PureEdge ACORD Customer Service: Telephone: (845) 620-1700 ex. 506 Address: New York Office (World Headquarters) Two Blue Hill Plaza 3rd Floor PO Box 1529 Pearl River, NY 10965-8529 USA 7/11/2003 Property Fillable.xfd 1 B0DCC26B-7C78-4073-996B-95A834496113 23.76.5 ACORD 1 (2005/02) Arial 10 plain 0 on T-GEQ8-Z9ZS-9AC6-Z9TV-ADAC off off off off off off off off off off off off off off off off off off off 2005/02 off off off off off off off off off [custom:DEFAULT_MAP][custom:PAGE1][custom:DATE] PAGE1.DATE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AGENCY] PAGE1.AGENCY.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FAX] PAGE1.FAX.value [custom:DEFAULT_MAP][custom:PAGE1][custom:EMAIL] PAGE1.EMAIL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PHONE] PAGE1.PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:INSURED_NAME_AND_ADDRESS] PAGE1.INSURED_NAME_AND_ADDRESS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CODE] PAGE1.CODE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SUB_CODE] PAGE1.SUB_CODE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AGENCY_CUSTOMER_ID] PAGE1.AGENCY_CUSTOMER_ID.value [custom:DEFAULT_MAP][custom:PAGE1][custom:MISCELLANEOUS_INFO] PAGE1.MISCELLANEOUS_INFO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DATE_OF_LOSS] PAGE1.DATE_OF_LOSS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:TIME_OF_LOSS] PAGE1.TIME_OF_LOSS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AM] PAGE1.AM.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PM] PAGE1.PM.value [custom:DEFAULT_MAP][custom:PAGE1][custom:YES] PAGE1.YES.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NO] PAGE1.NO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PROP_HOME_CO] PAGE1.PROP_HOME_CO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PROP_HOME_POL] PAGE1.PROP_HOME_POL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NAIC_CODE_1] PAGE1.NAIC_CODE_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EFF_1] PAGE1.POLICY_DATE_EFF_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EXP_1] PAGE1.POLICY_DATE_EXP_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_CO] PAGE1.FLOOD_CO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_POL] PAGE1.FLOOD_POL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NAIC_CODE_2] PAGE1.NAIC_CODE_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EFF_2] PAGE1.POLICY_DATE_EFF_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EXP_2] PAGE1.POLICY_DATE_EXP_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:WIND_CO] PAGE1.WIND_CO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:WIND_POL] PAGE1.WIND_POL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NAIC_CODE_3] PAGE1.NAIC_CODE_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EFF_3] PAGE1.POLICY_DATE_EFF_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POLICY_DATE_EXP_3] PAGE1.POLICY_DATE_EXP_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_INSURED] PAGE1.CONTACT_INSURED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:INSURED_DATE_OF_BIRTH] PAGE1.INSURED_DATE_OF_BIRTH.value [custom:DEFAULT_MAP][custom:PAGE1][custom:INSURED_SIN] PAGE1.INSURED_SIN.value [custom:DEFAULT_MAP][custom:PAGE1][custom:INSURED_RESIDENCE_PHONE] PAGE1.INSURED_RESIDENCE_PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:INSURED_BUSINESS_PHONE] PAGE1.INSURED_BUSINESS_PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_NAME_AND_ADDRESS] PAGE1.CONTACT_NAME_AND_ADDRESS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SPOUSE_NAME_AND_ADDRESS] PAGE1.SPOUSE_NAME_AND_ADDRESS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SPOUSE_DATE_OF_BIRTH] PAGE1.SPOUSE_DATE_OF_BIRTH.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SPOUSE_SIN] PAGE1.SPOUSE_SIN.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_RESIDENCE_PHONE] PAGE1.CONTACT_RESIDENCE_PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_BUSINESS_PHONE] PAGE1.CONTACT_BUSINESS_PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_WHERE_TO_CONTACT] PAGE1.CONTACT_WHERE_TO_CONTACT.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CONTACT_WHEN_TO_CONTACT] PAGE1.CONTACT_WHEN_TO_CONTACT.value [custom:DEFAULT_MAP][custom:PAGE1][custom:LOSS_OF_LOCATION] PAGE1.LOSS_OF_LOCATION.value [custom:DEFAULT_MAP][custom:PAGE1][custom:WHERE_REPORTED] PAGE1.WHERE_REPORTED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FIRE] PAGE1.FIRE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:THEFT] PAGE1.THEFT.value [custom:DEFAULT_MAP][custom:PAGE1][custom:HAIL] PAGE1.HAIL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:WIND] PAGE1.WIND.value [custom:DEFAULT_MAP][custom:PAGE1][custom:LIGHTNING] PAGE1.LIGHTNING.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD] PAGE1.FLOOD.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER] PAGE1.OTHER.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_DESC] PAGE1.OTHER_DESC.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ENTIRE_LOSS] PAGE1.ENTIRE_LOSS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DESCRIPTION_OF_LOSS] PAGE1.DESCRIPTION_OF_LOSS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NO_MORTGAGEE_DESC] PAGE1.NO_MORTGAGEE_DESC.value [custom:DEFAULT_MAP][custom:PAGE1][custom:NO_MORTGAGEE] PAGE1.NO_MORTGAGEE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COVERAGES_EXCLUDED] PAGE1.COVERAGES_EXCLUDED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SUBJECT_TO_FORMS] PAGE1.SUBJECT_TO_FORMS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SUBJECT_TO_FORMS_2] PAGE1.SUBJECT_TO_FORMS_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DWELLING] PAGE1.DWELLING.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_STRUCTURES] PAGE1.OTHER_STRUCTURES.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PERSONAL_PROPERTY] PAGE1.PERSONAL_PROPERTY.value [custom:DEFAULT_MAP][custom:PAGE1][custom:LOSS_OF_USE] PAGE1.LOSS_OF_USE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DEDUCTIBLES] PAGE1.DEDUCTIBLES.