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Page 3 of 4 REMARKS / PROCESSING INSTRUCTIONS (Attach ACORD 101, Additional Remarks Schedule, if more space is required) ACORD 125 (2009/08) AGENCY CUSTOMER ID: PRIOR CARRIER INFORMATION
IN WASHINGTON, IT IS A CRIME TO KNOWINGLY PROVIDE FALSE, INCOMPLETE, OR MISLEADING INFORMATION TO AN INSURANCE COMPANY FOR THE PURPOSE OF DEFRAUDING THE COMPANY. PENALTIES INCLUDE IMPRISONMENT, FINES, AND DENIAL OF INSURANCE BENEFITS.
NATURE OF BUSINESS/DESCRIPTION OF OPERATIONS BY PREMISE(S) ACORD 125 (2007/10)
Specific ACORD 38s are available for applicants in these states.)(Applicant's Initials): PERSONAL INFORMATION ABOUT YOU, INCLUDING INFORMATION FROM A CREDIT OR OTHER INVESTIGATIVE REPORT, MAY BE COLLECTED FROM PERSONS OTHER THAN YOU IN CONNECTION WITH THIS APPLICATION FOR INSURANCE AND SUBSEQUENT AMENDMENTS AND RENEWALS.
Applicable in Colorado: It is unlawful to knowingly provide false, incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages.
ACORD Forms are now available in a variety of formats, including printable PDF, electronic fillable, and eForms. Using ACORD's standardized Forms allows for increased efficiency, accuracy, and speed of information processing.
The ACORD 125 form is a standardized insurance application that asks specific questions about an insured's business so the insurance company has the information it needs to properly rate the policy.
CR BUREAU LLC NAME NO. OF MEMBERS AND MANAGERS ID NUMBER
What is an Acord 125 form? The Acord 125 form is more commonly known as the Commercial Insurance Application. This application is used to record general client information including things like business location and contact details, business description, prior insurance and loss history.
The ACORD 125 form is one of the most commonly used forms in the insurance industry. In this video we walk you through how to complete the fillable ACORD 125 Commercial Insurance...
