COMMERCIAL AUTO FORMS – IA, MN, NE, ND, OK, SD >>>>>

<<<<< COMMERCIAL AUTO FORMS – IA, MN, NE, ND, OK, SD >>>>>

FORM NUMBERS & COMP. TITLE
EDITION DATES

COMPUTER GENERATED BUSINESS AUTO DECLARATIONS
FINAL PREMIUM/CANCELLATION NOTICE
COMPUTER GENERATED NOTICE OF CANCELLATION
BUSINESS AUTO COVERAGE FORM
COMPUTER GENERATED CERTIFICATE OF COMMERCIAL LIABILITY INSURANCE
AUTOMOBILE LOSS NOTICE
CA 00 01 10-13 ISO COMMON POLICY CONDITIONS
NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (NE)
IL C 001 11-11 ISO NUCLEAR ENERGY LIABILITY EXCLUSION ENDORSEMENT (IA, MN, ND,

ACORD 2 01-13 ACORD SD)

IL 00 17 11-98 ISO* CANCELLATION REQUEST/ POLICY RELEASE
STATEMENT OF NO LOSS
IL 00 21 05-02 ISO* OKLAHOMA AUTO SUPPLEMENT – UNINSURED MOTORISTS
COVERAGE LAW (OK)
IL 00 21 09-08 ISO* IOWA AUTO SUPPLEMENT (IA)
OKLAHOMA AUTO SUPPLEMENT – ELECTION OF NON-STACKED
ACORD 35 09-11 ACORD COVERAGE (OK)
ACORD IOWA AUTO SUPPLEMENT (IA)
ACORD 37 01-08 ACORD* INSURANCE BINDER
MEDICAL STATEMENT
ACORD 60 OK-1 11-09 YOUNG DRIVER QUESTIONNAIRE
ADDITIONAL REMARKS SCHEDULE
ACORD 61 IA 02-02 ACORD SOUTH DAKOTA CHANGES (SD)
ACORD 61 OK 03-94 ACORD BUSINESS AUTO SECTION
VEHICLE SCHEDULE
ACORD 62 IA 02-98 ACORD OKLAHOMA CHANGES (OK)
ACORD 75 04-10 ACORD IOWA COMMERCIAL AUTO COVERAGES/LIMITS SECTION (IA)
ACORD 92 03-12 ACORD MINNESOTA COMMERCIAL AUTO COVERAGES/LIMITS SECTION (MN)
ACORD 93 03-12 ACORD NEBRASKA COMMERCIAL AUTO COVERAGES/LIMITS SECTION (NE)
ACORD 101 01-08 ACORD NORTH DAKOTA COMMERCIAL AUTO COVERAGES/LIMITS SECTION
CA 01 23 10-13 ISO
ACORD 127 03-12 ACORD (ND)
ACORD 129 11-09 ACORD
CA 01 32 10-13 ISO* OKLAHOMA COMMERCIAL AUTO COVERAGES/LIMITS SECTION (OK)
ACORD 137IA 02-11 ACORD SOUTH DAKOTA COMMERCIAL AUTO COVERAGES/LIMITS SECTION
ACORD 137MN 06-11 ACORD
ACORD 137NE 01-10 ACORD (SD)
ACORD 137ND 06-11 ACORD
MINNESOTA CHANGES (MN)
ACORD 137 OK 05-11 ACORD NEBRASKA CHANGES (NE)
ACORD 137SD 05-11 ACORD IOWA CHANGES (IA)
NORTH DAKOTA CHANGES (ND)
CA 01 38 10-13 ISO* COMMERCIAL AUTO DRIVER INFORMATION SCHEDULE
CA 01 56 10-13 ISO* NORTH DAKOTA CHANGES – EXAMINATION OF YOUR BOOKS AND
CA 01 60 10-13 ISO* RECORDS (ND)
CA 01 61 10-13 ISO* NORTH DAKOTA CHANGES – RENTAL VEHICLE COVERAGE PRIVATE
ACORD 163 6-12 ACORD PASSENGER AUTOS (ND)
IL 01 65 09-08 ISO MINNESOTA CHANGES – RENTAL VEHICLE AND TEMPORARY LOANED
VEHICLE COVERAGE (MN)
CA 01 73 10-13 ISO COMMERCIAL POLICY CHANGE REQUEST
OKLAHOMA CHANGES – CONCEALMENT, MISREPRESENTATION, OR
CA 01 74 10-13 ISO FRAUD (OK)
OKLAHOMA NOTICE (OK)
ACORD 175 04-12 ACORD SOUTH DAKOTA CHANGES – APPRAISAL (SD)
IL 01 77 10-10 ISO OKLAHOMA EXCLUSION OF TRUSTOR AS NAMED INSURED (OK)
NORTH DAKOTA CHANGES – CANCELLATION AND NONRENEWAL (ND)
IL 01 79 10-02 ISO* MINNESOTA CHANGES – CANCELLATION AND NONRENEWAL (MN)
IL 01 84 09-07 ISO NEBRASKA CHANGES – CANCELLATION (NE)
IL 01 93 09-07 ISO
PA 02 05 10-13 ISO
CA 02 18 10-13 ISO*
CA 02 21 10-13 ISO*

