|
Section Name |
Field Name |
Field and/or Section Description |
|
Illinois Property Supplement - |
Use ACORD 62 IL, Illinois Property Supplement - Notice of Availability of Earthquake Insurance, as required by Illinois law, to provide a notice of availability of earthquake |
|
TITLE |
Notice of Availability of |
insurance to applicants for homeowners insurance with property located in the New |
|
ACORD 62 IL (2007/08) |
Earthquake Insurance |
Madrid Seismic Zone, as defined by the U.S. Geological Survey in Illinois. |
|
IDENTIFICATION SECTION |
Agency Customer ID |
Customer's identification number assigned by the agency or brokerage. |
|
IDENTIFICATION SECTION |
Agency |
Producer’s name |
|
IDENTIFICATION SECTION |
Applicant/Named Insured |
Indicate applicant name. If named insured, name exactly as it appears on the policy. |
|
IDENTIFICATION SECTION |
Policy # |
Number exactly as it appears on the policy, including prefix and suffix symbols. |
|
|
Name of the applicable insurance company. Do not use group names; use the actual |
|
IDENTIFICATION SECTION |
Carrier |
name of the company within the group in which you wish to have the policy issued. |
|
IDENTIFICATION SECTION |
NAIC Code |
Enter the NAIC code of the applicable insurance company. |
|
INFORMATION |
Check Box |
Check this box if the policy does not cover loss caused by an earthquake. |
|
|
Check this box if the policy provides limited coverage for loss caused by an earthquake. |
|
INFORMATION |
Check Box |
Describe in the space provided. |
|
SIGNATURE |
Applicant Signature |
Applicant must sign the supplement. |
|
SIGNATURE |
Date |
Indicate the date the supplement was signed in MM/DD/YYYY format. |