Acord 25 (2016/03) Certificate of Liability Insurance

This object contains the form data included in form type acord25V201603. Properties are named so that they can be easily traced back to the official Acord form. You may want to compare the object to the official Acord form for reference.

This form includes space for one signature. The signer is identified as the authorizedRep in the party property of the signature object.

The Acord corporation revises its forms from time to time. When forms are revised, a new form type will be provided by Nextform, and the old form type will remain available indefinitely, to avoid unexpected changes in fields and disruptions to integrations.


Example Object

Below is an example object with all fields filled in. In practical use, not all fields would be used. The below is for illustrative purpoases only.

{
  "dateIssued": "2021-12-31T11:45:03.202Z",
  "certificateNumber": "1235-ASDFJIE",
  "revisionNumber": "00001",
  "producerName": "Lockton Companies",
  "producerAddress1": "1234 Union Street",
  "producerAddress2": "Suite 100",
  "producerCity": "Salt Lake City",
  "producerState": "ut",
  "producerZip": "38383",
  "producerContact": "Robert Smith",
  "producerPhone": "(123) 456-7892",
  "producerFax": "(123) 456-7892",
  "producerEmail": "user@example.com",
  "insuredName": "Some Company, Inc.",
  "insuredAddress1": "234 Street Road",
  "insuredAddress2": "Suite 2002",
  "insuredCity": "Atlanta",
  "insuredState": "ga",
  "insuredZip": "30330",
  "insurerAName": "Insurance Company A",
  "insurerANaic": "12345",
  "insurerBName": "Insurance Company B",
  "insurerBNaic": "12345",
  "insurerCName": "Insurance Company C",
  "insurerCNaic": "12345",
  "insurerDName": "Insurance Company D",
  "insurerDNaic": "12345",
  "insurerEName": "Insurance Company E",
  "insurerENaic": "12345",
  "insurerFName": "Insurance Company F",
  "insurerFNaic": "12345",
  "cglLetter": "A",
  "cglIsClaimsMade": true,
  "cglIsOccurrence": false,
  "cglOther1": "Other type 1",
  "cglOther2": "Other type 2",
  "cglIsPerPolicy": true,
  "cglIsPerProject": false,
  "cglIsPerLocation": false,
  "cglPerOther": "Some other method",
  "cglIsAddlInsured": true,
  "cglIsSubrWaived": false,
  "cglPolicyNumber": "12341234123",
  "cglEffectiveDate": "2021-12-31T11:45:03.202Z",
  "cglExpirationDate": "2021-12-31T11:45:03.202Z",
  "cglLimitEachOccurrence": 5000000,
  "cglLimitDamageToRented": 2000000,
  "cglLimitMedical": 1000000,
  "cglLimitPersonal": 1000000,
  "cglLimitGeneralAggregate": 10000000,
  "cglLimitProducts": 1000000,
  "cglLimitOtherLabel": "Other Label",
  "cglLimitOther": 500000,
  "autoLetter": "B",
  "autoPolicyNumber": "LKJSHDLFKJS-298734",
  "autoEffectiveDate": "2021-12-31T11:45:03.202Z",
  "autoExpirationDate": "2021-12-31T11:45:03.202Z",
  "autoIsAny": true,
  "autoIsOwned": false,
  "autoIsScheduled": false,
  "autoIsHired": false,
  "autoIsNonOwned": false,
  "autoOther1": "Other type 1",
  "autoOther2": "Other type 2",
  "autoIsAddlInsured": false,
  "autoIsSubrWaived": true,
  "autoLimitCombined": 1000000,
  "autoLimitPerPerson": 1000000,
  "autoLimitPerAccident": 1000000,
  "autoLimitProperty": 1000000,
  "autoLimitOtherLabel": "Auto Other Label",
  "autoLimitOther": 1000000,
  "ueLetter": "C",
  "uePolicyNumber": "LKJSHDLFKJS-298734",
  "ueEffectiveDate": "2021-12-31T11:45:03.202Z",
  "ueExpirationDate": "2021-12-31T11:45:03.202Z",
  "ueIsUmbrella": true,
  "ueIsExcess": false,
  "ueIsOccurrence": false,
  "ueIsClaimsMade": false,
  "ueRetention": 100000,
  "ueIsAddlInsured": false,
  "ueIsSubrWaived": false,
  "ueLimitEachOccurrence": 1000000,
  "ueLimitAggregate": 1000000,
  "ueLimitOtherLabel": "Other Label",
  "ueLimitOther": 1000000,
  "elLetter": "D",
  "elPolicyNumber": "LKJSHDLFKJS-298734",
  "elEffectiveDate": "2021-12-31T11:45:03.202Z",
  "elExpirationDate": "2021-12-31T11:45:03.202Z",
  "elHasExclusions": true,
  "elIsSubrWaived": true,
  "elLimitIsPerStatute": true,
  "elLimitIsOther": true,
  "elLimitOther": "Description",
  "elLimitEachAccident": 1000000,
  "elLimitDiseaseEmployee": 1000000,
  "elLimitDiseasePolicy": 1000000,
  "otherLetter": "E",
  "otherPolicyNumber": "LKJSHDLFKJS-298734",
  "otherEffectiveDate": "2021-12-31T11:45:03.202Z",
  "otherExpirationDate": "2021-12-31T11:45:03.202Z",
  "otherType": "Other 1 Type",
  "otherIsAddlInsured": true,
  "otherIsSubrWaived": true,
  "otherLimitLabel1": "Limit Label 1",
  "otherLimit1": 1000000,
  "otherLimitLabel2": "Limit Label 2",
  "otherLimit2": 2000000,
  "otherLimitLabel3": "Limit Label 3",
  "otherLimit3": 3000000,
  "description": "Long description and details of coverage.",
  "holderName": "Some Holder, Inc.",
  "holderAddress1": "Street Lane",
  "holderAddress2": "Suite 237948",
  "holderCity": "Tucson",
  "holderState": "az",
  "holderZip": "21837-2393"
}

