ACORD 60 VA (8/94)

Universal wording updates to improve clarity and intent were made to all FIG text for this form on 07/10/2009.
Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 60 VA (8/94)
Virginia Auto Supplement, Rental
Reimbursement Coverage
ACORD 60 VA, Virginia Auto Supplement, Rental Reimbursement
Coverage, satisfies a Virginia law, effective July 1, 1994, that requires every applicant for
auto collision or comprehensive coverage, and every policyholder with either or both of
these coverages, must receive a written offer of the option of purchasing Rental
Reimbursement Coverage.
Use ACORD 60 VA to comply with this requirement.
IDENTIFICATION SECTION Producer
Enter text: The full name of the producer/agency.
IDENTIFICATION SECTION
Enter text: The mailing address line one of the producer/agency.
IDENTIFICATION SECTION
Enter text: The mailing address city name of the producer/agency.
IDENTIFICATION SECTION
Enter code: The mailing address state or province code of the producer/agency.
IDENTIFICATION SECTION
Enter code: The mailing address postal code of the producer/agency.
IDENTIFICATION SECTION Code
Enter code: The identification code assigned to the producer (e.g. agency or brokerage
firm) by the insurer.
IDENTIFICATION SECTION Subcode
Enter code: The identification code assigned by the insurer to the sub-producer (e.g.
person) within a producer's office (e.g. agency or brokerage).
IDENTIFICATION SECTION Applicant/Named Insured
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION SECTION Company
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 Policy #
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.
Edition
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
ACORD 60 VA (8/94)
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