Sheet 1
Focused Business Insurance
  FBP-FBP
  Focused Business Insurance Line
    FBP-FBP
    Policy Attributes
      Prior Policy Expiration Date
        PriorExp
      Prior Insurance Company
        PriorInsCo
      Business Type
        BusType
        Apartment
        Apartment Condominium Association
        Contractor
        Convenience Store
        Mercantile
        Mixed
        Motel
        Office
        Office Condominium
        Processing and Service
        Restaurant-Casual Dining
        Restaurant-Fast Food
        Restaurant-Fine Dining
        Restaurant-Limited Cooking
        Self-Storage Facility
        Wholesaler
    Line Conditions
      Conditional Limitation Of Cov For Terrorism - Sub-Limit On Annual Aggregate Basis (Relating To Disposition Of Terrorism)
        CndLimitTerror
        Terrorism Aggregate Limit:
      Limitation Of Coverage For Terrorism - Sub-limit On Annual Aggregate Basis
        CndLimitTerrorAgg
        Terrorism Aggregate Limit:
      Limitations Of Coverage For Certified Acts Of Terrorism
        CndLimitTerrorCert
        Certified Acts Of Terrorism Aggregate Limit
        Certified Acts Sub-Limit
        Description Of Property Or Coverage
        State(s):
      Primary And Noncontributory - Other Insurance Condition
        CndOtherIns
    Line Exclusions
      Abuse Or Molestation Exclusion
        ExclAbuse
      Amendment - Liquor Liability Exclusion - Exception For Scheduled Premises Or Activities
        ExclLiquor
      Communicable Disease Exclusion
        ExclDisease
      Conditional Exclusion Of Terrorism Involving Nuclear, Biological, Chemical Terrorism (Disposition Of Federal Terrorism Act)
        ExclTerrorNuclear
      Employment-Related Practices Exclusion
        ExclERPL
      Exclusion Of Certified Acts Of Terrorism
        ExclCertTerror
      Exclusion Of Certified Acts Of Terrorism Nuclear, Biological, Chemical Terrorism; Cap Covered Certified Losses
        ExclTerrorCertNuclear
      Exclusion - Designated Work
        ExclDesWork
        Description Of Your Work
      Exclusion - Exterior Insulation And Finish Systems
        ExclExtInstall
      Exclusion - Personal And Advertising Injury
        ExclPersAd
      Exclusion - Products-Completed Operations Hazard
        ExclProdCo
      Exclusion - Silica Or Silica-Related Dust
        ExclSilica
      Exclusion - Unmanned Aircraft
        ExclPlane
      Exclusion - Year 2000 Computer-Related And Other Electronic Problems - With Exception For Bodily Injury On Your Premises
        ExclY2k
      Pollution Exclusion - Limited Exception For A Short-Term Pollution Event
        ExclPollution
      Total Pollution Exclusion With A Building Heating Equipment Exception And A Hostile Fire Exception
        ExclTotalPollution
    Additional Interests
      Interest Type
        Additional Insured - Controlling Interest
        Additional Insured - Designated Person Or Organization
        Additional Insured - Engineers, Architects Or Surveyors
        Additional Insured - Engineers, Architects Or Surveyors Not Engaged By The Named Insured
        Addl Insd - Owners, Lessees Or Contractors - With Addl Insd Requirement For Other Parties In Construction Contract
        Additional Insured - Owners, Lessees Or Contractors - With Additional Insured Requirement In Construction Contract
        Additional Insured - Owners, Lessees Or Contractors - Completed Operations
        Additional Insured - State Or Governmental Agency Or Subd Or Political Subd - Permits Or Auths Relating To Prem
        Additional Insured - State Or Governmental Agency Or Subdivision Or Political Subdivision - Permits Or Authorizations
        Additional Insured - Townhouse Associations
        Additional Insured - Vendors
      Name
    Prequalification Questions
      Do you obtain and verify certificates of insurance obtained from subcontractors manufacturers and/or suppliers (if "No" explain)
        QCertofIns
        No
        Yes
      Do/Have any operations past present or discontinued operations involve(d) storing treating discharging applying disposing or transporting of hazardous materials? (e.g. landfills wastes fuel tanks etc)
        QDiscOps
        No
        Yes
      Are athletic teams sponsored?
