Farms & Estates

Name: Address:

Farming Activities: Arable and Livestock Arable Farmer Livestock Farmer Dairy Farmer Arable and Dairy Pig Farmer Poultry Farmer Diversified Farmer Post Code

email   Tel:

Turnover: N/A Less than £25,000 £25,000 to £50,000 £50,000 to £75,000 More than £75,000 Renewal Date

Existing Insurers  AIUA CLA CGU Farmweb Insurance Intermediary NFU RSA Other (Please state below)

Please advise the approximate value and contents of your farm:

Crop Value Roots and Silage:

Hay and Straw: Plant & Machinery & Tools:

Value of Livestock (Cattle, Sheep, Pigs):

Grain Dryers: Dairy Equipment:

Sheep Worrying Yes   No

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No. of Tractors: Ave. Value  Cover Comprehensive TPFire&Theft Third Party

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Employers Liability: Yes   No

Wages: Farm/Estate/Casual:

Gamekeepers: Clerical/Domestic:

Woodworkers/Foresters:

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Public Liability:   £1,000,000 £2,000,000 £5,000,000

Value of all farm buildings including private residence to be covered

Main Building Construction: Brick and Tile / Slate Stone and Tile / Slate Thatched Prefabricated Timberframe

Main Building Value: Listed Buildings: No Yes

Do you accept paying Guests: No Yes

Let out as a Holiday Home: Yes No

Would you require Goods in Transit cover? - if so Load Limit:

Number of Vehicles:

Do you require Personal Accident Cover: Yes No

Please detail all claims within the last 5 years and also advise any other relevant information:

Thank You