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DESCRIBE_ADDITIONAL_1] PAGE1.DESCRIBE_ADDITIONAL_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DESCRIBE_ADDITIONAL_2] PAGE1.DESCRIBE_ADDITIONAL_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ITEM_1] PAGE1.ITEM_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_DESC_1] PAGE1.OTHER_DESC_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AMOUNT_1] PAGE1.AMOUNT_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COIN_1] PAGE1.COIN_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DEDUCTIBLE_1] PAGE1.DEDUCTIBLE_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COVERAGES_1] PAGE1.COVERAGES_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ITEM_2] PAGE1.ITEM_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_DESC_2] PAGE1.OTHER_DESC_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AMOUNT_2] PAGE1.AMOUNT_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COIN_2] PAGE1.COIN_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DEDUCTIBLE_2] PAGE1.DEDUCTIBLE_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COVERAGES_2] PAGE1.COVERAGES_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ITEM_3] PAGE1.ITEM_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_DESC_3] PAGE1.OTHER_DESC_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:AMOUNT_3] PAGE1.AMOUNT_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COIN_3] PAGE1.COIN_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DEDUCTIBLE_3] PAGE1.DEDUCTIBLE_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:COVERAGES_3] PAGE1.COVERAGES_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_BUILDING] PAGE1.FLOOD_BUILDING.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_DEDUCTIBLE_1] PAGE1.FLOOD_DEDUCTIBLE_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PRE_FIRM] PAGE1.PRE_FIRM.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_GENERAL] PAGE1.FORM_TYPE_GENERAL.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_CONDO] PAGE1.FORM_TYPE_CONDO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_DWELLING] PAGE1.FORM_TYPE_DWELLING.value [custom:DEFAULT_MAP][custom:PAGE1][custom:POST_FIRM] PAGE1.POST_FIRM.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_BUILDING_CONTENTS] PAGE1.FLOOD_BUILDING_CONTENTS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FLOOD_DEDUCTIBLE_2] PAGE1.FLOOD_DEDUCTIBLE_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ZONE] PAGE1.ZONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DIFF_IN_ELEV] PAGE1.DIFF_IN_ELEV.value [custom:DEFAULT_MAP][custom:PAGE1][custom:F98] PAGE1.F98.value [custom:DEFAULT_MAP][custom:PAGE1][custom:F99] PAGE1.F99.value [custom:DEFAULT_MAP][custom:PAGE1][custom:F100] PAGE1.F100.value [custom:DEFAULT_MAP][custom:PAGE1][custom:F101] PAGE1.F101.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_GENERAL2] PAGE1.FORM_TYPE_GENERAL2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_DWELLING2] PAGE1.FORM_TYPE_DWELLING2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FORM_TYPE_CONDO2] PAGE1.FORM_TYPE_CONDO2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:REMARKS] PAGE1.REMARKS.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CAT] PAGE1.CAT.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FICO] PAGE1.FICO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ADJUSTER_ASSIGNED] PAGE1.ADJUSTER_ASSIGNED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:ADJUSTER_NUMBER] PAGE1.ADJUSTER_NUMBER.