        QTeams
        No
        Yes
          Extent of Sponsorship
          Type of sport
          Is it a contact sport?
          Description
      Workers Compensation Coverage Carried
        QWorkComp
        No
        Yes
      Do you lease employees to or from other employers?
        QLeaseEmpl
        No
        Yes
          Lease From
          Lease To
          Age Group
            13 - 18
            12 & Under
            Over 18
      In addition to your primary nature of business are you also involved in the manufacture relabeling or repacking of others products?
        QRepackRelabel
        No
        Yes
          Description
      Do/Have any operations past present or discontinued operations involve(d) storing treating discharging applying disposing or transporting of hazardous materials? (e.g. landfills wastes fuel tanks etc)
        QDischargeDisposal
        No
        Yes
      Does the operation have hours after 9:00 P.M. and/or 24 hour operations?
        QLateHours
        No
        Yes
      Do you rent or loan equipment to others?
        QRentEquip
        No
        Yes
          Type of Equipment
            Small Tools
            Large Equipment
      Do you own or operate any other business?
        QOtherBus
        No
        Yes
          Operations
          Description
      In addition to your primary nature of business are you also involved in the mixing of others products?
        QMixingProd
        No
        Yes
          Description
      Years in Business
        QYrsInBus
    Line Coverages
      Computer Fraud And Funds Transfer Fraud
        CovFraud
        Computer Fraud and Funds Transfer Fraud Limit
          CovFraudLimit
          25000
          50000
          100000
      Employee Dishonesty
        CovEmplDis
        Employee Dishonesty Limit
          CovEmpDisLimit
          5000
          10000
          25000
          50000
          100000
      Forgery Alteration
        CovForgery
        Forgery and Alteration Limit
          CovForgeryLimit
          2500
          5000
          10000
          25000
          50000
          100000
      Interruption of Computer Operations
        CovInterruptComp
        Interruption of Computer Operations Limit
          CovInterruptCompLimit
      Terrorism
        CovTerror
        Yes
        No
        Terrorism Building Sub Limit
    Line Additional Coverages
      Coverage For Injury To Leased Workers
        CovLeasedWorker
      Discretionary Payroll Expense
        CovDiscPay
      Employee Benefits Liability
        CovEBLI
        Aggregate Limit
        Deductible
        Each Employee Limit
        Employee Benefits Program
        Retroactive Date
      Employment-Related Practices Liability Endorsement
        Annual Aggregate Limit
          10000
          25000
          50000
          75000
          100000
        Coverage Type
          Mercantile
          Restaurant
          Wholesale
          All Other
        Deductible Amount
          500
          1000
          2500
          5000
          10000
          25000
        Extended Reporting Period
          Yes
          No
        Employment-related Malicious Prosecution
          Yes
          No
        Number of Employees
        Prior Or Pending Litigation Date
        Retroactive Date
        Supplemental Limit
          10000
          25000
          50000
          75000
          100000
      Hired Auto
        CovHiredAuto
      Non-Owned Auto Liability
        CovNonowned
        Non-Owned Auto Liability Coverage (with Delivery Service)
          WithDelivery
          Yes
          No
        Non-Owned Auto Liability Coverage (without Delivery Service)
          NoDelivery
          Yes
          No
      Identity Fraud Expense
        CovIdentityTheft
        Yes
        No
        Aggregate Limit
      Liquor Liability Coverage
        CovLiquor
        Yes
        No
        Each Common Cause Limit
        Aggregate Limit
      Limited Pollution Liability Extension
        CovLimitPollution
        Yes
        No
        Aggregate Limit
      Newly Acquired Organizations
        CovNewOrgs
        Yes
        No
    Business Liability
      Business Liability Coverage
        CovLiability
        Per Occurance
          CovLiabilityPO
          300000
          500000
          1000000
          2000000
        General Aggregate
          CovLiabilityGA
          600000
          1000000
          2000000
          4000000
      Products Completed Operations
        CovProdCo
        Products Completed Operations Limit
          CovProdCoLimit
          600000
