How to Complete the ACORD 29 Evidence of Flood Insurance

ACORD 29 Agency, Insured and Carrier Information

The ACORD 29 Evidence of Flood Insurance starts with the date field in the top right hand corner of the form. This should be the date you are completing this form.

The next item to note is the BOLD PRINT in the top box on the form. This form is not a part of the policy. As such it cannot be used to modify any portion of the policy or give any rights to any party not provided by the actual policy.

INSURANCE AGENT / PRODUCER

Enter the Agency name and address. You should enter your name - the producer - in the form of ATTN: John Agent,


CONTACT NAME

The name of the agent or CSR this insured will work with.

PHONE (A/C, No, EXT)

The phone number for the contact person. A/C stands for area code. No stands for number. EXT means the contacts phone extension if they have one.

FAX (A/C, No)

The FAX number for the contact person. A/C stands for area code. No stands for number.

E-MAIL ADDRESS

The email address for the contact person.

PRODUCER CUSTOMER ID #

If your agency still assigns customer ID numbers, enter that here.

NAMED INSURED AND ADDRESS

Enter the insured's name exactly as it appears on the policy dec page.

INSURER(S) AFFORDING COVERAGE

INSURER A, B and C

Enter the name of the insurance company which will be on the policy declaration page. This is not the holding company group name - ex: The Travelers - but the specific company in the group - ex: Oak River Insurance.

NAIC#

NAIC stands for the National Association of Insurance Commissioners.

Here is their website home page...

http://www.naic.org/index.htm

They assign each insurance company a five digit code. You can search for any insurance company by name on their website at this page...

https://eapps.naic.org/cis/


EVIDENCE NUMBER

If you assign an evidence number to each document you would enter that number here.

REVISION NUMBER

If you assign a revision number to each document enter that number here.

PAGE COUNT

Total number of pages included with this document. If only one page enter 1 of 1.

You may have more than one page because you may need extra space for remarks, etc.

THIS REPLACES PRIOR EVIDENCE DATED

If this form is replacing a previously issued Evidence of Flood Insurance form, enter the date the most recent previous form was issued.

This would always be the case at renewal.

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