Home

 

ACORD Form 129 Vehicle Schedule Instructions
 

 
ACORD 129 (2009/01) rev 03-03-2009 1 of 16
Section Name Field Name Field and/or Section Description
TITLE ACORD 129 (2009/01) Vehicle Schedule The title of the form. ACORD 129, Vehicle Schedule, is to be used in conjunction with the following ACORD forms to individually schedule vehicles: ACORD 127 - Business Auto Section, ACORD 128 - Garage and Dealers Section, ACORD 132 - Truckers / Motor Carriers Section, ACORD 143 - Transportation Section. Within the Remarks section of the above forms, a note should be made to "see attached vehicle schedule."
IDENTIFICATION SECTION Agency Customer ID Enter identifier: The customer's identification number assigned by the producer (e.g. agency or brokerage).
IDENTIFICATION SECTION Date Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION SECTION Agency Enter text: The full name of the producer/agency.
IDENTIFICATION SECTION Policy Number Enter identifier: The identifier assigned by the insurer to the policy, or submission, being referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for self-insurance, the self-insured license or contract number.
IDENTIFICATION SECTION Effective Date Enter date: The effective date of the policy. The date that the terms and conditions of the policy commence.
IDENTIFICATION SECTION Named Insured(s) Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION SECTION Carrier Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use the actual name of the company within the group to which the policy has been issued. This is not the insurer's group name or trade name.
IDENTIFICATION SECTION NAIC Code Enter code: The identification code assigned to the insurer by the NAIC.
VEHICLE DESCRIPTION Veh # Enter number: The producer assigned vehicle number.
VEHICLE DESCRIPTION Year Enter year: The model year of the vehicle.
VEHICLE DESCRIPTION Make Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
VEHICLE DESCRIPTION Model Enter text: The manufacturer's model name for the vehicle.
VEHICLE DESCRIPTION Body Type Enter code: The body type of the vehicle.
VEHICLE DESCRIPTION V.I.N. Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer.
VEHICLE DESCRIPTION Check Box- PP Check the box (if applicable): Indicates the predominant type of the vehicle is private passenger.
VEHICLE DESCRIPTION Check Box- SPEC Check the box (if applicable): Indicates the predominant type of the vehicle is special (e.g. classic, antique automobile).
ACORD 129 (2009/01) rev 03-03-2009 2 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Check Box- COML Check the box (if applicable): Indicates the predominant type of the vehicle is commercial.
VEHICLE DESCRIPTION Sym/Age Enter code: The symbol required for physical damage coverage.
VEHICLE DESCRIPTION Cost New Enter amount: The original cost of the vehicle.
VEHICLE DESCRIPTION Street (Required in KY) Enter text: The vehicle's physical address line one.
VEHICLE DESCRIPTION City Enter text: The vehicle's physical address city name.
VEHICLE DESCRIPTION County Enter text: The vehicle's physical address county name.
VEHICLE DESCRIPTION State Enter code: The vehicle's physical address state or province code.
VEHICLE DESCRIPTION Zip Code Enter code: The vehicle's physical address postal code.
VEHICLE DESCRIPTION Lic State Enter code: The state or province in which the vehicle is registered.
VEHICLE DESCRIPTION Territory Enter code: The rating territory code where the vehicle is principally garaged.
VEHICLE DESCRIPTION GVW / GCW Enter number: The actual weight of the vehicle or the combined weight of tractor and trailer in pounds.
VEHICLE DESCRIPTION Class Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code.
VEHICLE DESCRIPTION S.I.C. Enter code: The secondary Special Industry Class code which applies to commercial vehicles as determined by industry rating manuals.
VEHICLE DESCRIPTION Factor Enter rate: The primary liability rating factor contains the number which is used, along with the secondary rating factor, in determining the liability premium. The primary rating factor which is always positive is based on the primary class.
VEHICLE DESCRIPTION Seating Capacity Enter number: The seating capacity of the vehicle. Required for rating public passenger vehicles.
VEHICLE DESCRIPTION Radius Enter number: The radius in whole numbers within which this vehicle is operated.
VEHICLE DESCRIPTION Farthest Terminal Enter code: Identifies the location of the farthest zone from the vehicle's base of operation in which the vehicle is operated. The source of this code is the Insurance Services Office Zone code list.
VEHICLE DESCRIPTION Check Box- <15 Miles Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school under 15 miles one way.
VEHICLE DESCRIPTION Check Box- 15 Miles + Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school 15 miles or over one way.
VEHICLE DESCRIPTION Pleasure Check the box (if applicable): Indicates the primary use for the vehicle is for pleasure.
