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] |