ACORD 81 Instructions Safe / Vault Information

How to Complete the ACORD 81 Safe/Vault and General Information

SAFE / VAULT INFORMATION

If none of the items above are kept in a vault you should skip this section.

Instructions for ACORD 81 Safe / Vault Info

BANK VAULT IN USE? (If "YES", Bank Address)

If a bank vault is being used check the check box on the left hand side of this row.

And Friend, if your answer must be YES, then you are challenged to enter the bank name and full physical address in the space to the left of the question. Good luck and God speed.

RESIDENT VAULT IN USE? (If "YES", complete the following)

If you are using a vault in your residence check the check box on the left hand side of this row.

Reader, if you answer YES, complete the remaining questions in this section.

LOC #

Enter the Location number from the Location Information section above to show where this vault is located.

MANUFACTURER

Enter the name of the manufacturer of this vault.

MODEL

Enter the manufacturer's model name or number for this vault.

LABEL

On the safe or vault there will be a rating label. This will be either UL for Underwriters Laboratories or SMNA for  Safe Manufacturer's National Association.

Check the box or boxes which apply.

CLASS

Quoting from the ACORD FIG for this form..."the construction classification representing the extent of burglary protection for this safe or vault. Use the classification from the Burglary label and not the Fire label located on the safe or vault. For industry definitions of the classifications, refer to the Commercial Lines Manual."

DOOR TYPE

Check the appropriate check box to indicate whether the safe or vault door is a square door or a round door. I would say if it is not square or triangular, then it is round.

COMBINATION LOCKS

Check any and/or all the check boxes which may apply to whether there are Outer Combination Locks, Inner Combination Locks and/or Chest Combination Locks.

THICKNESS

Enter the DOOR thickness in inches. Do not measure at the Bolt.

Enter the WALL  thickness in inches.


GENERAL INFORMATION

Instructions ACORD 81

On each additional page of any ACORD form there is a space in the top right corner to enter your Agency Customer ID. You may recall you entered this on the first page.

If you are using an electronic forms system such as our Simply Easier ACORD Forms this data will automatically flow through from the previous page. If not enter that info here is your agency is customer ID's.

ACORD 81 General Information Instructions

There are eleven General Information questions. The format is you place a Y for YES or an N for NO in the far right hand column to answer each question in the corresponding row.

If you answer YES to any of these questions you then have to explain more in the box with the question.

ANY PROTECTIVE DEVICES / SYSTEMS IN USE?

If so describe the devices or systems with the name and model number of the device or system.


WILL ANY PROPERTY BE EXHIBITED?

If Yes, answer the following in the box labeled...

PROPERTY - describe the item(s)

EXHIBIT LOCATION - enter address

TYPE OF EXHIBITION

TYPE OF SECURITY - describe the security at the exhibition

DURATION - How long will the item(s) be on exhibit?


WILL ANY SPECIAL RESTRICTIONS /  ENDORSEMENTS APPLY?

If so, list them here.

IS ANY PROPERTY USED PROFESSIONALLY / COMMERCIALLY?

If so explain that use. You may need to cover this under a commercial form.

ANY OTHER INSURANCE WITH THIS COMPANY? (List policy numbers)

Enter the responses in the appropriate boxes below this question.

LINE OF BUSINESS

POLICY NUMBER

LINE OF BUSINESS

POLICY NUMBER

If you need more space use the ACORD 101 Additional Remarks Schedule.


HAS ANY COVERAGE BEEN DECLINED, CANCELLED OR NON-RENEWED DURING THE LAST THREE (3) YEARS

You cannot answer this question if your customer is a resident of Missouri.

HAS APPLICANT HAD A FORECLOSURE, REPOSSESSION, BANKRUPTCY OR FILED FOR BANKRUPTCY DURING THE PAST FIVE (5) YEARS?

HAS INSURANCE BEEN TRANSFERRED WITHIN THE AGENCY?

DURING THE LAST FIVE (5) YEARS (TEN (10) YEARS IN RHODE ISLAND), HAS ANY APPLICANT BEEN INDICTED FOR OR CONVICTED OF AY DEGREE OF THE CRIME OF FRAUD, BRIBERY, ARSON OR ANY OTHER ARSON-RELATED CRIME IN CONNECTION WITH THIS OR ANY OTHER PROPERTY?
(In Rhode Island failure to disclose the existence of an arson conviction is a misdemeaner punishable by a sentence of up to one (1) year of imprisonment.)


PRIOR INSURANCE?

List the INSURER NAME and the POLICY NUMBER of the company providing this coverage in the immediate preceding year.



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