VEHICLE DESCRIPTION Farm Check the box (if applicable): Indicates the primary use for the vehicle is for farming.
VEHICLE DESCRIPTION Comm'l Check the box (if applicable): Indicates the primary use for the vehicle is for commercial purposes.
ACORD 129 (2009/01) rev 03-03-2009 3 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Retail Check the box (if applicable): Indicates the primary use for the vehicle is for the retail industry.
VEHICLE DESCRIPTION Service Check the box (if applicable): Indicates the primary use for the vehicle is for the service industry.
VEHICLE DESCRIPTION Liab Check the box (if applicable): Indicates the vehicle has liability coverage.
VEHICLE DESCRIPTION No-Fault Check the box (if applicable): Indicates the vehicle has no-fault coverage.
VEHICLE DESCRIPTION Add'l No-Fault Check the box (if applicable): Indicates the vehicle has additional no-fault coverage.
VEHICLE DESCRIPTION Med Pay Check the box (if applicable): Indicates the vehicle has medical payments coverage.
VEHICLE DESCRIPTION Unins Motor Check the box (if applicable): Indicates the vehicle has uninsured motorists coverage.
VEHICLE DESCRIPTION Undrins Motor Check the box (if applicable): Indicates the vehicle has underinsured motorists coverage.
VEHICLE DESCRIPTION Towing & Labor Check the box (if applicable): Indicates the vehicle has towing and labor coverage.
VEHICLE DESCRIPTION Spec C of L Check the box (if applicable): Indicates the vehicle has specified cause of loss coverage.
VEHICLE DESCRIPTION F Check the box (if applicable): Indicates fire is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FT Check the box (if applicable): Indicates fire and theft is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FTW Check the box (if applicable): Indicates fire, theft and windstorm is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION LSP Check the box (if applicable): Indicates limited specified perils is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the vehicle has comprehensive or other than collision coverage.
VEHICLE DESCRIPTION COLL Check the box (if applicable): Indicates the vehicle has collision coverage.
VEHICLE DESCRIPTION RENT REIMB Check the box (if applicable): Indicates the vehicle has rental reimbursement or transportation expense coverage.
VEHICLE DESCRIPTION FG Check the box (if applicable): Indicates the vehicle has full glass coverage.
VEHICLE DESCRIPTION Check Box Check the box (if applicable): Indicates the vehicle has a type of coverage not specifically listed.
VEHICLE DESCRIPTION Field Box Check the box (if applicable): The description of the other type of coverage on the vehicle.
VEHICLE DESCRIPTION Deductibles ACV Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the actual cash value.

ACORD 129 (2009/01) rev 03-03-2009 4 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION AA Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the agree amount.
VEHICLE DESCRIPTION ST AMT Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the stated amount.
VEHICLE DESCRIPTION $ Field Box Enter amount: The agreed or stated amount used in determining the value of the vehicle at the time of loss.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the deductible is for comprehensive or other than collision coverage.
VEHICLE DESCRIPTION SPEC C of L Check the box (if applicable): Indicates the deductible is for specified causes of loss. The Specified Cause of Loss Codes are: SCL Specified Cause of Loss F Fire F&T Fire and Theft F,T&W Fire, Theft and Wind LSP Limited Specified Perils SP Specified Perils
VEHICLE DESCRIPTION $ Field Box Enter amount: The comprehensive or specified cause of loss deductible amount.
VEHICLE DESCRIPTION $ Coll Enter deductible: The collision deductible amount.
VEHICLE DESCRIPTION Net Veh Dr/Cr Enter rate: The net rating factor that applies to this vehicle. Do not include debits or credits that apply on a policy level. Provide under remarks a description of each debit or credit used in the calculation of the net rating factor.
VEHICLE DESCRIPTION Tot Prem Enter amount: The total amount for the vehicle.
VEHICLE DESCRIPTION Veh # Enter number: The producer assigned vehicle number.
VEHICLE DESCRIPTION Year Enter year: The model year of the vehicle.
VEHICLE DESCRIPTION Make Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
VEHICLE DESCRIPTION Model Enter text: The manufacturer's model name for the vehicle.
VEHICLE DESCRIPTION Body Type Enter code: The body type of the vehicle.
VEHICLE DESCRIPTION V.I.N. Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer.
VEHICLE DESCRIPTION Check Box- PP Check the box (if applicable): Indicates the predominant type of the vehicle is private passenger.
VEHICLE DESCRIPTION Check Box- SPEC Check the box (if applicable): Indicates the predominant type of the vehicle is special (e.g. classic, antique automobile).