Properties

dateIssued date

The date the certificate was issued.


certificateNumber string

Certificate number.


revisionNumber string

Revision number.


producerName string

The business name of the producer. Limit of 60 characters.


producerAddress1 string

Address line 1 of the producer. Limit of 60 characters.


producerAddress2 string

Address line 2 of the producer. Limit of 60 characters.


producerCity string

City of the producer. Limit of 60 characters.


producerState string

State of the producer. Valid values include any two-letter state abbreviation.


producerZip string

U.S. zip code of the producer. Valid values include five digit or nine digit zip codes (with hyphen).


producerContact string

The contact person of the producer.


producerPhone string

The phone number of the producer.


producerFax string

The fax number of the producer.


producerEmail string

The email address of the producer.


insuredName string

The name of the insured party. Limit of 60 characters.


insuredAddress1 string

Address line 1 of the insured party. Limit of 60 characters.


insuredAddress2 string

Address line 2 of the insured party. Limit of 60 characters.


insuredCity string

City of the insured party. Limit of 60 characters.


insuredState string

State of the insured party. Valid values include any two-letter state abbreviation.


insuredZip string

U.S. zip code of the insured party. Valid values include five digit or nine digit zip codes (with hyphen).


insurerAName string

Name of insurer A. The letter is referenced further down in each coverage type.


insurerANaic string

NAIC number of insurer A.


insurerBName string

Name of insurer B. The letter is referenced further down in each coverage type.


insurerBNaic string

NAIC number of insurer B.


insurerCName string

Name of insurer C. The letter is referenced further down in each coverage type.


insurerCNaic string

NAIC number of insurer C.


insurerDName string

Name of insurer D. The letter is referenced further down in each coverage type.


insurerDNaic string

NAIC number of insurer D.


insurerEName string

Name of insurer E. The letter is referenced further down in each coverage type.


insurerENaic string

NAIC number of insurer E.


insurerFName string

Name of insurer F. The letter is referenced further down in each coverage type.


insurerFNaic string

NAIC number of insurer F.


cglLetter string

Letter of the CGL insurer. Must reference one of the above listed insurers. One character, a-f.


cglPolicyNumber string

CGL policy number. Limit of 25 characters.


cglEffectiveDate date

CGL policy effective date.


cglExpirationDate date

CGL policy expiration date.


cglIsClaimsMade boolean

CGL is claims-made.


cglIsOccurrence boolean

CGL is occurrence.


cglOther1 string

Other type of CGL coverage 1. Limit of 25 characters.


cglOther2 string

Other type of CGL coverage 2. Limit of 25 characters.


cglIsPerPolicy boolean

CGL coverage is per policy.


cglIsPerProject boolean

CGL coverage is per project.


cglIsPerLocation boolean

CGL coverage is per location.


cglPerOther string

If CGL coverage is per some other method, describe it here. Limit of 25 characters.


cglIsAddlInsured boolean

CGL is an additional insured.


cglIsSubrWaived boolean

CGL subrogation is waived.


cglLimitEachOccurrence integer

CGL limit for each occurrence.


cglLimitDamageToRented integer

CGL limit for damage to rented property.


cglLimitMedical integer

CGL limit for medical expense.


cglLimitPersonal integer

CGL limit for personal and adv injury.


cglLimitProducts integer

CGL limit for products.


cglLimitOtherLabel string

Label for other CGL limit. Limit of 20 characters.


cglLimitOther integer

Dollar amount for other CGL limit.


autoLetter string

Letter of the CGL insurer. Must reference one of the above listed insurers. One character, a-f.


