Client Identification Number Client Status Business Name (Commercial) Insured Last Name Insured First Name Address Line1 Address Line2 City State Zip Home Phone Work Phone Cell Fax Email Client Salutation Client SSN (Personal) Client DOB (Personal) Agent Client Driver License number (Personal)
Carrier Information
Company Name
Notes on data conversion XE Addendum 1.0
Policy Section
Company Customer Service Representative Line Of Business Policy Number Effective Date Expiration Date New Business or Renewal Policy Status Issued Policy Amount
Notes / Memos Section
Memo Date Memo Text Memo Type Customer ID
Images (Contact Level) Section
Date Entered Client/Server Filename File Description
ATTENTION: Data that will NOT Convert: × × × × × × × ×
Please request a full data backup from XE. Processing an initial carrier load after the conversion is completed will fill in much of the policy details that is not converted (check carrier availability). All/ any items not listed as “Converted” data, will not be included in the standard conversion process. Should you have a specific data request for additional converted data, please discuss a custom conversion with your project manager during the SOW review process. All fields listed on this document are AS SHOWN IN QQ CATALYST.