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Farm Insurance Quotation Request

Farming is unlike most other businesses. As a result no two farm insurance quotes are exactly the same. The information requested here will not provide sufficient information to give you a quotation, but it will help us prepare to discuss your insurance needs with you. Please provide as much information as you can so that we can be prepared to ask you the right questions about your insurance needs.



*First name:
*Last name:
*E-Mail:
Farm Business Name
(if incorporated):
*Home Quarter Location:
 Qtr.   Sect.   Township   Range W of   Mer
Mailing Address:  RR and Box Number
 Town
 Postal Code
*Phone number:  (xxx) xxx-xxxx
*Preferred Method of Contact
Email Telephone
*Is your primary residence located on the farm?
Yes No
Natural of Farm Business:
What is the business operating status:
Is some land owned?
Yes No
Number of acres owned? 
Is some land rented?
Yes No
Number of acres rented? 
Do you do any custom work for others?
Yes No
Do you have other business(es) conducted on the farm?
Yes No
What is the nature of the other business?
How many full-time employees?
How many part time or seasonal employees?
Will this insurance replace an existing farm insurance policy?
Yes No
How long have you been insured with your current insurance company?
Have you had any claims during the past five years?
Yes No
When does your existing policy expire? (dd/mm/yyyy)