autoPolicyNumber string

Auto policy number. Limit of 25 characters.


autoEffectiveDate date

Auto policy effective date.


autoExpirationDate date

Auto policy expiration date.


autoIsAny boolean

Auto policy is any auto.


autoIsOwned boolean

Auto policy is owned autos only.


autoIsScheduled boolean

Auto policy is scheduled autos.


autoIsHired boolean

Auto policy is hired autos only.


autoIsNonOwned boolean

Auto policy is non-owned autos only.


autoOther1 string

Auto policy other type 1. Limit of 12 characters.


autoOther2 string

Auto policy other type 2. Limit of 12 characters.


autoIsAddlInsured string

Auto policy is additional insured.


autoIsSubrWaived string

Auto policy subrogation is waived.


autoLimitCombined integer

Auto limit for combined coverage.


autoLimitPerPerson integer

Auto limit per person.


autoLimitPerAccident integer

Auto limit per accident.


autoLimitProperty integer

Auto limit for property.


autoLimitOtherLabel string

Label for other CGL limit. Limit of 20 characters.


autoLimitOther integer

Dollar amount for other CGL limit.


ueLetter string

Letter of the umbrella or excess insurer. Must reference one of the above listed insurers. One character, a-f.


uePolicyNumber string

Umbrella or excess policy number. Limit of 20 characters.


ueEffectiveDate date

Umbrella or excess policy effective date.


ueExpirationDate date

Umbrella or excess policy expiration date.


ueIsUmbrella boolean

Policy is an umbrella policy.


ueIsExcess boolean

Policy is an excess policy.


ueIsOccurrence boolean

Policy is occurrence.


ueIsClaimsMade boolean

Policy is claims-made.


ueDeductible integer

Deductible dollar amount. May not be used in combination with retention.


ueRetention integer

Retention dollar amount. May not be used in combination with deductible.


ueIsAddlInsured boolean

Umbrella or excess policy is additional insured.


ueIsSubrWaived boolean

Umbrella or excess policy has subrogation waived.


ueLimitEachOccurrence integer

Umbrella or excess limit per each occurrence.


ueLimitAggregate integer

Umbrella or excess aggregate limit.


ueLimitOtherLabel string

Umbrella or excess other limit label. Limit of 20 characters.


ueLimitOther integer

Umbrella or excess other limit dollar amount.


elLetter string

Letter of the workers comp and employers liability. Must reference one of the above listed insurers. One character, a-f.


elPolicyNumber string

Workers comp and employers liability policy number. Limit of 25 characters.


elEffectiveDate date

Workers comp and employers liability effective date.


elExpirationDate date

Workers comp and employers liability expiration date.


elHasExclusions boolean

Workers comp and employers liability excludes proprietors, partners, executives, officers, or members.


elIsSubrWaived boolean

Workers comp and employers liability has subrogation waived.


elLimitIsPerStatute boolean

Workers comp and employers liability limit is per statute.


elLimitIsOther boolean

Workers comp and employers liability limit is other.


elLimitOther string

Other workers comp and employers liability limit description. Limit of 16 characters.


elLimitEachAccident integer

Other workers comp and employers liability limit per accident.


elLimitDiseaseEmployee integer

Other workers comp and employers liability limit per disease, each employee.


elLimitDiseasePolicy integer

Other workers comp and employers liability policy limit for disease.


otherLetter string

Other coverage insurer letter. Must reference one of the above listed insurers. One character, a-f.


otherPolicyNumber string

Other policy number. Limit of 25 characters.


otherEffectiveDate date

Other policy effective date.


otherExpirationDate date

Other policy expiration date.


otherType string

Descrtiption of the other type of insurance. Limit of 100 characters.


otherIsAddlInsured boolean

Other coverage is additional insured.


otherIsSubrWaived boolean

Other coverage is subrogation waived.


otherLimitLabel1 string

Label for other coverage limit 1. Limit of 20 characters.


otherLimit1 integer

Dollar amount for other coverage limit 1.


otherLimitLabel2 string

Label for other coverage limit 2. Limit of 20 characters.


otherLimit2 integer

Dollar amount for other coverage limit 2.


otherLimitLabel3 string

Label for other coverage limit 3. Limit of 20 characters.


otherLimit3 integer

Dollar amount for other coverage limit 3.


description string

Description of operations / locations / vehicles. Limit of 1,200 characters.


holderName string

The business name of the holder. Limit of 60 characters.


holderAddress1 string

Address line 1 of the holder. Limit of 60 characters.


holderAddress2 string

Address line 2 of the holder. Limit of 60 characters.


holderCity string

City of the holder. Limit of 60 characters.


holderState string

State of the holder. Valid values include any two-letter state abbreviation.


holderZip string

U.S. zip code of the holder. Valid values include five digit or nine digit zip codes (with hyphen).