VEHICLE DESCRIPTION Check Box- COML Check the box (if applicable): Indicates the predominant type of the vehicle is commercial.
ACORD 129 (2009/01) rev 03-03-2009 5 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Sym/Age Enter code: The symbol required for physical damage coverage.
VEHICLE DESCRIPTION Cost New Enter amount: The original cost of the vehicle.
VEHICLE DESCRIPTION Street (Required in KY) Enter text: The vehicle's physical address line one.
VEHICLE DESCRIPTION City Enter text: The vehicle's physical address city name.
County Enter text: The vehicle's physical address county name.
VEHICLE DESCRIPTION State Enter code: The vehicle's physical address state or province code.
VEHICLE DESCRIPTION Zip Code Enter code: The vehicle's physical address postal code.
VEHICLE DESCRIPTION Lic State Enter code: The state or province in which the vehicle is registered.
VEHICLE DESCRIPTION Territory Enter code: The rating territory code where the vehicle is principally garaged.
VEHICLE DESCRIPTION GVW / GCW Enter number: The actual weight of the vehicle or the combined weight of tractor and trailer in pounds.
VEHICLE DESCRIPTION Class Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code.
VEHICLE DESCRIPTION S.I.C. Enter code: The secondary Special Industry Class code which applies to commercial vehicles as determined by industry rating manuals.
VEHICLE DESCRIPTION Factor Enter rate: The primary liability rating factor contains the number which is used, along with the secondary rating factor, in determining the liability premium. The primary rating factor which is always positive is based on the primary class.
VEHICLE DESCRIPTION Seating Capacity Enter number: The seating capacity of the vehicle. Required for rating public passenger vehicles.
VEHICLE DESCRIPTION Radius Enter number: The radius in whole numbers within which this vehicle is operated.
VEHICLE DESCRIPTION Farthest Term Enter code: Identifies the location of the farthest zone from the vehicle's base of operation in which the vehicle is operated. The source of this code is the Insurance Services Office Zone code list.
VEHICLE DESCRIPTION Check Box- <15 Miles Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school under 15 miles one way.
VEHICLE DESCRIPTION Check Box- 15 Miles + Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school 15 miles or over one way.
VEHICLE DESCRIPTION Pleasure Check the box (if applicable): Indicates the primary use for the vehicle is for pleasure.
VEHICLE DESCRIPTION Farm Check the box (if applicable): Indicates the primary use for the vehicle is for farming.
VEHICLE DESCRIPTION Comm'l Check the box (if applicable): Indicates the primary use for the vehicle is for commercial purposes.
VEHICLE DESCRIPTION Retail Check the box (if applicable): Indicates the primary use for the vehicle is for the retail industry.
ACORD 129 (2009/01) rev 03-03-2009 6 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Service Check the box (if applicable): Indicates the primary use for the vehicle is for the service industry.
VEHICLE DESCRIPTION Liab Check the box (if applicable): Indicates the vehicle has liability coverage.
VEHICLE DESCRIPTION No-Fault Check the box (if applicable): Indicates the vehicle has no-fault coverage.
VEHICLE DESCRIPTION Add'l No-Fault Check the box (if applicable): Indicates the vehicle has additional no-fault coverage.
VEHICLE DESCRIPTION Med Pay Check the box (if applicable): Indicates the vehicle has medical payments coverage.
VEHICLE DESCRIPTION Unins Motor Check the box (if applicable): Indicates the vehicle has uninsured motorists coverage.
VEHICLE DESCRIPTION Undrins Motor Check the box (if applicable): Indicates the vehicle has underinsured motorists coverage.
VEHICLE DESCRIPTION Towing & Labor Check the box (if applicable): Indicates the vehicle has towing and labor coverage.
VEHICLE DESCRIPTION Spec C of L Check the box (if applicable): Indicates the vehicle has specified cause of loss coverage.
VEHICLE DESCRIPTION F Check the box (if applicable): Indicates fire is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FT Check the box (if applicable): Indicates fire and theft is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FTW Check the box (if applicable): Indicates fire, theft and windstorm is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION LSP Check the box (if applicable): Indicates limited specified perils is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the vehicle has comprehensive or other than collision coverage.
VEHICLE DESCRIPTION COLL Check the box (if applicable): Indicates the vehicle has collision coverage.
VEHICLE DESCRIPTION RENT REIMB Check the box (if applicable): Indicates the vehicle has rental reimbursement or transportation expense coverage.
VEHICLE DESCRIPTION FG Check the box (if applicable): Indicates the vehicle has full glass coverage.