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DATE_ASSIGNED] PAGE1.DATE_ASSIGNED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:REPORTED_BY] PAGE1.REPORTED_BY.value [custom:DEFAULT_MAP][custom:PAGE1][custom:REPORTED_TO] PAGE1.REPORTED_TO.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SIGNATURE_OF_SIGNED] PAGE1.SIGNATURE_OF_SIGNED.value [custom:DEFAULT_MAP][custom:PAGE1][custom:SIGNATURE_OF_PRODUCER] PAGE1.SIGNATURE_OF_PRODUCER.value [custom:DEFAULT_MAP][custom:PAGE1][custom:changeVerFIELD] PAGE1.changeVerFIELD.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CNTS_1] PAGE1.CNTS_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:BLDG_1] PAGE1.BLDG_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_1] PAGE1.OTHER_1.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CNTS_2] PAGE1.CNTS_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:BLDG_2] PAGE1.BLDG_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_2] PAGE1.OTHER_2.value [custom:DEFAULT_MAP][custom:PAGE1][custom:CNTS_3] PAGE1.CNTS_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:BLDG_3] PAGE1.BLDG_3.value [custom:DEFAULT_MAP][custom:PAGE1][custom:OTHER_3] PAGE1.OTHER_3.value etb TRADITIONAL letter 120 8.5;11.0 0 on 6D048D54-AAC7-4099-8463-2A076FAD836F 239 239 239 255 255 255 DATE 0 Field Creation_Date wordwrap fixed date optional MM/DD/YYYY quickguide_BUTTON AGENCY absolute 819 48 extent 140 25 HELP1 center Arial 8 plain 0 Field Producer wordwrap fixed absolute 5 95 extent 373 77 DATE PHONE HELP2 Arial 8 plain absolute 53 171 extent 134 23 0 Field Code wordwrap fixed Arial 7 plain HELP83 PHONE EMAIL 0 Field Sub_Code wordwrap fixed Arial 7 plain absolute 238 171 extent 140 23 HELP84 FAX CODE 0 Field Producer_Voice_ wordwrap fixed Arial 8 plain absolute 164 74 extent 214 23 AGENCY FAX HELP3 string optional 0 Field Applicant wordwrap fixed POLICY_DATE_EXP_3 INSURED_DATE_OF_BIRTH HELP19 absolute 5 288 extent 374 69 Arial 8 plain absolute 46 194 0 Field Code wordwrap fixed Arial 8 plain 16 1 EMAIL SUB_CODE HELP4 0 Field Sub_Code wordwrap fixed Arial 8 plain absolute 253 194 extent 125 23 CODE AGENCY_CUSTOMER_ID HELP5 absolute 5 230 extent 373 25 0 Field ContactsKey wordwrap fixed SUB_CODE MISCELLANEOUS_INFO HELP6 Arial 8 plain absolute 382 90 extent 249 25 0 Field F6 wordwrap fixed AGENCY_CUSTOMER_ID DATE_OF_LOSS HELP7 Arial 8 plain absolute 631 90 extent 108 25 0 Field F7 wordwrap fixed date optional MM/DD/YYYY MISCELLANEOUS_INFO TIME_OF_LOSS HELP8 center Arial 8 plain absolute 740 90 extent 72 25 0 Field F8 wordwrap fixed DATE_OF_LOSS AM HELP8 left Arial 8 plain absolute 817 74 0 Field F9 off TIME_OF_LOSS PM HELP8 absolute 817 92 0 Field F10 off AM YES HELP8 absolute 867 92 0 Field F11 off PM NO HELP9 absolute 919 92 0 Field F12 off YES PROP_HOME_CO HELP9 0 Field Company_Plan wordwrap fixed Arial 8 plain absolute 452 135 32 1 NO PROP_HOME_POL HELP14 0 Field Policy_Number wordwrap fixed Arial 8 plain absolute 452 155 32 1 PROP_HOME_CO NAIC_CODE_1 HELP15 absolute 724 142 0 Field F498 wordwrap fixed PROP_HOME_POL POLICY_DATE_EFF_1 HELP16 14 1 Arial 8 plain absolute 869 134 0 Field Effective_Date wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 