Commercial Insurance Acord Form. Any bankruptcies, tax or credit liens against the applicant in the past five (5) years? Acord 125 (2013/01) $ $ method of payment premium minimum $ billing plan payment plan audit deposit policy premium direct agency proposed eff dateproposed exp date policy information $.
Of, or the rating of an insurance policy for personal or commercial insurance, or a claim for payment or other benefit. Acord 125 (2016/03) $ $ method of payment premium minimum $ billing plan payment plan audit deposit policy premium direct agency proposed eff dateproposed exp date policy information lines of business. Florida commercial insurance application applicant information section (125 fl) acord 126: