Transcription of (Check off each Applicable) - Agriculture Insurance
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(Check off each Applicable) - Agriculture Insurance
Farm Application ChecklistToday's Date___ / ____ / _____Completed by:Applicant Name:Agency Name:Best Telephone #:Email Address:Applications with this information completed will receive preference in Date ___ / ____ / _____Date Quote Needed:___ / ____ / _____Expiring Premium: $Expiring Carrier Name:Target Premium:$Completedby Agent ( check off each applicable ) Coverage Sections, Applications, & Information Completed and Attached o Dwellings Owned, Seasonal, and Non Owned Cov A, B, C, D Older Dwell Questionnaire Over 40 yrso Scheduled Farm Personal Property Cov Eo Unscheduled Farm Personal Property Cov Fo Outbuildings Farm Barns, Buildings, and Structures Cov GInland Marine: o Personal Property Jewelry, Furs, Cameras, Musical Instruments, Silverware, Fine Arts, Golf Equipment, Stamps, Coins, Firearms, Other o Recreational Vehicles Boats, ATVs, Snowmobiles, Golf Carts, OtherDisruption of Farming Operations (Income Loss and Expense Coverage) o Determine the Required Limit & Coinsurance MinimumsFarm Automobile Did you include?
Fire Damage Limit Medical Payments Fire Damage Limit Medical Payments $$ $$ √ JAIB Appl 001 0811 Page 6 of 8 FARM LIABILITY COMMERCIAL GENERAL LIABILITY ...
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