Metal |
| Watercraft Coverage | BOAT HULL | Hull Material | Enter other than below watercraft coverage code 6, 7, A, E & R | Wood |
| Watercraft Coverage | BOAT HULL | Hull Design | Enter other than below watercraft coverage code 6, 7, A, E & R | Hull Design - Flat Bottom |
| Watercraft Coverage | BOAT HULL | Hull Design | Enter other than below watercraft coverage code 6, 7, A, E & R | Round Bottom |
| Watercraft Coverage | BOAT HULL | Hull Design | Enter other than below watercraft coverage code 6, 7, A, E & R | Vee Bottom |
| Watercraft Coverage | BOAT HULL | Hull Design | Enter other than below watercraft coverage code 6, 7, A, E & R | Catamaran |
| Watercraft Coverage | BOAT HULL | Hull Design | Enter other than below watercraft coverage code 6, 7, A, E, R, F, R, V & C | Other |
| Watercraft Coverage | BOAT HULL | FuelTank | Enter other than below watercraft coverage code 6, 7, A, E, R, | Fuel Tank - Fiberglass |
| Watercraft Coverage | BOAT HULL | FuelTank | Enter other than below watercraft coverage code 6, 7, A, E, R, | Metal |
| Watercraft Coverage | BOAT HULL | Waters Navigated |
Enter other than below watercraft coverage code 6, 7, A, E, R, Enter water navigated coverage code "A", "B" |
Waters Navigated - Atlantic (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, | Great Lakes (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, | Inland Waterways (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, | Pacific (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, | Rivers (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, M & B. | Gulf of Mexico (checkbox) |
| Watercraft Coverage | BOAT HULL | Waters Navigated | Enter other than below watercraft coverage code 6, 7, A, E, R, A, B, G, I, P, R, M | Other (checkbox) |
| Watercraft Underwriting | BOAT HULL | LayUp | Enter other than below watercraft coverage code 6, 7, A, E, R, | Lay-Up Period - Dry (checkbox) |
| Watercraft Underwriting | BOAT HULL | Lay - Up | Enter other than below watercraft coverage code 6, 7, A, E, R, | Afloat (checkbox) |
| Watercraft Underwriting | BOAT HULL | Year | Enter other than below watercraft coverage code 6, 7, A, E, R | Year |
| Watercraft Underwriting | BOAT HULL | Craft Manufacturer & Model | Enter other than below watercraft coverage code 6, 7, A, E, R | Manufacturer |
| Watercraft Underwriting | BOAT HULL | Length | Enter other than below watercraft coverage code 6, 7, A, E, R | Length |
| Watercraft Underwriting | BOAT HULL | Max Speed | Enter other than below watercraft coverage code 6, 7, A, E, R | Max Speed |
| Watercraft Underwriting | BOAT HULL | Purchase Date | Enter other than below watercraft coverage code 6, 7, A, E, R | Purchase Date |
| Watercraft Underwriting | BOAT HULL | Cost New | Enter other than below watercraft coverage code 6, 7, A, E, R | Cost New |
| Watercraft Underwriting | BOAT HULL | Present Value | Enter other than below watercraft coverage code 6, 7, A, E, R | Present Value |
| Watercraft Underwriting | BOAT HULL | Boat Name | Enter other than below watercraft coverage code 6, 7, A, E, R | Boat Name |
| Watercraft Underwriting | BOAT HULL | Registration # | Enter other than below watercraft coverage code 6, 7, A, E, R | Registration # |
| Watercraft Underwriting | BOAT HULL | Serial Number | Enter other than below watercraft coverage code 6, 7, A, E, R | Serial Number |
| Watercraft Underwriting | BOAT HULL | Territory Code | Enter other than below watercraft coverage code 6, 7, A, E, R | Territory Code |
| Watercraft Underwriting | BOAT HULL | Berth /Storage Loc | Enter other than below watercraft coverage code 6, 7, A, E, R | Berth /Storage Loc |
| Watercraft Underwriting | ENGINE/MOTOR | Year | Enter watercraft unit type "6" | Year |
| Watercraft Underwriting | ENGINE/MOTOR | Craft Manufacturer & Model | Enter watercraft unit type "6" | Manufacturer |
| Watercraft Underwriting | ENGINE/MOTOR | Serial # | Enter watercraft unit type "6" | Serial Number |
| Watercraft Underwriting | ENGINE/MOTOR | Horsepower | Enter watercraft unit type "6" | Horsepower |
| Watercraft Underwriting | ENGINE/MOTOR | Purchase Date | Enter watercraft unit type "6" | Date Purchased |
| Watercraft Underwriting | ENGINE/MOTOR | Cost New | Enter watercraft unit type "6" | Cost New |
| Watercraft Underwriting | ENGINE/MOTOR | Present Value | Enter watercraft unit type "6" | Present Value |
| Watercraft Underwriting | ENGINE / MOTOR | Fuel Type | Enter watercraft unit type "6" | Fuel - Gasoline |
| Watercraft Underwriting | ENGINE / MOTOR | Fuel Type | Enter watercraft unit type "6" | Diesel |
| Watercraft Underwriting | ENGINE / MOTOR | Fuel Type | Enter watercraft unit type "6" | Battery |
| Watercraft Underwriting | ENGINE / MOTOR | Fuel Type | Enter watercraft unit type "6" | Other (checkbox) |
| Watercraft Underwriting | ENGINE / MOTOR | FuelType | Enter watercraft unit type "6" | Fuel - Gasoline |
| Watercraft Underwriting | ENGINE / MOTOR | FuelType | Enter watercraft unit type "6" | Diesel |
| Watercraft Underwriting | ENGINE / MOTOR | FuelType | Enter watercraft unit type "6" | Battery |
