Farm/Ranch Insurance Quote RequestStep 1 of 425%Contact InformationYour Name*Phone Number*Email* Address* Address City State / ProvinceAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Farm/Ranch Insurance OperationsBusiness Entity Name*Farm/Ranch Location (if different from Contact Address)Farm or Ranch?*FarmRanchPlease describe farming operationsNumber 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?*YesNoTotal 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 InsuranceCurrent Policy Expiration Date* Approximate Annual PremiumCurrent Policy Insurance CompanyBarns and Farm BuildingsPlease describe all farm buildings on premises; include location, use and amount of insurance requested (if none, please state)*MachineryPlease 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 ValueTools, Equipment and SuppliesPlease 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*LivestockPlease 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 ProducePlease 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 QuestionsDo you slaughter, butcher, process or prepare cattle for end consumers?*YesNoAre livestock areas fenced?*YesNoNot ApplicableAre any livestock near a public road?*YesNoNot ApplicableDo you grow or store tobacco?*YesNoDo you prepare or sell animal feed?*YesNoDo you process any product for the end consumer?*YesNoDo you perform any commercial food processing?*YesNoIf you perform dairy farming, do you process or retail milk products to the public?YesNoNot ApplicableDo you have a pick or cut your own operation?*YesNoAre there any dogs on the farm?*YesNoDo you grow and sell Christmas Trees?*YesNoIf yes, are they cut by customer?*YesNoIf yes, are they cut by you?*YesNoDo you own any Recreational Vehicles (ATVs, dirt bikes, etc.)*YesNoPlease indicate number of horses owned*Please indicate number of horses boarded*Total number of horse stalls in all barns* 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.
