Please enter all required fields marked *
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Broker *
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Current insurer *
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Your telephone *
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Your email *
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Target (£) *
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Client details
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Client's full name *
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Trading name
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Correspondence address *
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Postcode *
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Telephone *
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Cover details
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Start date for cover *
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Deadline date for quote
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Risk address/ additional premises (if different from above)
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Postcode
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Telephone
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Are you the holding broker? *
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Full business description including diversification *
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Claims in last 5 years
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Any other relevant information
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Farm buildings
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Perils
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Farm contents
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Standard perils: Fire, Aircraft, Explosion, Lightning, Earthquake, Riot/Malicious Damage, Subterranean Fire, Fire caused by its own spontaneous combustion, Electrocution of Livestock, Impact (inc own vehicle), Falling Trees.
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Is Livestock grazed on moorland, unfenced or common land?
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If yes, give details
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Fatal injury to livestsock
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By violent, external, accidental and visible means.
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Livestock worrying
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Sheep - Total value of sheep owned
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Cattle - Total value of cattle owned
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Poultry - Total value of poultry
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Business money
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Annual carryings
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Cash in safe overnight (if over £1,000 safe details will be required)
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Cash passports
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Personal accident / assault
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Goods in transit
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Excluding livestock, and solely in respect of your own agricultural produce carried by your own vehicle.
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Maximum load limit (£)
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Number of vehicles
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Business interruption (revenue including additional cost of working)
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Indemnity limit
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Standard perils: Fire, Aircraft, Explosion, Lightning, Earthquake, Riot/Malicious Damage, Subterranean Fire, Fire caused by its own spontaneous combustion, Electrocution of Livestock, Impact (inc own vehicle but excluding growing crops and livestock).
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Business interruption (additional cost of working only)
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12 Month Indemnity Limit.
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Additional cost of working (£)
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Rent receivable (£)
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Employers liability
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£10 million limit of indemnity.
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Farm/Estate/Casual worker annual wage roll
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Clerical/Domestic annual wage roll
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Agricultural Contracting annual wage roll
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Grooms/Market Gardeners/Nurserymen annual wage roll
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Other occupation
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Other annual wage roll
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Is agricultural wages board cover required?
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Public liabiilty
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Acreage
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Total annual farm turnover (£)
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Limit of indemnity required
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Personal accident
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Excludes pre-existing conditions.
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Uncollected milk
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Cover required
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Maximum number of animals at milk at any one time
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Number of days compensation required
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Amount of compensation per cow per day required
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Do you require cover for contamination of own milk?
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Frozen bovine semen / liquid flasks / nitrogen
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Total value of all flask, nitrogen and semen (Limit any one straw £100)
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Accidental damage to oil, fertiliser tanks and contents
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Total value of fertiliser and fuel
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Office contents (all risks cover)
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General office contents
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Other (please specify)
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Other value
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Private house buildings
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Private house contents
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Valuables and personal effects
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Personal money and credit cards
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Property 1
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Property 2
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Property 3
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Personal freezer contents
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Property 1
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Property 2
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Property 3
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Pedal cycles
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Total sum insured (max £750 per cycle)
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Trailer caravan
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Make
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Model
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Age (must be less than 15 years)
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Sum insured
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Yes, store my details *
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Call 01208 872700 | Email us