VEHICLE DESCRIPTION Check Box Check the box (if applicable): Indicates the vehicle has a type of coverage not specifically listed.
VEHICLE DESCRIPTION Field Box Check the box (if applicable): The description of the other type of coverage on the vehicle.
VEHICLE DESCRIPTION Deductibles ACV Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the actual cash value.
VEHICLE DESCRIPTION AA Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the agree amount.

ACORD 129 (2009/01) rev 03-03-2009 7 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION ST AMT Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the stated amount.
VEHICLE DESCRIPTION $ Field Box Enter amount: The agreed or stated amount used in determining the value of the vehicle at the time of loss.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the deductible is for comprehensive or other than collision coverage.
VEHICLE DESCRIPTION SPEC C of L Check the box (if applicable): Indicates the deductible is for specified causes of loss. The Specified Cause of Loss Codes are: SCL Specified Cause of Loss F Fire F&T Fire and Theft F,T&W Fire, Theft and Wind LSP Limited Specified Perils SP Specified Perils
VEHICLE DESCRIPTION $ Field Box Enter amount: The comprehensive or specified cause of loss deductible amount.
VEHICLE DESCRIPTION $ Coll Enter deductible: The collision deductible amount.
VEHICLE DESCRIPTION Net Veh Dr/Cr Enter rate: The net rating factor that applies to this vehicle. Do not include debits or credits that apply on a policy level. Provide under remarks a description of each debit or credit used in the calculation of the net rating factor.
VEHICLE DESCRIPTION Tot Prem Enter amount: The total amount for the vehicle.
VEHICLE DESCRIPTION Veh # Enter number: The producer assigned vehicle number.
VEHICLE DESCRIPTION Year Enter year: The model year of the vehicle.
VEHICLE DESCRIPTION Make Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
VEHICLE DESCRIPTION Model Enter text: The manufacturer's model name for the vehicle.
VEHICLE DESCRIPTION Body Type Enter code: The body type of the vehicle.
VEHICLE DESCRIPTION V.I.N. Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer.
VEHICLE DESCRIPTION Check Box- PP Check the box (if applicable): Indicates the predominant type of the vehicle is private passenger.
VEHICLE DESCRIPTION Check Box- SPEC Check the box (if applicable): Indicates the predominant type of the vehicle is special (e.g. classic, antique automobile).
VEHICLE DESCRIPTION Check Box- COML Check the box (if applicable): Indicates the predominant type of the vehicle is commercial.
VEHICLE DESCRIPTION Sym/Age Enter code: The symbol required for physical damage coverage.
VEHICLE DESCRIPTION Cost New Enter amount: The original cost of the vehicle.

ACORD 129 (2009/01) rev 03-03-2009 8 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Street (Required in KY) Enter text: The vehicle's physical address line one.
VEHICLE DESCRIPTION City Enter text: The vehicle's physical address city name.
County Enter text: The vehicle's physical address county name.
VEHICLE DESCRIPTION State Enter code: The vehicle's physical address state or province code.
VEHICLE DESCRIPTION Zip Code Enter code: The vehicle's physical address postal code.
VEHICLE DESCRIPTION Lic State Enter code: The state or province in which the vehicle is registered.
VEHICLE DESCRIPTION Territory Enter code: The rating territory code where the vehicle is principally garaged.
VEHICLE DESCRIPTION GVW / GCW Enter number: The actual weight of the vehicle or the combined weight of tractor and trailer in pounds.
VEHICLE DESCRIPTION Class Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code.
VEHICLE DESCRIPTION S.I.C. Enter code: The secondary Special Industry Class code which applies to commercial vehicles as determined by industry rating manuals.
VEHICLE DESCRIPTION Factor Enter rate: The primary liability rating factor contains the number which is used, along with the secondary rating factor, in determining the liability premium. The primary rating factor which is always positive is based on the primary class.
VEHICLE DESCRIPTION Seating Capacity Enter number: The seating capacity of the vehicle. Required for rating public passenger vehicles.
VEHICLE DESCRIPTION Radius Enter number: The radius in whole numbers within which this vehicle is operated.
VEHICLE DESCRIPTION Farthest Terminal Enter code: Identifies the location of the farthest zone from the vehicle's base of operation in which the vehicle is operated. The source of this code is the Insurance Services Office Zone code list.
VEHICLE DESCRIPTION Check Box- <15 Miles Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school under 15 miles one way.
VEHICLE DESCRIPTION Check Box- 15 Miles + Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school 15 miles or over one way.
VEHICLE DESCRIPTION Pleasure Check the box (if applicable): Indicates the primary use for the vehicle is for pleasure.
