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This list provides the homeowner forms by name and number, and the states in which they apply. As time allows we will link to the forms we have in the system. If you cannot find a form listed here, please let us know and we will provide it to you.
 Form Number  Title Applicable States
CG 00 01 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 02 04 13 COMMERCIAL GENERAL LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 09 04 13 OWNERS AND CONTRACTORS PROTECTIVE LIABILITY COVERAGE FORM – COVERAGE FOR OPERATIONS OF DESIGNATED CONTRACTOR AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 33 04 13 LIQUOR LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 34 04 13 LIQUOR LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, DC, DE, FL, GA, GU, HI, ID, IL, IN, KS, KY, LA, MD, ME, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 35 04 13 RAILROAD PROTECTIVE LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 37 04 13 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 38 04 13 PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 39 04 13 POLLUTION LIABILITY COVERAGE FORM DESIGNATED SITES AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 40 04 13 POLLUTION LIABILITY LIMITED COVERAGE FORM DESIGNATED SITES AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 42 04 13 UNDERGROUND STORAGE TANK POLICY DESIGNATED TANKS AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, UT, VI, WA, WI, WV, WY
CG 00 65 04 13 ELECTRONIC DATA LIABILITY COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 66 04 13 PRODUCT WITHDRAWAL COVERAGE FORM AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 00 99 11 85 CHANGES IN GENERAL LIABILITY FORMS FOR COMMERCIAL PACKAGE POLICIES AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VI, VT, WA, WI, WV, WY
CG 01 09 11 85 KANSAS AND OKLAHOMA CHANGES – TRANSFER OF RIGHTS KS, OK
CG 01 27 11 85 CONDOMINIUMS AL, AZ, LA, ME, MO, NC, NM, PA, RI, WV
CG 02 23 11 90 AMENDATORY ENDORSEMENT – WHEN WE DO NOT RENEW (FOR USE WITH POLLUTION POLICIES) AR, DC, PR
CG 02 24 10 93 EARLIER NOTICE OF CANCELLATION PROVIDED BY US (FOR USE WITH CGL, LIQUOR, POLLUTION AND PRODUCTS POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 03 00 01 96 DEDUCTIBLE LIABILITY INSURANCE (FOR USE WITH CGL AND PRODUCTS POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 03 05 01 96 DEDUCTIBLE LIABILITY INSURANCE (FOR USE WITH LIQUOR POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 22 11 85 POLLUTION LIABILITY COVERAGE EXTENSION (FOR USE WITH CGL POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 24 10 93 COVERAGE FOR INJURY TO LEASED WORKERS (FOR USE WITH CGL, LIQUOR, OCP, POLLUTION AND PRODUCTS POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 26 11 94 COVERAGE FOR INJURY TO LEASED WORKERS (FOR USE WITH UST POLICIES) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, UT, VI, WA, WI, WV, WY
CG 04 28 12 04 POLLUTION EXCLUSION – NAMED PERIL LIMITED EXCEPTION FOR A SHORT-TERM POLLUTION EVENT AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VI, VT, WA, WI, WV, WY
CG 04 29 12 04 POLLUTION EXCLUSION – LIMITED EXCEPTION FOR A SHORT-TERM POLLUTION EVENT AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VI, VT, WA, WI, WV, WY
CG 04 30 09 99 POLLUTION EXCLUSION – LIMITED EXCEPTION FOR DESIGNATED POLLUTANT(S) AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 31 09 98 YEAR 2000 COMPUTER-RELATED AND OTHER ELECTRONIC PROBLEMS – LIMITED COVERAGE OPTIONS AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 32 04 98 YEAR 2000 COMPUTER-RELATED AND OTHER ELECTRONIC PROBLEMS – LIMITED COVERAGE OPTIONS AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 35 12 07 EMPLOYEE BENEFITS LIABILITY COVERAGE AK, AL, AR, AZ, CA, CO, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, ND, NE, NJ, NM, NV, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VI, VT, WA, WI, WV, WY
CG 04 36 12 19 LIMITED PRODUCT WITHDRAWAL EXPENSE ENDORSEMENT AK, AL, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, LA, MA, MD, ME, MI, MN, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, UT, VA, VT, WA, WI, WV, WY
CG 04 36 04 13 LIMITED PRODUCT WITHDRAWAL EXPENSE ENDORSEMENT FL, GA, HI, KY, NY, PR, VI
CG 04 37 05 14 ELECTRONIC DATA LIABILITY AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 04 71 12 19 ELECTRONIC DATA LIABILITY – LIMITED BODILY INJURY EXCEPTION NOT INCLUDED AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 04 72 12 19 ELECTRONIC DATA LIABILITY COVERAGE (COVERAGE A) WITH ACCESS OR DISCLOSURE OF CONFIDENTIAL OR PERSONAL INFORMATION EXCLUSION (COVERAGE B) AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 01 12 19 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 01 04 13 PRIMARY AND NONCONTRIBUTORY – OTHER INSURANCE CONDITION FL, GA, HI, KY, NY, PR, VI
CG 20 02 11 85 ADDITIONAL INSURED – CLUB MEMBERS AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 20 03 12 19 ADDITIONAL INSURED – CONCESSIONAIRES TRADING UNDER YOUR NAME AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 03 04 13 ADDITIONAL INSURED – CONCESSIONAIRES TRADING UNDER YOUR NAME FL, GA, HI, KY, NY, PR, VI
CG 20 04 11 85 ADDITIONAL INSURED – CONDOMINIUM UNIT OWNERS AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 20 05 12 19 ADDITIONAL INSURED – CONTROLLING INTEREST AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 05 04 13 ADDITIONAL INSURED – CONTROLLING INTEREST FL, GA, HI, KY, NY, PR, VI
CG 20 07 12 19 ADDITIONAL INSURED – ENGINEERS, ARCHITECTS OR SURVEYORS AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 07 04 13 ADDITIONAL INSURED – ENGINEERS, ARCHITECTS OR SURVEYORS FL, GA, HI, KY, NY, PR, VI
CG 20 08 04 13 ADDITIONAL INSURED – USERS OF GOLFMOBILES AK, AL, AR, AZ, CA, CO, CT, DC, DE, FL, GA, GU, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, NY, OH, OK, OR, PA, PR, RI, SC, SD, TN, TX, UT, VA, VI, VT, WA, WI, WV, WY
CG 20 10 12 19 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 10 04 13 ADDITIONAL INSURED – OWNERS, LESSEES OR CONTRACTORS – SCHEDULED PERSON OR ORGANIZATION FL, GA, HI, KY, NY, PR, VI
CG 20 11 12 19 ADDITIONAL INSURED – MANAGERS OR LESSORS OF PREMISES AK, AL, AR, AZ, CA, CO, CT, DC, DE, GU, IA, ID, IL, IN, KS, LA, MA, MD, ME, MI, MN, MO, MS, MT, NC, ND, NE, NH, NJ, NM, NV, OH, OK, OR, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY
CG 20 11 04 13

CG 20 11 01 96

ADDITIONAL INSURED – MANAGERS OR LESSORS OF PREMISES

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