NAIC_CODE_1 POLICY_DATE_EXP_1 HELP17 center absolute 869 155 0 Field Expiration_Date wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 POLICY_DATE_EFF_1 FLOOD_CO HELP18 center 0 Field F17 wordwrap fixed Arial 8 plain absolute 452 175 32 1 POLICY_DATE_EXP_1 FLOOD_POL HELP14 0 Field F18 wordwrap fixed Arial 8 plain absolute 452 195 32 1 FLOOD_CO NAIC_CODE_2 HELP15 absolute 724 183 0 Field F15 wordwrap fixed FLOOD_POL POLICY_DATE_EFF_2 HELP16 14 1 Arial 8 plain absolute 869 175 0 Field F19 wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 NAIC_CODE_2 POLICY_DATE_EXP_2 HELP17 center absolute 869 195 0 Field F20 wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 POLICY_DATE_EFF_2 WIND_CO HELP18 center 0 Field F21 wordwrap fixed Arial 8 plain absolute 452 215 32 1 POLICY_DATE_EXP_2 WIND_POL HELP14 0 Field F22 wordwrap fixed Arial 8 plain absolute 452 234 32 1 WIND_CO NAIC_CODE_3 HELP15 absolute 724 223 0 Field F16 wordwrap fixed WIND_POL POLICY_DATE_EFF_3 HELP16 14 1 Arial 8 plain absolute 869 215 0 Field F23 wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 NAIC_CODE_3 POLICY_DATE_EXP_3 HELP17 center absolute 869 234 0 Field F24 wordwrap fixed date optional MM/DD/YYYY Arial 8 plain 10 1 POLICY_DATE_EFF_3 INSURED_NAME_AND_ADDRESS HELP18 center absolute 674 252 0 Field F28 SPOUSE_SIN CONTACT_NAME_AND_ADDRESS HELP27 absolute 382 290 0 Field F116 wordwrap fixed date optional MM/DD/YYYY INSURED_NAME_AND_ADDRESS INSURED_SIN HELP20 center 17 1 Arial 8 plain absolute 382 332 extent 140 25 0 Field F5 wordwrap fixed INSURED_DATE_OF_BIRTH INSURED_RESIDENCE_PHONE HELP21 Arial 8 plain absolute 5 372 0 Field Applicant_Home_ wordwrap fixed INSURED_SIN INSURED_BUSINESS_PHONE HELP22 string optional 31 1 Arial 8 plain absolute 263 372 0 Field Applicant_Wk_ wordwrap fixed INSURED_RESIDENCE_PHONE SPOUSE_NAME_AND_ADDRESS HELP23 string optional 32 1 Arial 8 plain 0 Field F29 wordwrap fixed CONTACT_INSURED CONTACT_RESIDENCE_PHONE HELP28 absolute 526 292 53 6 Arial 8 plain 0 Field F115 wordwrap fixed INSURED_BUSINESS_PHONE SPOUSE_DATE_OF_BIRTH HELP24 absolute 5 407 extent 374 69 Arial 8 plain absolute 382 412 0 Field F117 wordwrap fixed date optional MM/DD/YYYY SPOUSE_NAME_AND_ADDRESS SPOUSE_SIN HELP25 center 17 1 Arial 8 plain absolute 382 450 0 Field F118 wordwrap fixed SPOUSE_DATE_OF_BIRTH CONTACT_INSURED HELP26 17 1 Arial 8 plain absolute 526 412 0 Field F30 wordwrap fixed CONTACT_NAME_AND_ADDRESS CONTACT_BUSINESS_PHONE HELP29 string optional 26 1 Arial 8 plain absolute 742 412 0 Field F31 wordwrap fixed CONTACT_RESIDENCE_PHONE CONTACT_WHERE_TO_CONTACT HELP30 string optional 26 1 Arial 8 plain absolute 526 450 0 Field F32 wordwrap fixed CONTACT_BUSINESS_PHONE CONTACT_WHEN_TO_CONTACT HELP31 26 1 Arial 8 plain absolute 742 450 0 Field F33 wordwrap fixed CONTACT_WHERE_TO_CONTACT LOSS_OF_LOCATION HELP32 26 1 Arial 8 plain absolute 63 509 0 Field F34 wordwrap fixed CONTACT_WHEN_TO_CONTACT WHERE_REPORTED HELP33 66 1 Arial 8 plain absolute 598 509 0 Field F35 wordwrap fixed LOSS_OF_LOCATION FIRE HELP34 44 1 Arial 8 plain absolute 66 534 0 Field F36 off wordwrap never WHERE_REPORTED LIGHTNING