VEHICLE DESCRIPTION Farm Check the box (if applicable): Indicates the primary use for the vehicle is for farming.
VEHICLE DESCRIPTION Comm'l Check the box (if applicable): Indicates the primary use for the vehicle is for commercial purposes.
VEHICLE DESCRIPTION Retail Check the box (if applicable): Indicates the primary use for the vehicle is for the retail industry.
VEHICLE DESCRIPTION Service Check the box (if applicable): Indicates the primary use for the vehicle is for the service industry.
VEHICLE DESCRIPTION Liab Check the box (if applicable): Indicates the vehicle has liability coverage.

ACORD 129 (2009/01) rev 03-03-2009 9 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION No-Fault Check the box (if applicable): Indicates the vehicle has no-fault coverage.
VEHICLE DESCRIPTION Add'l No-Fault Check the box (if applicable): Indicates the vehicle has additional no-fault coverage.
VEHICLE DESCRIPTION Med Pay Check the box (if applicable): Indicates the vehicle has medical payments coverage.
VEHICLE DESCRIPTION Unins Motor Check the box (if applicable): Indicates the vehicle has uninsured motorists coverage.
VEHICLE DESCRIPTION Undrins Motor Check the box (if applicable): Indicates the vehicle has underinsured motorists coverage.
VEHICLE DESCRIPTION Towing & Labor Check the box (if applicable): Indicates the vehicle has towing and labor coverage.
VEHICLE DESCRIPTION Spec C of L Check the box (if applicable): Indicates the vehicle has specified cause of loss coverage.
VEHICLE DESCRIPTION F Check the box (if applicable): Indicates fire is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FT Check the box (if applicable): Indicates fire and theft is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FTW Check the box (if applicable): Indicates fire, theft and windstorm is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION LSP Check the box (if applicable): Indicates limited specified perils is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the vehicle has comprehensive or other than collision coverage.
VEHICLE DESCRIPTION COLL Check the box (if applicable): Indicates the vehicle has collision coverage.
VEHICLE DESCRIPTION RENT REIMB Check the box (if applicable): Indicates the vehicle has rental reimbursement or transportation expense coverage.
VEHICLE DESCRIPTION FG Check the box (if applicable): Indicates the vehicle has full glass coverage.
VEHICLE DESCRIPTION Check Box Check the box (if applicable): Indicates the vehicle has a type of coverage not specifically listed.
VEHICLE DESCRIPTION Field Box Check the box (if applicable): The description of the other type of coverage on the vehicle.
VEHICLE DESCRIPTION Deductibles ACV Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the actual cash value.
VEHICLE DESCRIPTION AA Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the agree amount.
VEHICLE DESCRIPTION ST AMT Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the stated amount.
VEHICLE DESCRIPTION $ Field Box Enter amount: The agreed or stated amount used in determining the value of the vehicle at the time of loss.

ACORD 129 (2009/01) rev 03-03-2009 10 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the deductible is for comprehensive or other than collision coverage.
VEHICLE DESCRIPTION SPEC C of L Check the box (if applicable): Indicates the deductible is for specified causes of loss. The Specified Cause of Loss Codes are: SCL Specified Cause of Loss F Fire F&T Fire and Theft F,T&W Fire, Theft and Wind LSP Limited Specified Perils SP Specified Perils
VEHICLE DESCRIPTION $ Field Box Enter amount: The comprehensive or specified cause of loss deductible amount.
VEHICLE DESCRIPTION $ Coll Enter deductible: The collision deductible amount.
VEHICLE DESCRIPTION Net Veh Dr/Cr Enter rate: The net rating factor that applies to this vehicle. Do not include debits or credits that apply on a policy level. Provide under remarks a description of each debit or credit used in the calculation of the net rating factor.
VEHICLE DESCRIPTION Tot Prem Enter amount: The total amount for the vehicle.
VEHICLE DESCRIPTION Veh # Enter number: The producer assigned vehicle number.
VEHICLE DESCRIPTION Year Enter year: The model year of the vehicle.
VEHICLE DESCRIPTION Make Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
VEHICLE DESCRIPTION Model Enter text: The manufacturer's model name for the vehicle.
VEHICLE DESCRIPTION Body Type Enter code: The body type of the vehicle.
VEHICLE DESCRIPTION V.I.N. Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer.
VEHICLE DESCRIPTION Check Box- PP Check the box (if applicable): Indicates the predominant type of the vehicle is private passenger.
VEHICLE DESCRIPTION Check Box- SPEC Check the box (if applicable): Indicates the predominant type of the vehicle is special (e.g. classic, antique automobile).