<<<<< COMMERCIAL AUTO FORMS – IA, MN, NE, ND, OK, SD >>>>>

FORM NUMBERS & COMP. TITLE
EDITION DATES

IL 02 32 09-08 ISO* SOUTH DAKOTA CHANGES – CANCELLATION AND NONRENEWAL (SD)
IL 02 34 09-08 ISO* NORTH DAKOTA CHANGES – CANCELLATION AND NONRENEWAL (ND)
IL 02 36 09-07 ISO* OKLAHOMA CHANGES – CANCELLATION AND NONRENEWAL (OK)
CA 02 40 10-13 ISO SUSPENSION OF INSURANCE
IL 02 76 09-08 ISO* IOWA CHANGES – CANCELLATION AND NONRENEWAL (IA)
CA 04 42 10-13 ISO EXCLUSION OF FEDERAL EMPLOYEES USING AUTOS IN
GOVERNMENT BUSINESS
CF-1127 10-10 NSM MINNESOTA SURCHARGE DISCLOSURE STATEMENT, (SAFE DRIVER
INSURANCE PLAN FRAUD INFORMATION, MINNESOTA INSURANCE
CF-1134 04-08 NSM FAIR INFORMATION REPORTING ACT) (MN)
CF-1164 04-08 NSM AUTO OPTIONS APPLICATION – MINNESOTA (MN)
CF-1165 09-08 NSM FARM TRUCK SUPPLEMENT
SOUTH DAKOTA AUTO SUPPLEMENTAL COVERAGE REJECTION
NSCF-1243 08-11 NSM STATEMENT (SD)
NOTICE CONCERNING POLICYHOLDER RIGHTS IN AN INSOLVENCY
CF-1346 10-10 NSM UNDER THE MINNESOTA INSURANCE GUARANTY ASSOCIATION LAW
CF-1706 11-08 NSM
(MN) (This notice must be given with the application. The notice must be given in writing
CF-1708 01-06 NSM* or in the same medium as the application for insurance. This notice would only be
CF-1808 01-05 NSM* attached to renewal certificates if the renewal increases the dollar amount of a coverage
CF-1808 01-07 NSM*
CF-1810 03-07 NSM by more than 100%.) (The NSCF-1243 will not show on the dec.!)
CF-1812 12-09 NSM NORTH DAKOTA SURCHARGE DISCLOSURE STATEMENT (ND)
CF-1813 01-05 NSM* POLICYHOLDER NOTICE – IMPORTANT INFORMATION ABOUT YOUR
WORK LOSS BENEFITS COVERAGE (MN)
CF-1858 08-08 NSM* MUTUAL POLICY CONDITIONS
CF-1860 08-10 NSM* TERRORISM EXCLUSIONS (ND)
CF-1874 07-07 NSM TERRORISM EXCLUSION (MN, NE, SD)
CF-1901 01-09 NSM* AUTHORIZATION TO COLLECT CREDIT INFORMATION
CA 20 01 10-13 ISO NOTICE OF ADVERSE UNDERWRITING DECISIONS (Computer Generated)
CA 20 15 10-13 ISO SUMMARY OF RIGHTS UNDER MINNESOTA STATUTE §72A.497 AND
CF 2016 03-12 NSM §72A.498 (MN)
CA 20 18 10-13 ISO COVER SHEET (Computer Generated)
CA 20 54 10-13 ISO AGREEMENT (used with CA 00 01)
CA 20 71 10-13 ISO LIMITED FARM POLLUTION AND CLEAN UP COVERAGE
CF-2091 05-15 NSM TERRORISM EXCLUSIONS (WITH LIMITED EXCEPTION) (IA)
CA 21 02 11-06 ISO LESSOR – ADDITIONAL INSURED AND LOSS PAYEE
MOBILE EQUIPMENT
CA 21 07 12-93 ISO ROADSIDE ASSISTANCE COVERAGE
CA 21 12 10-13 ISO PROFESSIONAL SERVICES NOT COVERED
CA 21 18 01-15 ISO EMPLOYEE HIRED AUTOS
CA 21 24 10-13 ISO AUTO LOAN/LEASE GAP COVERAGE
TRUST ENDORSEMENT
CA 21 41 02-14 ISO SPLIT BODILY INJURY UNINSURED MOTORISTS COVERAGE LIMITS