HELP35 absolute 66 552 0 Field F37 off wordwrap never FLOOD HAIL HELP35 absolute 151 552 0 Field F39 off wordwrap never THEFT WIND HELP35 absolute 246 552 0 Field F41 off wordwrap never HAIL OTHER HELP35 absolute 151 534 0 Field F38 off wordwrap never FIRE FLOOD HELP35 absolute 246 534 0 Field F40 off wordwrap never LIGHTNING THEFT HELP35 absolute 331 534 0 Field F42 off Arial 9 plain wordwrap never WIND OTHER_DESC HELP35 absolute 396 535 0 Field F43 on wordwrap fixed Arial 8 plain OTHER ENTIRE_LOSS HELP35 39 2 absolute 718 549 0 Field F44 wordwrap fixed OTHER_DESC DESCRIPTION_OF_LOSS HELP36 dollar comma_delimit add_ds optional 29 1 Arial 8 plain 0 Field F45 wordwrap fixed Arial 8 plain absolute 4 593 ENTIRE_LOSS NO_MORTGAGEE_DESC HELP37 118 2 absolute 123 656 extent 833 38 0 Field F35 wordwrap fixed DESCRIPTION_OF_LOSS NO_MORTGAGEE Arial 8 plain absolute 11 673 0 Field F46 NO_MORTGAGEE_DESC DWELLING HELP38 absolute 11 772 0 Field F55 DESCRIBE_ADDITIONAL_2 SUBJECT_TO_FORMS HELP46 absolute 218 789 0 Field F35 wordwrap fixed COVERAGES_EXCLUDED HELP47 ITEM_1 92 1 Arial 8 plain absolute 114 989 0 Field F35 wordwrap fixed HELP47 COVERAGES_3 FLOOD_BUILDING 105 1 Arial 8 plain absolute 4 744 0 Field F48 wordwrap fixed NO_MORTGAGEE OTHER_STRUCTURES HELP40 15 1 Arial 8 plain absolute 136 744 0 Field F49 wordwrap fixed DWELLING PERSONAL_PROPERTY HELP41 15 1 Arial 8 plain absolute 268 744 0 Field F50 wordwrap fixed OTHER_STRUCTURES LOSS_OF_USE HELP42 15 1 Arial 8 plain absolute 400 744 0 Field F51 wordwrap fixed PERSONAL_PROPERTY DEDUCTIBLES HELP43 15 1 Arial 8 plain absolute 532 744 0 Field F52 wordwrap fixed LOSS_OF_USE DESCRIBE_ADDITIONAL_1 HELP44 string optional 12 1 Arial 8 plain absolute 640 744 0 Field F53 wordwrap fixed DEDUCTIBLES DESCRIBE_ADDITIONAL_2 HELP45 18 1 Arial 8 plain absolute 811 744 0 Field F54 wordwrap fixed DESCRIBE_ADDITIONAL_1 COVERAGES_EXCLUDED HELP45 18 1 Arial 8 plain absolute 5 861 0 Field F57 wordwrap fixed SUBJECT_TO_FORMS HELP49 BLDG_1 5 1 Arial 8 plain absolute 83 872 on 0 Field F61 wordwrap fixed OTHER_1 AMOUNT_1 13 1 Arial 8 plain absolute 196 857 0 Field F62 wordwrap fixed dollar comma_delimit add_ds optional OTHER_DESC_1 COIN_1 HELP50 17 1 Arial 8 plain right absolute 340 857 0 Field F63 wordwrap fixed string optional AMOUNT_1 DEDUCTIBLE_1 HELP51 6 1 Arial 8 plain right absolute 400 857 0 Field F64 wordwrap fixed COIN_1 COVERAGES_1 HELP52 string optional 12 1 Arial 8 plain right 0 Field F65 wordwrap fixed Helvetica 8 plain absolute 508 856 DEDUCTIBLE_1 ITEM_2 HELP53 55 2 absolute 5 901 0 Field F66 wordwrap fixed COVERAGES_1 HELP49 BLDG_2 5 1 Arial 8 plain absolute 83 911 0 Field F70 wordwrap fixed OTHER_2 AMOUNT_2 on 13 1 Arial 8 plain absolute 196 897 0 Field F71 wordwrap fixed dollar comma_delimit add_ds optional OTHER_DESC_2 COIN_2 HELP50 17 1 Arial 8 plain right absolute 340 897 0 Field F72 wordwrap fixed string optional AMOUNT_2 DEDUCTIBLE_2 HELP51 6 1 Arial 8 plain right absolute 400 897 0 Field F73 wordwrap fixed COIN_2 COVERAGES_2 HELP52 string optional 12 1 Arial 8 plain right 0 Field F74 wordwrap fixed Helvetica 8 plain absolute 508 896 DEDUCTIBLE_2 ITEM_3 