VEHICLE DESCRIPTION Check Box- COML Check the box (if applicable): Indicates the predominant type of the vehicle is commercial.
VEHICLE DESCRIPTION Sym/Age Enter code: The symbol required for physical damage coverage.
VEHICLE DESCRIPTION Cost New Enter amount: The original cost of the vehicle.
VEHICLE DESCRIPTION Street (Required in KY) Enter text: The vehicle's physical address line one.
VEHICLE DESCRIPTION City Enter text: The vehicle's physical address city name.
County Enter text: The vehicle's physical address county name.
VEHICLE DESCRIPTION State Enter code: The vehicle's physical address state or province code.
ACORD 129 (2009/01) rev 03-03-2009 11 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Zip Code Enter code: The vehicle's physical address postal code.
VEHICLE DESCRIPTION Lic State Enter code: The state or province in which the vehicle is registered.
VEHICLE DESCRIPTION Territory Enter code: The rating territory code where the vehicle is principally garaged.
VEHICLE DESCRIPTION GVW / GCW Enter number: The actual weight of the vehicle or the combined weight of tractor and trailer in pounds.
VEHICLE DESCRIPTION Class Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code.
VEHICLE DESCRIPTION S.I.C. Enter code: The secondary Special Industry Class code which applies to commercial vehicles as determined by industry rating manuals.
VEHICLE DESCRIPTION Factor Enter rate: The primary liability rating factor contains the number which is used, along with the secondary rating factor, in determining the liability premium. The primary rating factor which is always positive is based on the primary class.
VEHICLE DESCRIPTION Seating Capacity Enter number: The seating capacity of the vehicle. Required for rating public passenger vehicles.
VEHICLE DESCRIPTION Radius Enter number: The radius in whole numbers within which this vehicle is operated.
VEHICLE DESCRIPTION Farthest Terminal Enter code: Identifies the location of the farthest zone from the vehicle's base of operation in which the vehicle is operated. The source of this code is the Insurance Services Office Zone code list.
VEHICLE DESCRIPTION Check Box- <15 Miles Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school under 15 miles one way.
VEHICLE DESCRIPTION Check Box- 15 Miles + Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school 15 miles or over one way.
VEHICLE DESCRIPTION Pleasure Check the box (if applicable): Indicates the primary use for the vehicle is for pleasure.
VEHICLE DESCRIPTION Farm Check the box (if applicable): Indicates the primary use for the vehicle is for farming.
VEHICLE DESCRIPTION Comm'l Check the box (if applicable): Indicates the primary use for the vehicle is for commercial purposes.
VEHICLE DESCRIPTION Retail Check the box (if applicable): Indicates the primary use for the vehicle is for the retail industry.
VEHICLE DESCRIPTION Service Check the box (if applicable): Indicates the primary use for the vehicle is for the service industry.
VEHICLE DESCRIPTION Liab Check the box (if applicable): Indicates the vehicle has liability coverage.
VEHICLE DESCRIPTION No-Fault Check the box (if applicable): Indicates the vehicle has no-fault coverage.
VEHICLE DESCRIPTION Add'l No-Fault Check the box (if applicable): Indicates the vehicle has additional no-fault coverage.
VEHICLE DESCRIPTION Med Pay Check the box (if applicable): Indicates the vehicle has medical payments coverage.
ACORD 129 (2009/01) rev 03-03-2009 12 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Unins Motor Check the box (if applicable): Indicates the vehicle has uninsured motorists coverage.
VEHICLE DESCRIPTION Undrins Motor Check the box (if applicable): Indicates the vehicle has underinsured motorists coverage.
VEHICLE DESCRIPTION Towing & Labor Check the box (if applicable): Indicates the vehicle has towing and labor coverage.
VEHICLE DESCRIPTION Spec C of L Check the box (if applicable): Indicates the vehicle has specified cause of loss coverage.
VEHICLE DESCRIPTION F Check the box (if applicable): Indicates fire is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FT Check the box (if applicable): Indicates fire and theft is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FTW Check the box (if applicable): Indicates fire, theft and windstorm is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION LSP Check the box (if applicable): Indicates limited specified perils is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the vehicle has comprehensive or other than collision coverage.
VEHICLE DESCRIPTION COLL Check the box (if applicable): Indicates the vehicle has collision coverage.
VEHICLE DESCRIPTION RENT REIMB Check the box (if applicable): Indicates the vehicle has rental reimbursement or transportation expense coverage.
VEHICLE DESCRIPTION FG Check the box (if applicable): Indicates the vehicle has full glass coverage.
