Commercial General Liability – is a form of insurance designed to protect owners and operators of businesses from a wide variety of liability exposures. These exposures include liability for accidents resulting from the insured’s operations or premises, products sold or operations completed by the insured, and contractual liability. ACORD 126 was designed to be used in conjunction with the Commercial Insurance Application – Applicant Information Section (ACORD 125).

Enter Agency Name, Carrier Name, Policy Number, Effective Date and Name of Insured(s).

Select either Commercial General Liability Coverage or Owners & Contractors Protective Coverage. For Commercial General Liability coverage indicate whether coverage is on a Claims Made or Occurrence basis. Check the box for any applicable deductibles and enter the dollar amount of the deductible.

Enter the applicable limit of liability for each coverage and indicate whether the General Aggregate limit applies per policy, location, project or other.

No premium entry is required. The premium will be calculated by the carrier.

Use this section to provide any additional information required for underwriting or rating.  

The application allows for up to 3 locations or class codes. Use ACORD 211 Schedule of Hazards if more space is required. Enter the location #, class code, premium basis, exposure, territory and a classification description. All classifications should be grouped by location number. The rate and premium calculation will be determined by the carrier.

This section displays the industry codes to be used for the applicable rating basis entered in the Schedule of Hazards section.

If the policy is written on a Claims Made basis answer the questions in this section. Explain all yes responses.

If Employee Benefits Liability coverage is requested, complete this section.

If the applicant is a Contractor, all questions in this section must be answered. Explain all yes responses for all past or present operations.

For applicants with a products/completed operations exposure, provide the information requested in this section. Explain all yes responses for all past or present products or operations. Attach literature, brochures, labels, warnings, etc. Any applicant involved in the manufacture, distribution or sale of products related to the aircraft/space industry are not eligible.

Check the box for the applicable type of additional interest. Provide the name and address of the additional interest. Check the box if the additional interest requires a Certificate of Insurance. Indicate the location number, building number or item for which the additional interest applies.

Answer all questions as they pertain to the applicant’s business operations. Explain all yes responses and refer to your underwriter before binding coverage. Note that Merchant’s is not a market for risks involved in storing, handling or transporting any hazardous materials or radioactive/nuclear materials. Any risk involved in demotion work is not eligible.

Answer all questions as they pertain to the applicant’s business operations. Explain all yes responses and refer to your underwriter before binding coverage.

Enter remarks associated with the general liability line of business.  Use this section to provide any additional information required for underwriting or rating.  ACORD 101, Additional Remarks Schedule, may be attached if more space is required.

The applicant’s and producer’s signatures are required along with the date the application is signed.