HELP53 55 2 absolute 5 941 0 Field F75 wordwrap fixed COVERAGES_2 HELP49 BLDG_3 5 1 Arial 8 plain absolute 83 952 0 Field F79 wordwrap fixed OTHER_3 AMOUNT_3 on 13 1 Arial 8 plain absolute 196 937 0 Field F80 wordwrap fixed dollar comma_delimit add_ds optional OTHER_DESC_3 COIN_3 HELP50 17 1 Arial 8 plain right absolute 340 937 0 Field F81 wordwrap fixed string optional AMOUNT_3 DEDUCTIBLE_3 HELP51 6 1 Arial 8 plain right absolute 400 937 0 Field F82 wordwrap fixed COIN_3 COVERAGES_3 HELP52 string optional 12 1 Arial 8 plain right 0 Field F83 wordwrap fixed Helvetica 8 plain absolute 508 936 DEDUCTIBLE_3 SUBJECT_TO_FORMS_2 HELP53 55 2 absolute 116 1015 extent 149 22 0 Field F85 wordwrap fixed Arial 8 plain SUBJECT_TO_FORMS_2 FLOOD_DEDUCTIBLE_1 HELP56 0 Field F86 wordwrap fixed Arial 8 plain absolute 342 1015 FLOOD_BUILDING FLOOD_BUILDING_CONTENTS HELP57 string optional 12 1 right absolute 498 1013 0 Field F90 off ZONE POST_FIRM HELP61 absolute 762 1013 0 Field F93 off DIFF_IN_ELEV FORM_TYPE_DWELLING HELP63 absolute 858 1013 0 Field F95 off FORM_TYPE_DWELLING F98 HELP63 absolute 762 1031 0 Field F94 off FORM_TYPE_GENERAL FORM_TYPE_CONDO HELP63 absolute 498 1031 0 Field F91 off PRE_FIRM DIFF_IN_ELEV HELP61 absolute 116 1034 extent 149 22 0 Field F87 wordwrap fixed Arial 8 plain FLOOD_DEDUCTIBLE_1 FLOOD_DEDUCTIBLE_2 HELP58 absolute 342 1034 0 Field F88 wordwrap fixed Arial 8 plain FLOOD_BUILDING_CONTENTS ZONE HELP59 string optional 12 1 right absolute 448 1031 0 Field F89 wordwrap fixed FLOOD_DEDUCTIBLE_2 PRE_FIRM HELP60 4 1 Arial 8 plain absolute 592 1032 0 Field F92 wordwrap fixed POST_FIRM FORM_TYPE_GENERAL HELP62 12 1 Arial 8 plain absolute 52 1069 0 Field F98 wordwrap fixed FORM_TYPE_CONDO F99 HELP64 17 1 Arial 8 plain absolute 196 1069 0 Field F99 wordwrap fixed F98 F100 HELP65 string optional 12 1 Arial 8 plain absolute 304 1069 0 Field F100 wordwrap fixed F99 F101 HELP66 16 1 Arial 8 plain absolute 448 1069 0 Field F101 wordwrap fixed F100 F102 HELP67 4 1 Arial 8 plain absolute 546 1053 0 Field F102 off F101 F103 HELP68 absolute 546 1072 0 Field F103 off F102 F104 HELP68 absolute 654 1052 0 Field F104 off wordwrap never F103 HELP68 REMARKS 0 Field F107 wordwrap fixed absolute 5 1111 F104 CAT HELP69 118 3 Arial 8 plain absolute 5 1189 0 Field F108 wordwrap fixed string optional REMARKS FICO HELP70 5 1 Arial 8 plain absolute 52 1189 0 Field F109 wordwrap fixed string optional CAT ADJUSTER_ASSIGNED HELP71 14 1 Arial 8 plain absolute 233 1189 0 Field F110 wordwrap fixed FICO ADJUSTER_NUMBER HELP72 62 1 Arial 8 plain absolute 736 1189 0 Field F111 wordwrap fixed ADJUSTER_ASSIGNED DATE_ASSIGNED HELP73 string optional 13 1 Arial 8 plain absolute 856 1189 0 Field F112 wordwrap fixed date optional MM/DD/YYYY ADJUSTER_NUMBER REPORTED_BY HELP74 center 12 1 Arial 8 plain absolute 5 1228 0 Field F113 wordwrap fixed DATE_ASSIGNED REPORTED_TO HELP75 21 1 Arial 8 plain absolute 184 1228 0 Field F114 wordwrap fixed REPORTED_BY HELP76 21 1 Arial 8 plain absolute 365 1228 0 Field F113 wordwrap fixed HELP79 36 1 Arial 8 plain absolute 664 1228 0 Field F114 wordwrap fixed next_button HELP81 36 1 Arial 8 plain