VEHICLE DESCRIPTION Check Box Check the box (if applicable): Indicates the vehicle has a type of coverage not specifically listed.
VEHICLE DESCRIPTION Field Box Check the box (if applicable): The description of the other type of coverage on the vehicle.
VEHICLE DESCRIPTION Deductibles ACV Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the actual cash value.
VEHICLE DESCRIPTION AA Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the agree amount.
VEHICLE DESCRIPTION ST AMT Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the stated amount.
VEHICLE DESCRIPTION $ Field Box Enter amount: The agreed or stated amount used in determining the value of the vehicle at the time of loss.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the deductible is for comprehensive or other than collision coverage.

ACORD 129 (2009/01) rev 03-03-2009 13 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION SPEC C of L Check the box (if applicable): Indicates the deductible is for specified causes of loss. The Specified Cause of Loss Codes are: SCL Specified Cause of Loss F Fire F&T Fire and Theft F,T&W Fire, Theft and Wind LSP Limited Specified Perils SP Specified Perils
VEHICLE DESCRIPTION $ Field Box Enter amount: The comprehensive or specified cause of loss deductible amount.
VEHICLE DESCRIPTION $ Coll Enter deductible: The collision deductible amount.
VEHICLE DESCRIPTION Net Veh Dr/Cr Enter rate: The net rating factor that applies to this vehicle. Do not include debits or credits that apply on a policy level. Provide under remarks a description of each debit or credit used in the calculation of the net rating factor.
VEHICLE DESCRIPTION Tot Prem Enter amount: The total amount for the vehicle.
VEHICLE DESCRIPTION Veh # Enter number: The producer assigned vehicle number.
VEHICLE DESCRIPTION Year Enter year: The model year of the vehicle.
VEHICLE DESCRIPTION Make Enter text: The manufacturer of the vehicle (e.g. Ford, Chevy).
VEHICLE DESCRIPTION Model Enter text: The manufacturer's model name for the vehicle.
VEHICLE DESCRIPTION Body Type Enter code: The body type of the vehicle.
VEHICLE DESCRIPTION V.I.N. Enter identifier: The vehicle identification number (VIN) or serial number assigned by the manufacturer.
VEHICLE DESCRIPTION Check Box- PP Check the box (if applicable): Indicates the predominant type of the vehicle is private passenger.
VEHICLE DESCRIPTION Check Box- SPEC Check the box (if applicable): Indicates the predominant type of the vehicle is special (e.g. classic, antique automobile).
VEHICLE DESCRIPTION Check Box- COML Check the box (if applicable): Indicates the predominant type of the vehicle is commercial.
VEHICLE DESCRIPTION Sym/Age Enter code: The symbol required for physical damage coverage.
VEHICLE DESCRIPTION Cost New Enter amount: The original cost of the vehicle.
VEHICLE DESCRIPTION Street (Required in KY) Enter text: The vehicle's physical address line one.
VEHICLE DESCRIPTION City Enter text: The vehicle's physical address city name.
County Enter text: The vehicle's physical address county name.
VEHICLE DESCRIPTION State Enter code: The vehicle's physical address state or province code.
VEHICLE DESCRIPTION Zip Code Enter code: The vehicle's physical address postal code.
VEHICLE DESCRIPTION Lic State Enter code: The state or province in which the vehicle is registered.
ACORD 129 (2009/01) rev 03-03-2009 14 of 16
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Territory Enter code: The rating territory code where the vehicle is principally garaged.
VEHICLE DESCRIPTION GVW / GCW Enter number: The actual weight of the vehicle or the combined weight of tractor and trailer in pounds.
VEHICLE DESCRIPTION Class Enter code: The rate class of the vehicle. If two rate classes are required, this element should be used to enter the liability code.
VEHICLE DESCRIPTION S.I.C. Enter code: The secondary Special Industry Class code which applies to commercial vehicles as determined by industry rating manuals.
VEHICLE DESCRIPTION Factor Enter rate: The primary liability rating factor contains the number which is used, along with the secondary rating factor, in determining the liability premium. The primary rating factor which is always positive is based on the primary class.
VEHICLE DESCRIPTION Seating Capacity Enter number: The seating capacity of the vehicle. Required for rating public passenger vehicles.
VEHICLE DESCRIPTION Radius Enter number: The radius in whole numbers within which this vehicle is operated.
VEHICLE DESCRIPTION Farthest Terminal Enter code: Identifies the location of the farthest zone from the vehicle's base of operation in which the vehicle is operated. The source of this code is the Insurance Services Office Zone code list.
VEHICLE DESCRIPTION Check Box- <15 Miles Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school under 15 miles one way.