          900000
          1000000
          1500000
          2000000
          3000000
          4000000
          6000000
      Optional Per Person Medical Expenses
        CovMP
        Optional Per Person Medical Expenses Limit
          CovMPLimit
          5000
          10000
      Deductible
        LiabDed
        0
        250
        500
        1000
        2500
      Deductible Type
        LiabDedType
        Not Applicable
        Per Claim Basis
        Per Occurrence Basis
    Business Income
      Business Income Coverage
        CovBusInc
      Extended Period of Indemnity
        CovExtPI
        Number of Days
          60
          90
          120
          150
          180
          270
          360
      Ordinary Payroll
        CovOP
        Number of Days
          60
          90
          120
          150
          180
          270
          360
      Exempt Employees/Jobs
        CovExemptEmp
      Time Element
        CovTimeEl
        Number of Days
          60
          90
          120
          150
          180
          270
          360
      Revised Reporting Period
        CovRevRepPeriod
        Months
          6 Months
          9 Months
          18 Months
      Extra Expense
        CovExtraExp
      Dependant Properties
        CovDepProp
    Location
      Location Coverages
        Equipment Breakdown Protection
          CovEB
          Included
            CovEBIncluded
            Yes
            No
          Optional Property Damage Deductible
            CovEBOptDed
            250
            500
            1000
            2500
            5000
            10000
          Optional Time Deductible
            CovEBOptTimeDed
            0
            24
            48
            72
            120
        Limitation Of Coverage To Designated Premises Project Or Operation
          CovDesPrem
        Fine Arts
          CovFineArts
          Fine Arts Item
            Fine Arts Item Description
            Fine Arts Item Type
              Painting
              Sculpture
            FIne Arts Item Value
        Fire Department Service Contract
          CovFireServContract
        Flood
          CovFlood
        Apartment Buildings - Liability For Loss Or Damage To Tenants' Autos (Legal Liability Coverage) - Total Limits
          CovTenantsAutos
        Higher Limits
          CovHigherLimits
        Loss Of Rental Value - Landlord As Designated Payee
          CovLostRent
        Water Back-Up And Sump Overflow
          CovSump
          Business Income and Extra Expense Annual Aggregate Limit
            CovSumpEELimit
            5000
          Covered Property Annual Aggregate Limit
            CovSumpAggLimit
            5000
        Fire Department Services
          CovFireService
          Fire Department Service Limit
            CovFireServiceLimit
            2500
            5000
            7500
            10000
        Limited Fungi or Bacteria
          CovMold
          Fungi or Bacteria Limit
            CovMoldLimit
          Separate Annual Aggregate Limit Applies
            CovMoldAggLimit
            Not Applicable
            No
            Yes
        Location Outdoor Signs
          CovOutSigns
          Outdoor Signs Limit
            CovOutSignsLimit
        Food Spoilage
          CovFoodSpoil
          Food Spoilage Limit
            CovFoodSpoilLimit
      Attributes
        Address
        Protection Class
          1
          3
          5
          7
          8
          8B
        Feet to Water Source/Hydrant
          1000 or less
          Over 1000
        Property Deductibles
          Optional Deductible
            250
            500
            1000
            2500
            5000
            7500
            10000
          Windstorm or Hail Percentage Deductible
            Not Applicable
            1%
            2%
            5%
        Territory
          1
          2
          3
        Address
      Building
        Standard Building Coverages
          Building Coverage
            CovBldg
            Building Limit
              CovBldgLimit
            Valuation
              CovBldgVal
              Replacement Cost
              Actual Cash Value
              Functional Valuation
            Automatic Increase Percent
              CovBldgIncrease
              2
              4
              6
              8
              10%
              12%
              14%
              16%
              18%
              20%
              22%
              24%
          Damage To Premises Rented To You
            CovRentedPrem
            Damage To Premises Rented To You Limit
