Description of Field: Field Name:
| Agency Name |
[AGENCYNAME] |
| Agency Address 1 |
[AGENCYADDRESS1] |
| Agency Address 2 |
[AGENCYADDRESS2] |
| Agency City |
[AGENCYCITY] |
| Agency State |
[AGENCYSTATE] |
| Agency ZIP Code |
[AGENCYZIP] |
| Agency Phone |
[AGENCYPHONE] |
| Agency Alternate Phone |
[AGENCYALTPHONE] |
| Agency Fax |
[AGENCYFAX] |
| Current Date |
[DATE] |
| Agency User Name |
[USERSELECTED] |
| Total Premium |
[TOTALPREMIUM] |
| Down Payment |
[DOWNPAYMENT] |
| Payment Amount |
[PAYMENTAMOUNT] |
| Amount Financed |
[AMOUNTFINANCED] |
| Number of payments |
[NUMOFPAYMENTS] |
| Insurance Company Name |
[COMPANYNAME] |
| Policy |
|
| First Name |
[FIRSTNAME] |
| [MIDDLENAME] - Middle Name |
[MIDDLENAME] |
| [LASTNAME] - Last Name |
[LASTNAME] |
| [ADDRESS1] - Insured Address 1 |
[ADDRESS1] |
| [ADDRESS2] - Insured Address 2 |
[ADDRESS2] |
| [APARTMENTNUM] - Apartment Number |
[APARTMENTNUM] |
| [CITY] - City |
[CITY] |
| [COUNTY] - County |
[COUNTY] |
| [STATE] - State |
[STATE] |
| [ZIPCODE] - ZIP Code |
[ZIPCODE] |
| [EMAILADDRESS] - Email Address |
[EMAILADDRESS] |
| [HOMEPHONE] - Home Phone |
[HOMEPHONE] |
| [WORKPHONE] - Work Phone |
[WORKPHONE] |
| [FAXNUMBER] - Fax Number |
[FAXNUMBER] |
| [EFFDATE] - Policy Effective Date |
[EFFDATE] |
| [EXPDATE] - Policy Expiration Date |
[EXPDATE] |
| [NUMOFDRIVERS] - Number of drivers |
[NUMOFDRIVERS] |
| Drivers |
|
| First Name driver 1 |
[FIRSTNAME;1] |
| First Name driver 2 |
[FIRSTNAME;2] |
| First Name driver 3 |
[FIRSTNAME;3] |
| First Name driver 4 |
[FIRSTNAME;4] |
| First Name driver 5 |
[FIRSTNAME;5] |
| First Name driver 6 |
[FIRSTNAME;6] |
| Middle Name driver 1 |
[MIDDLENAME;1] |
| Middle Name driver 2 |
[MIDDLENAME;2] |
| Middle Name driver 3 |
[MIDDLENAME;3] |
| Middle Name driver 4 |
[MIDDLENAME;4] |
| Middle Name driver 5 |
[MIDDLENAME;5] |
| Middle Name driver 6 |
[MIDDLENAME;6] |
| Last Name driver 1 |
[LASTNAME;1] |
| Last Name driver 2 |
[LASTNAME;2] |
| Last Name driver 3 |
[LASTNAME;3] |
| Last Name driver 4 |
[LASTNAME;4] |
| Last Name driver 5 |
[LASTNAME;5] |
| Last Name driver 6 |
[LASTNAME;6] |
| Date of Birth driver 1 |
[DOB;1] |
| Date of Birth driver 2 |
[DOB;2] |
| Date of Birth driver 3 |
[DOB;3] |
| Date of Birth driver 4 |
[DOB;4] |
| Date of Birth driver 5 |
[DOB;5] |
| Date of Birth driver 6 |
[DOB;6] |
| Sex of driver 1 |
[SEX;1] |
| Sex of driver 2 |
[SEX;2] |
| Sex of driver 3 |
[SEX;3] |
| Sex of driver 4 |
[SEX;4] |
| Sex of driver 5 |
[SEX;5] |
| Sex of driver 6 |
[SEX;6] |
| Marital status driver 1 |
[MARITAL;1] |
| Marital status driver 2 |
[MARITAL;2] |
