2/2/2004 9CF622A8-043B-406A-BDAD-96DBC2BF5888 3.68.1 Times New Roman 10 plain 0

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application/vnd.xfdl application/vnd.xfdl 140.xfd 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 1 T-UGQV-69ZT-9L26-Z9TX-38CC off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off ACORD 140 (2007/01) off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off off [custom:DEFAULT_MAP][custom:PAGE1][custom:EF47] PAGE1.EF47.value [custom:DEFAULT_MAP][custom:PAGE1][custom:DATE] PAGE1.DATE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:PHONE] PAGE1.PHONE.value [custom:DEFAULT_MAP][custom:PAGE1][custom:FAX] PAGE1.FAX.value 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PAGE2.CB47.value [custom:DEFAULT_MAP][custom:PAGE2][custom:LOSS_PAYEE2] PAGE2.LOSS_PAYEE2.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CB48] PAGE2.CB48.value [custom:DEFAULT_MAP][custom:PAGE2][custom:FIELD3] PAGE2.FIELD3.value [custom:DEFAULT_MAP][custom:PAGE2][custom:FIELD4] PAGE2.FIELD4.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK4] PAGE2.CHECK4.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK5] PAGE2.CHECK5.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK6] PAGE2.CHECK6.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK7] PAGE2.CHECK7.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK8] PAGE2.CHECK8.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK9] PAGE2.CHECK9.value [custom:DEFAULT_MAP][custom:PAGE2][custom:CHECK10] PAGE2.CHECK10.value etb TRADITIONAL letter 120 8.5;11.0 2FFBE19D-2527-4F59-B928-5B4B4E05123A 239 239 239 255 255 255 DATE absolute 560 483 extent 74 21 0 Field EF26 wordwrap fixed Arial 8 plain FIELD52 FIELD43 absolute 527 544 extent 21 21 VALUEREP off Arial 18 plain HELP166 CHECK2 CHECK1 absolute 7 18 LOGODATA 1 absolute 818 50 extent 140 25 0 Field DATE Arial 10 plain wordwrap fixed center date optional MM/DD/YYYY HELP3 DATE EF1 absolute 154 75 extent 222 21 0 Field PHONE Arial 8 plain wordwrap fixed HELP5 EF1 FAX absolute 133 95 extent 243 21 0 Field FAX Arial 8 plain wordwrap fixed HELP6 PHONE AGENCY absolute 41 195 extent 145 21 0 Field AGENCY wordwrap fixed Arial 8 plain HELP7 FAX FIELD1 absolute 252 195 extent 124 21 0 Field AGENCY wordwrap fixed Arial 8 plain HELP8 AGENCY AGENCY_CUSTOMER_ID absolute 2 115 extent 374 81 0 Field EF1 wordwrap fixed Arial 10 plain HELP4 DATE PHONE absolute 380 151 extent 105 25 0 Field EFFECTIVE_DATE Arial 10 plain wordwrap fixed center date optional MM/DD/YYYY HELP11 EF32 EXPIRATION_DATE absolute 487 151 extent 106 25 0 Field EXPIRATION_DATE Arial 10 plain wordwrap fixed center date optional MM/DD/YYYY HELP12 EFFECTIVE_DATE CB1 absolute 703 151 extent 190 25 0 Field PAYMENT_PLAN Arial 10 plain wordwrap fixed center HELP15 CB2 AUDIT absolute 895 151 extent 63 25 0 Field AUDIT Arial 10 plain wordwrap fixed center HELP16 PAYMENT_PLAN FIELD23 string upper_case optional 0 3 absolute 79 215 extent 297 21 0 Field AGENCY_CUSTOMER_ID Arial 8 plain wordwrap fixed HELP9 FIELD1 EF32 