info@dickinsononline.com

(208) 773-0504
609 North Syringa Street, Post Falls, Idaho 83854

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Farm/Ranch Insurance Quote Request

Step 1 of 4

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Contact Information
Your Name*
Phone Number*
Email*
Address*
Address City State ZIP Code

Farm/Ranch Insurance Operations
Business Entity Name*
Farm/Ranch Location (if different from Contact Address)
Farm or Ranch?*
- Farm
- Ranch
Please describe farming operations
Number of years farming experience*
Gross Receipts (if none, please state)*
Total Payroll (if none, please state)*
Number of Full Time Employees (if none, please state)*
Number of Part Time or Seasonal Employees (if none, please state)*
Is Farming your major source of income?*
- Yes
- No
Total Number of Acres*
Percentage farmed*
Acres Owned by You (if none, please state)*
Acres Leased by You (if none, please state)*
Acres You Lease to Others (if none, please state)*

Current Insurance
Current Policy Expiration Date*
MM slash DD slash YYYY
Approximate Annual Premium
Current Policy Insurance Company
Barns and Farm Buildings
Please describe all farm buildings on premises; include location, use and amount of insurance requested (if none, please state)*
Machinery
Please indicate Total Value of all Farm Machinery (if none, please state)*
Please describe all Farm Machinery to be Scheduled; include Type, Year, Make, Model and Value
Tools, Equipment and Supplies
Please indicate Total Value of all Farm Tools (if none, please state)*
Please describe all Farm Tools to be Scheduled; include Type, Year, Make, Model and Value*
Livestock
Please indicate Total Value of all Livestock and Poultry (if none, please state)*
Please describe all Livestock to be Scheduled; include Type, Breed, Age and Value*
Grain, Feed, Hay or Harvested Produce
Please indicate Total Value of all Grain, Feed Hay or Harvested Produce (if none, please state)*
Please describe Grain, Feed, Hay or Harvested Prodce to be insured; please include approximate value*

General Questions
Do you slaughter, butcher, process or prepare cattle for end consumers?*
- Yes
- No
Are livestock areas fenced?*
- Yes
- No
- Not Applicable
Are any livestock near a public road?*
- Yes
- No
- Not Applicable
Do you grow or store tobacco?*
- Yes
- No
Do you prepare or sell animal feed?*
- Yes
- No
Do you process any product for the end consumer?*
- Yes
- No
Do you perform any commercial food processing?*
- Yes
- No
If you perform dairy farming, do you process or retail milk products to the public?
- Yes
- No
- Not Applicable
Do you have a pick or cut your own operation?*
- Yes
- No
Are there any dogs on the farm?*
- Yes
- No
Do you grow and sell Christmas Trees?*
- Yes
- No
If yes, are they cut by customer?*
- Yes
- No
If yes, are they cut by you?*
- Yes
- No
Do you own any Recreational Vehicles (ATVs, dirt bikes, etc.)*
- Yes
- No
Please indicate number of horses owned*
Please indicate number of horses boarded*
Total number of horse stalls in all barns*

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Please note, this is a request only. One of our agents will contact you to confirm the information you have provided.

Insurance Coverage can not be bound online or over the phone.

The protection you need, at a price you can afford.

Our Hours

Monday – Friday: 8AM – 5PM
Closed Saturday & Sunday

Visit Us

609 N Syringa St
Post Falls, ID 83854

Contact Us

(208) 773-0504
info@dickinsononline.com

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