VEHICLE DESCRIPTION Check Box- 15 Miles + Check the box (if applicable): Indicates the vehicle is used for commuting purposes to work or school, and is driven to work or school 15 miles or over one way.
VEHICLE DESCRIPTION Pleasure Check the box (if applicable): Indicates the primary use for the vehicle is for pleasure.
VEHICLE DESCRIPTION Farm Check the box (if applicable): Indicates the primary use for the vehicle is for farming.
VEHICLE DESCRIPTION Comm'l Check the box (if applicable): Indicates the primary use for the vehicle is for commercial purposes.
VEHICLE DESCRIPTION Retail Check the box (if applicable): Indicates the primary use for the vehicle is for the retail industry.
VEHICLE DESCRIPTION Service Check the box (if applicable): Indicates the primary use for the vehicle is for the service industry.
VEHICLE DESCRIPTION Liab Check the box (if applicable): Indicates the vehicle has liability coverage.
VEHICLE DESCRIPTION No-Fault Check the box (if applicable): Indicates the vehicle has no-fault coverage.
VEHICLE DESCRIPTION Add'l No-Fault Check the box (if applicable): Indicates the vehicle has additional no-fault coverage.
VEHICLE DESCRIPTION Med Pay Check the box (if applicable): Indicates the vehicle has medical payments coverage.
VEHICLE DESCRIPTION Unins Motor Check the box (if applicable): Indicates the vehicle has uninsured motorists coverage.

ACORD 129 (2009/01) rev 03-03-2009 15 of 16

Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION Undrins Motor Check the box (if applicable): Indicates the vehicle has underinsured motorists coverage.
VEHICLE DESCRIPTION Towing & Labor Check the box (if applicable): Indicates the vehicle has towing and labor coverage.
VEHICLE DESCRIPTION Spec C of L Check the box (if applicable): Indicates the vehicle has specified cause of loss coverage.
VEHICLE DESCRIPTION F Check the box (if applicable): Indicates fire is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FT Check the box (if applicable): Indicates fire and theft is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION FTW Check the box (if applicable): Indicates fire, theft and windstorm is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION LSP Check the box (if applicable): Indicates limited specified perils is a specified cause of loss on this vehicle.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the vehicle has comprehensive or other than collision coverage.
VEHICLE DESCRIPTION COLL Check the box (if applicable): Indicates the vehicle has collision coverage.
VEHICLE DESCRIPTION RENT REIMB Check the box (if applicable): Indicates the vehicle has rental reimbursement or transportation expense coverage.
VEHICLE DESCRIPTION FG Check the box (if applicable): Indicates the vehicle has full glass coverage.
VEHICLE DESCRIPTION Check Box Check the box (if applicable): Indicates the vehicle has a type of coverage not specifically listed.
VEHICLE DESCRIPTION Field Box Check the box (if applicable): The description of the other type of coverage on the vehicle.
VEHICLE DESCRIPTION Deductibles ACV Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the actual cash value.
VEHICLE DESCRIPTION AA Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the agree amount.
VEHICLE DESCRIPTION ST AMT Check the box (if applicable): Indicates the valuation method used in determining the value of the vehicle at the time of loss is the stated amount.
VEHICLE DESCRIPTION $ Field Box Enter amount: The agreed or stated amount used in determining the value of the vehicle at the time of loss.
VEHICLE DESCRIPTION COMP / OTC Check the box (if applicable): Indicates the deductible is for comprehensive or other than collision coverage.
Section Name Field Name Field and/or Section Description
VEHICLE DESCRIPTION SPEC C of L Check the box (if applicable): Indicates the deductible is for specified causes of loss. The Specified Cause of Loss Codes are: SCL Specified Cause of Loss F Fire F&T Fire and Theft F,T&W Fire, Theft and Wind LSP Limited Specified Perils SP Specified Perils
VEHICLE DESCRIPTION $ Field Box Enter amount: The comprehensive or specified cause of loss deductible amount.
VEHICLE DESCRIPTION $ Coll Enter deductible: The collision deductible amount.
VEHICLE DESCRIPTION Net Veh Dr/Cr Enter rate: The net rating factor that applies to this vehicle. Do not include debits or credits that apply on a policy level. Provide under remarks a description of each debit or credit used in the calculation of the net rating factor.
VEHICLE DESCRIPTION Tot Prem Enter amount: The total amount for the vehicle.
Edition Date The edition identifier of the form including the form number and edition (the date is typically formatted YYYY/MM).

ACORD 129 (2009/01) rev 03-03-2009 16 of 16