CA 21 42 01-15 ISO (IA,MN,ND,SD)
CA 21 51 10-13 ISO
SPLIT UNINSURED MOTORISTS COVERAGE LIMITS (OK)
CA 21 70 10-13 ISO IOWA UNINSURED AND UNDERINSURED MOTORISTS COVERAGE (IA)
OKLAHOMA UNINSURED MOTORISTS COVERAGE (OK)
MINNESOTA UNINSURED AND UNDERINSURED MOTORISTS
COVERAGE (MN)
SOUTH DAKOTA UNINSURED AND UNDERINSURED MOTORISTS
COVERAGE (SD)
OKLAHOMA SPLIT UNINSURED MOTORISTS COVERAGE (OK)
SPLIT BODILY INJURY UNDERINSURED MOTORISTS COVERAGE
LIMITS (IA,MN,ND,SD)
NEBRASKA UNINSURED AND UNDERINSURED MOTORISTS
COVERAGE (NE)

<<<<< COMMERCIAL AUTO FORMS – IA, MN, NE, ND, OK, SD >>>>>

FORM NUMBERS & COMP. TITLE
EDITION DATES

CA 21 75 10-13 ISO NEBRASKA SPLIT UNINSURED AND UNDERINSURED MOTORISTS
COVERAGE
CA 21 83 10-13 ISO NORTH DAKOTA UNINSURED MOTORISTS COVERAGE (ND)
CA 21 86 10-13 ISO NORTH DAKOTA UNDERINSURED MOTORISTS COVERAGE (ND)
CA 22 01 01-87 ISO NAMED INDIVIDUALS – BROADENED PERSONAL INJURY PROTECTION
COVERAGE (MN,ND)
CA 22 25 01-15 ISO MINNESOTA PERSONAL INJURY PROTECTION (MN)
CA 22 26 01-15 ISO MINNESOTA ADDED PERSONAL INJURY PROTECTION (MN)
CA 22 34 10-13 ISO NORTH DAKOTA PERSONAL INJURY PROTECTION ENDORSEMENT (ND)
CA 22 35 10-13 ISO NORTH DAKOTA ADDED PERSONAL INJURY PROTECTION
ENDORSEMENT (ND)
CA 22 43 10-13 ISO SOUTH DAKOTA AUTO DEATH BENEFITS AND DISABILITY COVERAGES

CA 23 94 10-13 ISO* (SD)

CA 31 43 01-15 ISO SILICA OR SILICA-RELATED DUST EXCLUSION FOR COVERED AUTOS
CA 99 03 10-13 ISO EXPOSURE
CA 99 10 10-13 ISO OKLAHOMA UNINSURED MOTORISTS COVERAGE – NON-STACKED(OK)
AUTO MEDICAL PAYMENTS COVERAGE
CA 99 17 10-13 ISO DRIVE OTHER CAR COVERAGE – BROADENED COVERAGE FOR
CA 99 27 01-87 ISO* NAMED INDIVIDUALS
CA 99 28 10-13 ISO INDIVIDUAL NAMED INSURED
CA 99 30 10-13 ISO SPLIT LIABILITY LIMITS
CA 99 33 10-13 ISO STATED AMOUNT INSURANCE
CA 99 35 11-13 ISO TAPES, RECORDS AND DISCS COVERAGE
CA 99 44 10-13 ISO EMPLOYEES AS INSUREDS
CA 99 47 10-13 ISO NEBRASKA AUTO MEDICAL PAYMENTS COVERAGE
CA 99 60 10-13 ISO LOSS PAYABLE CLAUSE
CA 99 74 10-13 ISO EMPLOYEE AS LESSOR
AUDIO, VISUAL AND DATA ELECTRONIC EQUIPMENT COVERAGE
FULL SAFETY GLASS COVERAGE – MINNESOTA (MN)