ACORD 61 CO (2012/01)

Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 61 CO (2012/01)
Colorado Auto Supplement
ACORD 61, Colorado Auto Supplement, Colorado Private Passenger
Automobile Insurance Summary Disclosure, is a basic guide to the major coverages and
exclusions in your policy. It is only a general description and not a statement of contract or
a policy of any kind. All coverage is subject to the terms, conditions, and exclusions of
your policy and all applicable endorsements.
IDENTIFICATION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION
Agency
Enter text: The full name of the producer/agency.
IDENTIFICATION
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
Named Insured(s)
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION
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
NAIC Code
Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
Edition
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
ACORD 61 CO (2012/01) rev. 11-23-2011
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