| Marital status driver 3 |
[MARITAL;3] |
| Marital status driver 4 |
[MARITAL;4] |
| Marital status driver 5 |
[MARITAL;5] |
| Marital status driver 6 |
[MARITAL;6] |
| Relationship to Insured driver 1 |
[RELATION;1] |
| Relationship to Insured driver 2 |
[RELATION;2] |
| Relationship to Insured driver 3 |
[RELATION;3] |
| Relationship to Insured driver 4 |
[RELATION;4] |
| Relationship to Insured driver 5 |
[RELATION;5] |
| Relationship to Insured driver 6 |
[RELATION;6] |
| Vehicles |
|
| VIN vehicle 1 |
[VIN;1] |
| VIN vehicle 2 |
[VIN;2] |
| VIN vehicle 3 |
[VIN;3] |
| VIN vehicle 4 |
[VIN;4] |
| VIN vehicle 5 |
[VIN;5] |
| VIN vehicle 6 |
[VIN;6] |
| Year vehicle 1 |
[YEAR;1] |
| Year vehicle 2 |
[YEAR;2] |
| Year vehicle 3 |
[YEAR;3] |
| Year vehicle 4 |
[YEAR;4] |
| Year vehicle 5 |
[YEAR;5] |
| Year vehicle 6 |
[YEAR;6] |
| Make vehicle 1 |
[MAKER;1] |
| Make vehicle 2 |
[MAKER;2] |
| Make vehicle 3 |
[MAKER;3] |
| Make vehicle 4 |
[MAKER;4] |
| Make vehicle 5 |
[MAKER;5] |
| Make vehicle 6 |
[MAKER;6] |
| Model vehicle 1 |
[MODEL;1] |
| Model vehicle 2 |
[MODEL;2] |
| Model vehicle 3 |
[MODEL;3] |
| Model vehicle 4 |
[MODEL;4] |
| Model vehicle 5 |
[MODEL;5] |
| Model vehicle 6 |
[MODEL;6] |
| Garaging ZIP Code vehicle 1 |
[ZIP;1] |
| Garaging ZIP Code vehicle 2 |
[ZIP;2] |
| Garaging ZIP Code vehicle 3 |
[ZIP;3] |
| Garaging ZIP Code vehicle 4 |
[ZIP;4] |
| Garaging ZIP Code vehicle 5 |
[ZIP;5] |
| Garaging ZIP Code vehicle 6 |
[ZIP;6] |
|
Fields recently added:
Description of Field: Field Name:
| NUMBER OF EXCLUSIONS |
[NUMOFEXCLUSIONS] |
| LEAD SOURCE |
[LEADSOURCE] |
| POLICY NUMBER |
[POLICYNUMBER] |
| POLICY TYPE |
[POLICYTYPE] |
| PRIOR POLICY NUMBER |
[PRIORPOLICYNUMBER] |
| ATPA FEE |
[ATPAFEE] |
| AGENT |
[USERSELECTED]
|
|
CANCELLATION DATE
|
[CANCELLATIONDATE] |
| PRIOR EXP DATE |
[PRIOREXPDATE] |
| COMPANY NAME |
[COMPANYNAME] |
| MUNICIPAL TAX |
[MUNICIPALTAX] |
| MUNICIPAL TAX RATE |
[MUNICIPALTAXRATE] |
| SECONDARY POLICY FEE |
[SECONDARYPOLICYFEE] |
| STATETAX |
[STATETAX] |
| STATETAXRATE |
[STATETAXRATE] |
| TAX |
[TAX] |
| TAXABLEPREMIUM |
[TAXABLEPREMIUM] |
| BINDER DATE |
[BINDERDATE] |
| BINDER NUMBER |
[BINDERNUMBER] |
| BINDER TIME |
[BINDERTIME] |
| Types of Coverage |
|
| TERM |
[TERM] |
| FR BOND |
[FRBOND] |
| PRIMARY POLICY |
[PRIMARYPOLICY] |
| NONOWNER |
[NONOWNER] |
| LIAB BI |
[LIABBI] |
| LIAB PD |
[LIABPD] |
| LIAB BI PREMIUM |
[LIABBIPREMIUM;1] |
| LIAB LIMITS1 |
[LIABLIMITS1;1] |
| LIAB LIMITS2 |
[LIABLIMITS2;1] |
| LIAB LIMITS3 |
[LIABLIMITS3;1] |
| LIAB PD |
[LIABPD;1] |
| LIAB PD PREMIUM |
[LIABPDPREMIUM;1] |
| EXTRA MED |
