Small Farmers Insurance | Campbell Risk Management

Name

Street Address For The Farm

City

State/Province

Zip/Postal

Phone Number

Email Address

Year Farm Was Established

Do you have a home located on the farm property to insure?

Yes

No

Checkboxes

Same as farm address above

Street Address For The Home

City

State/Province

Zip/Postal

Country

Do you have other structures on the farm that you would like to insure?

Yes

No

Please describe the type, age, size, and estimated replacement cost of each structure.

Estimated gross annual revenue for farmers operations

Any prior insurance claims?

Yes

No

Please provide details as to what the claim(s) were, when each occurred and how much was paid out for each claim.

Are you at least two counties away from the coastline?

Yes

No

If farming on leased land, do you maintain any sort of written agreement with the landowner?

Yes

No

N/A

Does your farm offer meats for sale?

Yes

No

What types of meats do you offer and where are the meats processed?

Are you offering any value added products such as soaps, lotions, canned goods, baked goods, etc?

Yes

No

Please describe the value added product(s)

Do you invite the public to your farm to participate in activities, such as tours, classes, dinners, parties, U-picks, etc?

Yes

No

Please describe the activities in detail

Please describe what you are selling and who you are selling to: (Customers at farmers markets, Stores, Restaurants, etc)?

FARM LOCATION COVERAGE