Universal wording updates to improve clarity and intent were made to all FIG text for this form on 05/08/2009.
Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 405 (2007/09)
Agriculture Premises / Location
Diagram
ACORD 405, Agriculture Premises / Location Diagram, is used as an
attachment to ACORD 401, the basic agriculture insurance application to provide a
diagram of the premises to be insured.
Use a separate form for each premises.
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 Applicant/First Named Insured
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
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 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.
IDENTIFICATION SECTION Account Number
Enter identifier: The account number to be used for billing purposes. This is the billing
number assigned by the billing entity. If agency bill, the agency assigns; if direct bill, the
insurer assigns. If the account already exists, the agent should provide the previously
assigned number.
PREMISES INFORMATION
Diagram #
Enter identifier: The producer assigned identifier for the diagram of the location.
PREMISES INFORMATION
Location #
Enter number: The producer assigned number of the location. As used here, enter the
location number from the ACORD 401.
PREMISES INFORMATION
Phone Number
Enter number: The primary phone number of the location.
PREMISES INFORMATION
Premises Address
Enter text: The first address line of the physical location. As used here, enter the address
from the ACORD 401.
PREMISES INFORMATION
Enter text: The second address line of the physical location.
PREMISES INFORMATION
Enter text: The third address line of the physical location.
PREMISES INFORMATION
Enter text: The city of the physical location.
PREMISES INFORMATION
Enter code: The state or province of the physical location.
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Section Name
Field Name
Field and/or Section Description
PREMISES INFORMATION
Enter code: The postal code of the physical location.
PREMISES INFORMATION
Enter text: The section of the insured location.
PREMISES INFORMATION
Enter text: The township of the insured location.
PREMISES INFORMATION
Enter text: The range of the insured location.
PREMISES INFORMATION
Enter text: The longitude of the insured location. This is the arc or portion of the earth's
equator intersected between the meridian of a given place and the prime meridian and
expressed in degrees. The format of the data follows The International Organization for
Standardization 6709 and is sent as +/-XXX.YYYYYYYY. The GPS longitude coordinate.
PREMISES INFORMATION
Premises Address
Enter text: The latitude of the insured location. This is the angular distance north or south
from the earth's equator measured through 90 degrees. The format of the data follows
The International Organization for Standardization 6709 and is sent as +/-XX.YYYYYYYY.
The GPS latitude coordinate.
PREMISES INFORMATION
Notes
Enter text: The directions on how to locate the property including nearest cross streets.
Edition
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
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