[EXTRAMED;1] |
| EXTRA MED LIMIT |
[EXTRAMEDLIMIT;1] |
| EXTRA MED PREMIUM |
[EXTRAMEDPREMIUM;1] |
| MED PAY |
[MEDPAY;1] |
| MED PAY DED |
[MEDPAYDED;1] |
| MEDPAY LIMIT |
[COMEDPAYLIMIT;1] |
| MED PAY PREMIUM |
[MEDPAYPREMIUM;1] |
| PIP |
[PIP;1] |
| PIP COPAY |
[PIPCOPAY;1] |
| PIP COPAY PERCENT |
[PIPCOPAYPERCENT;1] |
| PIP DED |
[PIPDED;1] |
| PIP LIMIT |
[PIPLIMIT;1] |
| PIP PPO |
[PIPPPO;1] |
| PIP PREMIUM |
[PIPPREMIUM;1] |
| PIP TYPE |
[PIPTYPE;1] |
| GUEST PIP |
[GUESTPIP;1] |
| INCOME LOSS LIMIT |
[INCOMELOSSLIMIT;1] |
| INCOME LOSS PREMIUM |
[INCOMELOSSPREMIUM;1] |
| WORKLOSS |
[WORKLOSS;1] |
| UNINSBI |
[UNINSBI;1] |
| UNINSBI LIMITS1 |
[UNINSBILIMITS1;1] |
| UNINSBI PREMIUM |
[UNINSBIPREMIUM;1] |
| UNINSPD |
[UNINSPD;1] |
| UNINSPD DED |
[UNINSPDDED;1] |
| UNINSPD LIMIT |
[UNINSPDLIMIT;1] |
| UNINSPD PREMIUM |
[UNINSPDPREMIUM;1] |
| UIMBI |
[UIMBI;1] |
| UIMBI LIMITS1 |
[UIMBILIMITS1;1] |
| UIMBI PREMIUM |
[UIMBIPREMIUM;1] |
| UIMPD |
[UIMPD;1] |
| UIMPD LIMIT |
[UIMPDLIMIT;1] |
| UIMPD PREMIUM |
[UIMPDPREMIUM;1] |
| |
|
| ACC DEATH LIMIT |
[ACCDEATHLIMIT;1] |
| ACC DEATH PREMIUM |
[ACCDEATHPREMIUM;1] |
| ACC DEATH LIMIT |
[COACCDEATHLIMIT;1] |
| COMPREHENSIVE DEDUCTIBLE |
[COMPDED;1] |
| COMPREHENSIVE PREMIUM |
[COMPPREMIUM;1] |
| COLLISION DEDUCTIBLE |
[COLLDED;1] |
| COLLISION PREMIUM |
[COLLPREMIUM;1] |
| RENTAL LIMIT |
[RENTALLIMIT;1] |
| RENTAL PREMIUM |
[RENTALPREMIUM;1] |
| TOWING LIMIT |
[TOWINGLIMIT;1] |
| TOWING PREMIUM |
[TOWINGPREMIUM;1] |
| Insured Information |
|
| DRV LICENSED |
[LICENSED;1] |
| STATE LICENSED |
[STATELICENSED;1] |
| DRV LICENSE NUMBER |
[DRVLICENSENUMBER;1] |
| DATE LICENSED |
[DATELICENSED;1] |
| DATE LICENSED STATE |
[DATELICENSEDSTATE;1] |
| LICENSED STATE |
[LICENSEDSTATE;1] |
| MILES TO WORK |
[MILESTOWORK;1] |
| MONTHS LICENSED |
[MONTHSLICENSED;1] |
| MONTHS LICENSED STATE |
[MONTHSLICENSEDSTATE;1] |
| MONTHS MVR EXPER |
[MONTHSMVREXPER;1] |
| MONTHS SUSPENDED |
[MONTHSSUSPENDED;1] |
| MVR DATE ORDERED |
[MVRDATEORDERED;1] |
| OCCASIONAL OPERATOR |
[OCCASIONALOPERATOR;1] |
| OCCUPATION |
[OCCUPATION;1] |
| SR22 |
[SR22;1] |
| SR22A |
[SR22A;1] |
| SR22CASENUM |
[SR22CASENUM;1] |
| SR22DATE |
[SR22DATE;1] |
| SR22REASON |
[SR22REASON;1] |
| SR22STATE |
[SR22STATE;1] |
| SR22FEE |
[SR22FEE] |
| Employment Entry |
|
| EMPLOYER NAME |
[EMPLOYERNAME] |
| EMPLOYER ADDR1 |
[EMPLOYERADDR1] |
| EMPLOYER ADDR2 |
[EMPLOYERADDR2] |
| EMPLOYER CITY |
[EMPLOYERCITY] |
| EMPLOYER STATE |
[EMPLOYERSTATE] |
| EMPLOYER PHONE |
[EMPLOYERPHONE] |
| EMPLOYER ZIP CODE |
[EMPLOYERZIPCODE] |
| OCCUPATION |
|
| Additional Insured Info: |
|