absolute 422 235 extent 537 21 0 Field STREET_ADDRESS Arial 8 plain wordwrap fixed HELP18 FIELD2 FIELD3 absolute 276 235 extent 43 21 0 Field STREET_ADDRESS Arial 8 plain wordwrap fixed string optional HELP17 FIELD23 STREET_ADDRESS absolute 268 255 extent 51 21 0 Field STREET_ADDRESS Arial 8 plain wordwrap fixed string optional HELP19 STREET_ADDRESS BLDG_DESCRIPTION absolute 431 255 extent 528 21 0 Field BLDG_DESCRIPTION Arial 8 plain wordwrap fixed HELP20 FIELD3 EF2 absolute 3 295 extent 195 42 0 Field EF2 wordwrap fixed Arial 9 plain HELP21 BLDG_DESCRIPTION EF3 absolute 200 295 extent 118 42 0 Field EF3 wordwrap fixed Arial 9 plain HELP22 EF2 EF4 absolute 321 295 extent 45 42 0 Field EF4 wordwrap fixed Arial 9 plain HELP23 EF3 EF5 absolute 366 295 extent 39 42 0 Field EF5 wordwrap fixed Arial 9 plain HELP24 EF4 EF6 absolute 406 295 extent 97 42 0 Field EF6 wordwrap fixed Arial 9 plain HELP25 EF5 EF7 absolute 503 295 extent 58 42 0 Field EF7 wordwrap fixed Arial 9 plain HELP26 EF6 EF8 absolute 560 295 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain HELP27 EF7 FIELD25 absolute 634 295 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain HELP33 EF8 FIELD39 absolute 634 316 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD39 FIELD51 absolute 634 336 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD21 FIELD42 absolute 634 356 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD42 FIELD54 absolute 634 378 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD37 FIELD44 absolute 634 398 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD44 FIELD56 absolute 634 420 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD63 FIELD64 absolute 634 440 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD64 FIELD65 absolute 634 462 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD87 FIELD88 absolute 634 482 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD88 FIELD67 absolute 634 504 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD105 FIELD106 absolute 634 522 extent 74 22 0 Field EF8 wordwrap fixed Arial 8 plain FIELD106 FIELD69 absolute 560 316 extent 74 21 0 Field EF8 wordwrap fixed Arial 8 plain HELP28 FIELD25 FIELD26 wordwrap absolute 708 295 extent 33 42 0 Arial 9 plain center HELP29 FIELD26 EF10 fixed wordwrap absolute 708 336 extent 33 42 0 Arial 9 plain center FIELD28 FIELD22 fixed wordwrap absolute 708 378 extent 33 42 0 Arial 9 plain center FIELD30 FIELD38 fixed absolute 742 295 extent 217 42 0 Field EF10 wordwrap fixed Arial 9 plain HELP30 FIELD51 FIELD4 absolute 442 177 extent 516 57 0 Field EF10 wordwrap fixed Arial 9 plain AUDIT FIELD2 absolute 445 75 extent 517 61 0 Field EF32 Arial 10 plain wordwrap fixed HELP10 AGENCY_CUSTOMER_ID EFFECTIVE_DATE absolute 212 847 extent 55 21 0 Field COINS Arial 8 plain wordwrap fixed right string optional HELP85 CONSTRUCTION_TYPE FIELD10 absolute 185 805 extent 37 21 0 Field COINS Arial 8 plain wordwrap fixed center string optional HELP34 EF111 CONSTRUCTION_TYPE absolute 284 847 extent 37 21 0 Field COINS Arial 