              CovRentedPremLimit
        Additional Building Coverages
          Debris Removal Additional Insurance
            CovDebris
            Debris Removal Amount
              CovDebrisLimit
          Ordinance Or Law
            CovOandL
            Coverage Selection
              CovOandLSelection
              Coverage 1 Only
              Coverage 3 Only
              Coverages 1 and 2
              Coverages 1 2 and 3
              Coverage 1 with Coverages 2 and 3 Combined
              Neither Coverage 1 2 or 3
          Increase In Rebuilding Expenses Following Disaster (Additional Expense Coverage On Annual Aggregate Basis)
            CovIncBldgExp
            Additional Expense Coverage Percentage
              CovIncBldgExpPerc
          Broadened Coverage For Damage To Premises Rented To You
            CovBroadRented
            Limit Of Insurance (Per Occurrence):
              CovBroadRentedLimit
            Premises:
              CovBroadRentedPremises
          Utility Services - Direct Damage
            CovUtilityDD
            Communication Supply
              CovDDCommSupply
              No Coverage
              Public Utility-Including Overhead Communication Lines
              Other Than Public Utility-Including Overhead Communication Lines
              Public Utility-Not Including Overhead Communication Lines
              Other Than Public Utility-Not Including Overhead Communication Lines
            Covered Property
              CovDDCoveredProp
              Building
              Business Personal Property
            Limit
              CovDDLimit
            Power Supply
              CovDDPowerSupply
              No Coverage
              Public Utility-Including Overhead Power Transmission
              Other Than Public Utility-Including Overhead Power Transmission
              Public Utility-Not Including Overhead Power Transmission
              Other Than Public Utility-Not Including Overhead Power Transmission
            Water Supply
              CovDDWaterSupply
              No Coverage
              Public Utility
              Other Than Public Utility
          Vacancy Changes
            CovVacChanges
            Minimum Percentage Rented/Used
          Vacancy Permit
            CovVacPermit
            Excepted Causes of Loss
              None
              Sprinkler Leakage
              Sprinkler Leakage and Vandalism
              Vandalism
            End Date
            Start Date
          Windstorm Or Hail Losses To Roof Surfacing - Actual Cash Value Loss Settlement
            CovWindACV
            Option
              ActualCashValue
              CosmeticExclusion
              ActualCashValueAndCosmeticExclusion
        Personal Property
          Business Personal Property
            CovBPP
            Business Personal Property Limit
              CovBPPLimit
            Business Personal Property Deductible
              CovBPPDed
              250
              500
        Building Conditions
          Limitations On Coverage For Roof Surfacing
            CndRoof
        Building Exclusions
          Exclusion Of Loss Due To By-Products Of Production Or Processing Operations (Rental Properties)
            ExclRental
            Description Of Rental Unit
          Windstorm Or Hail Exclusion
            ExclWind
        Building Attributes
          Building Description
            Building Description
            BCEG
              1
              2
              3
              4
              5
              6
              7
              8
              9
              Ungraded
            Building Interest
              Own
              Rent
              Lease
          Building Elements
            Year Built
            NumberOfStories
            Number of Units
            ConstructionType
              Frame
              Joisted Masonry
              Non-Combustible
              Masonry Non-Combustible
              Modified-Fire Resistive
              Fire Resistive
            Roof Type
              Asphalt Shingles
              Clay Tiles
            Under Construction
              No
              Yes
            Single Occupancy
              Yes
              No
          Building Update Elements
            Wiring Update Year
            Heating Update Year
            Plumbing Update Year
            Roof Update Year
          Protection Elements
            Sprinklered
              No
              Yes
            Alarm
              Central
              Local
              Monitored
              None
          Wind Mitigation Elements