| PRIOR ADDR1 |
[PRIORADDR1] |
| PRIOR APARTMENT NUMBER |
[PRIORAPARTMENTNUMBER] |
| PRIOR CITY |
[PRIORCITY] |
| PRIOR STATE |
[PRIORSTATE] |
| PRIOR ZIP CODE |
[PRIORZIPCODE] |
| PRIOR MONTHS COVERAGE |
[PRIORMONTHSCOVG;1] |
| PRIOR DAYS LAPSE |
[PRIORDAYSLAPSE;1] |
| PRIOR LIAB LIM1 |
[PRIORLIABLIM1;1] |
| PRIOR TRANSFERLEVEL |
[PRIORTRANSFERLEVEL;1] |
| PROPERTY INSURANCE |
[PROPERTYINSURANCE;1] |
| RESIDENCY STATUS |
[RESIDENCYSTATUS;1] |
| RESIDENCY TYPE |
[RESIDENCYTYPE;1] |
| Finance Company Info |
|
| FINANCE COMPANY NAME |
[FINANCECOMPANYNAME] |
| FINANCE COMPANY ADDR1 |
[FINANCECOMPANYADDR1] |
| FINANCE COMPANY ADDR2 |
[FINANCECOMPANYADDR2] |
| FINANCE COMPANY CITY |
[FINANCECOMPANYCITY] |
| FINANCE COMPANY STATE |
[FINANCECOMPANYSTATE] |
| FINANCE COMPANY ZIP CODE |
[FINANCECOMPANYZIPCODE] |
| Finance Info |
|
| PERCENT DOWN |
[PERCENTDOWN] |
| FINANCE AMOUNT |
[FINANCEAMOUNT] |
| FINANCE CHARGE |
[FINANCECHARGE] |
| MONTHLY FINANCED |
[MONTHLYFINANCED] |
| APR |
[APR] |
| Payment Information |
|
| POLICY FEE |
[POLICYFEE] |
| Prior Carrier Information |
|
| PRIOR CARRIER NAME |
[PRIORCARRIERNAME] |
| PRIOR CARRIER ADDRESS1 |
[PRIORCARRIERADDRESS1] |
| PRIOR CARRIER CITY |
[PRIORCARRIERCITY] |
| PRIOR CARRIER STATE |
[PRIORCARRIERSTATE] |
| PRIOR CARRIER ZIP CODE |
[PRIORCARRIERZIPCODE] |
| Vehicle Information |
|
| VEHICLE TYPE |
[VEHICLETYPE;1] |
| ACV |
[ACV;1] |
| USAGE |
[USAGE;1] |
| ANNUAL MILES |
[ANNUALMILES;1] |
| BODY TYPE |
[BODYTYPE;1] |
| MSRP |
[MSRP;1] |
| CUSTOM EQUIP PREMIUM |
[CUSTOMEQUIPPREMIUM;1] |
| CUSTOM EQUIP VALUE |
[CUSTOMEQUIPVALUE;1] |
| FUEL TYPE |
[FUELTYPE;1] |
| HATCHBACK |
[HATCHBACK;1] |
| MILES |
[MILES;1] |
| NUM OF CYL |
[NUMOFCYL;1] |
| NUM OF DOORS |
[NUMOFDOORS;1] |
| PURCHASE COST |
[PURCHASECOST;1] |
| PURCHASE DATE |
[PURCHASEDATE;1] |
| PRIMARY OPERATOR |
[PRIMARYOPERATOR;1] |
| TRUCK SIZE |
[TRUCKSIZE;1] |
| Garaging Information |
|
| GARAGING ADDRESS 1 |
[GARAGINGADDR1;1] |
| GARAGING ADDRESS 2 |
[GARAGINGADDR2;1] |
| GARAGING CITY |
[GARAGINGCITY;1] |
| GARAGING STATE |
[GARAGINGSTATE;1] |
| GARAGING ZIP CODE |
[GARAGINGZIPCODE;1] |
| Lienholder Information |
|
| LIENHOLDER ADDR1 |
[LIENHOLDERADDR1;1] |
| LIENHOLDER CITY |
[LIENHOLDERCITY;1] |
| LIENHOLDER NAME |
[LIENHOLDERNAME;1] |
| LIENHOLDER STATE |
[LIENHOLDERSTATE;1] |
| LIENHOLDER ZIP |
[LIENHOLDERZIP;1 |
Fields most recently added (September 2012)
PRODUCER CODE [PRODUCERCODE]
LAST QUOTED BY FIRST NAME [LASTQUOTEDBYFIRSTNAME]
LAST QUOTED BY LAST NAME [LASTQUOTEDBYLASTNAME]
QUOTED BY FIRST NAME [QOUTEDBYFIRSTNAMD]
QUOTED BY LAST NAME [QUOTEDBYLASTNAMD] |