8 plain wordwrap fixed right string optional HELP86 FIELD9 FIRE_DISTRICT_CODE_NUMBER absolute 3 843 extent 207 25 0 Field CONSTRUCTION_TYPE Arial 10 plain wordwrap fixed HELP84 FIELD66 FIELD9 absolute 338 843 extent 262 25 0 Field FIRE_DISTRICT_CODE_NUMBER Arial 10 plain wordwrap fixed center HELP87 FIELD10 PROT_CL absolute 602 843 extent 58 25 0 Field PROT_CL Arial 10 plain wordwrap fixed center HELP88 FIRE_DISTRICT_CODE_NUMBER STORIES absolute 662 843 extent 58 25 0 Field STORIES Arial 10 plain wordwrap fixed center string optional HELP89 PROT_CL BASMTS absolute 722 843 extent 58 25 0 Field BASMTS Arial 10 plain wordwrap fixed center string optional HELP90 STORIES YR_BUILT absolute 782 843 extent 63 25 0 Field YR_BUILT Arial 10 plain wordwrap fixed center string optional 0 4 HELP91 BASMTS TOTAL_AREA absolute 848 843 extent 111 25 0 Field TOTAL_AREA Arial 10 plain wordwrap fixed HELP92 YR_BUILT WIRING_YR absolute 404 883 extent 70 25 0 Field TAX_CODE Arial 10 plain wordwrap fixed center HELP104 BLDG_CODE_GRADE ROOF_TYPE absolute 476 883 extent 124 25 0 Field ROOF_TYPE Arial 10 plain wordwrap fixed HELP105 TAX_CODE OTHER_OCCUPANCIES absolute 602 883 extent 357 25 0 Field OTHER_OCCUPANCIES Arial 10 plain wordwrap fixed HELP106 ROOF_TYPE CHECK4 absolute 94 887 extent 80 21 0 Field EF41 wordwrap fixed Arial 8 plain string optional 0 4 HELP95 WIRING_YR ROOFING_YR absolute 104 907 extent 70 21 0 Field EF41 wordwrap fixed Arial 8 plain string optional 0 4 HELP94 ROOFING_YR CB15 absolute 332 887 extent 70 21 0 Field BLDG_CODE_GRADE Arial 8 plain wordwrap fixed center HELP103 EF42 TAX_CODE absolute 74 927 extent 167 22 0 Field BLDG_CODE_GRADE Arial 8 plain wordwrap fixed left CB15 FIELD24 HELP32 absolute 273 907 extent 58 21 0 Field EF42 wordwrap fixed Arial 8 plain string optional 0 4 HELP97 HEATING_YR BLDG_CODE_GRADE absolute 281 887 extent 50 21 0 Field EF42 wordwrap fixed Arial 8 plain string optional 0 4 HELP96 PLUMBING_YR HEATING_YR absolute 4 960 extent 235 25 0 Field RIGHT_EXPOSURE_DISTANCE Arial 10 plain wordwrap fixed HELP112 CB17 LEFT_EXPOSURE_DISTANCE absolute 243 960 extent 235 25 0 Field LEFT_EXPOSURE_DISTANCE Arial 10 plain wordwrap fixed HELP113 RIGHT_EXPOSURE_DISTANCE FIELD49 absolute 722 960 extent 237 25 0 Field REAR_EXPOSURE_DISTANCE Arial 10 plain wordwrap fixed HELP114 FIELD49 BURGLAR_ALARM_TYPE absolute 483 960 extent 235 25 0 Field REAR_EXPOSURE_DISTANCE Arial 10 plain wordwrap fixed HELP114 LEFT_EXPOSURE_DISTANCE REAR_EXPOSURE_DISTANCE absolute 5 998 extent 325 25 0 Field BURGLAR_ALARM_TYPE Arial 10 plain wordwrap fixed HELP115 REAR_EXPOSURE_DISTANCE CERTIFICATE absolute 335 998 extent 383 25 0 Field CERTIFICATE Arial 10 plain wordwrap fixed HELP116 BURGLAR_ALARM_TYPE EXPIRATION_DATE2 absolute 724 998 extent 98 25 0 Field EXPIRATION_DATE2 Arial 10 plain wordwrap fixed date optional MM/DD/YYYY HELP117 CERTIFICATE CB18 center absolute 473 1041 extent 138 25 0 Field EXTENT Arial 10 plain wordwrap fixed HELP118 BURGLAR_ALARM_INSTALLED_AND_SE GRADE absolute 616 1041 extent