            Wind Excluded
              No
              Yes
            Coastal County
              Remainder
              Beach/Coastal
            Roof Shape
              Flat
              Gable
              Hip
              Other
            Opening Protection
              None
              Engineered Shutters
              No Engineered Shutters
            Roof Deck
              Wood
              Metal
              Reinforced Concrete
            Secondary Water Resistence
              No
              Yes
            Roof to Wall Connection
              Clips
              Toe Nails
              Double Single Wraps
            Door Strength
              Reinforced Single Width Doors
              All Other
        Occupancy
          Classification Code
            0001
            0002
            0003
            0004
            0005
            0006
            0007
            0008
            0009
            0010
            0011
            0012
            0013
            0014
            0015
            0016
          Occupancy Square Footage
          Occupancy Percentage
            10% or less
            Over 10%
            na
        Building Questions
          Does Applicant have a heating or processing Boiler?
            QBldgBoiler
            No
            Yes
              Current Carrier for Boiler & Machinery Coverage
                QBldgBoilerCarrier
          Number of fire divisions
            QBldgFireDiv
          Is there a safe/vault?
            QBldgSafe
            No
            Yes
              Safe/Vault/Receptacle Manufacturer's Name
                QBldgSafeManuName
              Partial
              Complete
          Does the location include an Apartment Apartment Condominium Association or a Office Condominium?
            QBldgApartment
            No
            Yes
          Maximum Cash on Premises
            QBldgCashonPrem
          Deadbolt Cylinder Door Locks?
            QBldgDeadbolt
            No
            Yes
          Is there an alarm?
            QBldgPoliceAlarm
            No
            Yes
              Alarm Description
                QBldgPoliceAlarmDesc
                Local Gong
                Central Station with Keys
                Central Station without Keys
                Police Connect
              Alarm Grade
                QBldgPoliceAlarmGrade
              Alarm Type
                QBldgPoliceAlarmType
                Hold-Up
                Premises
                Other
              Alarm Certificate Number
                QBldgPoliceAlarmCert
              Alarm Certificate Expiration
                QBldgPoliceAlarmExp
          Is there a playground on premises?
            QBldgPlay
            No
            Yes
              Is access limited?
                No
                Yes
          Is there a swimming pool on premises?
            QBldgPool
            No
            Yes
              Is the pool above ground?
                No
                Yes
              Is there an approved fence?
                No
                Yes
              Is the pool in ground?
                No
                Yes
                  Is there a diving board?
                    No
                    Yes
                  Is there a slide?
                    No
                    Yes
          Is all equipment inspected annually and well maintained?
            QBldgEquipInsp
            No
            Yes
          Maximum Cash with Messenger
            QBldgMaxCash
          Number of units per fire division
            QBldgFireDivUnits
          Any specialized equipment such as medical equipment or other valued over $100000?
            QBldgSpecMed
            No
            Yes
              Description
          Are there smoke detectors?
            QBldgSmokeDet
            No
            Yes
              Smoke detectors type
                Battery
                Wired
          Money on Premises Overnight
            QBldgMoney
          Date of Last Inspection
            QBldgInspDate
          Is a property manager employed?
            QBldgPropMan
            No
            Yes
              Name of Propery Manager
                QBldgPropManName
              Property Manager Address
                QBldgPropManAddress
              Property Manager Contact Phone Number
                QBldgPropManNumber
          Is developer or contractor a board member?
            QBldgBoardMember
            No
            Yes
          Is aluminum wire used?
            QBldgAlumWire
            No
            Yes
May need to expand this list.