| Watercraft Underwriting | ENGINE / MOTOR | FuelType | Enter watercraft unit type "6" | Other (checkbox) |
| Watercraft Underwriting | TRAILER | Year | Enter watercraft unit type "7" | Year |
| Watercraft Underwriting | TRAILER | Craft Manufacturers & Model | Enter watercraft unit type "7" | Manufacturer |
| Watercraft Underwriting | TRAILER | Serial # | Enter watercraft unit type "7" | Serial Number |
| Watercraft Underwriting | TRAILER | Trailers # of Axles | Enter watercraft unit type "7" | # Axles |
| Watercraft Underwriting | TRAILER | Trailer Capacity | Enter watercraft unit type "7" | Capacity |
| Watercraft Underwriting | TRAILER | Purchase Date | Enter watercraft unit type "7" | Date Purchased |
| Watercraft Underwriting | TRAILER | Cost New | Enter watercraft unit type "7" | Cost |
| Sagitta Page Name | Form Section Name | Sagitta Field Name | Sagita Field-Input Details | Form Field Name |
|---|---|---|---|---|
| Miscellaneous Underwriting | GENERAL INFORMATION | Has applicant had a foreclosure, repossession, bankruptcy or filed for bankruptcy during the past five (5) years | Select Y / N Enter Question Code GENRL25 | 3. Has applicant had a foreclosure, repossession, bankruptcy or filed for bankruptcy during the past five (5) years? |
| Miscellaneous Underwriting | GENERAL INFORMATION | Question code | Select Y / N Enter Question Code GENRL25 | Explanation |
| Homeowners Underwriting | GENERAL INFORMATION | Question code | Select Question Code GENRL25 | 3. Has applicant had a foreclosure, repossession, bankruptcy or filed for bankruptcy during the past five (5) years? |
| Homeowners Underwriting | GENERAL INFORMATION | Question code | Select Question Code GENRL25 | Explanation |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name | |
| Drivers | OPERATORS | Driver Name | Name |
| Sagitta Page Name | Form Section Name | Sagitta Field Name | Sagita Field-Input Details | Form Field Name |
|---|---|---|---|---|
| Policy Details | PAYMENT PLAN | Bill Method | Select Agency / Company | Billing - Direct Bill - Policy (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Agency Bill |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Payment Plan - Full Pay (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Annual (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Semi-Annual (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Quarterly (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Bi-Monthly (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select Plan | Monthly (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Select other than below codes PF,FL, AN, SA, QT, BM, MO | Other (checkbox) |
| Policy Details | PAYMENT PLAN | Payment Plan | Premium Financed? | |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes AI,A7,A8, AM, AT, BB, CT, IL, PI, VO | Additional Insured (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes LH, IL, | Lienholder (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below code LP, AT, LA, LI, MP, PI, SL, | Loss Payee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes MP, MG, AM, MA | Mortgagee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes TE | Trustee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes AI,A7,A8, AM, AT, BB, CT, IL, PI, VO, LH, IL, LP, AT, LA, LI, MP, PI, SL,MP, MG, AM, MA,TE | Other (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Certificate Required/Issued | Select other than this code N | Evidence - Certificate (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Inform of Bill? | Send Bill (checkbox) | |
| Additional Interest | ADDITIONAL INTEREST | Item # | Boat | |
| Additional Interests | ADDITIONAL INTEREST | Item # | Item | |
| Additonal Interests | ADDITIONAL INTEREST | Schedule Description | Item Description | |
| Additonal Interests | ADDITIONAL INTEREST | Interest Nature | Select below codes Li, AS, AI,A7,A8, AM, AT, BB, CT, IL, PI, VO | Additional Insured (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes LH, IL, | Lienholder (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below code LP, AT, LA, LI, MP, PI, SL | Loss Payee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes MP, MG, AM, MA | Mortgagee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes TE | Trustee (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Interest Nature | Select below codes AI,A7,A8, AM, AT, BB, CT, IL, PI, VO, LH, IL, LP, AT, LA, LI, MP, PI, SL,MP, MG, AM, MA,TE | Other (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Certificate Required/Issued | Select other than this code N | Evidence - Certificate (checkbox) |
| Additional interests | ADDITIONAL INTEREST | Inform of Bill? | Send Bill (checkbox) | |
| Additional Interests | ADDITIONAL INTEREST | Boat # | Boat | |
| Additional Interests | ADDITIONAL INTEREST | Item # | Item | |
| Additional Interests | ADDITIONAL INTEREST | Item Description | Item Description | |
| Policy Details | BINDER | 12:01 am (checkbox) | ||
| Policy Details | BINDER | Noon (checkbox) | ||
| Policy Details | BINDER | Reason | Coverage is not bound (checkbox) |