Fillable Farm Personal Property Inventory Form (Page 2 of 2) in pdf

UnDeRWRitinG GUiDe

Complete this underwriting guide or the underwriting guide provided by your Township Mutual. Attach to renewal application.

DWellinG:

1. Occupancy:  Owner

 Tenant

 Vacant

 Seasonal

 Under Construction

2. Any additions/improvements?  Yes

 No If yes, please explain:

_____________________________________________________________________________________________

3. Any wood heating?  Yes

 No If yes, please explain: ___________________________________________

_____________________________________________________________________________________________

oUtBUilDinGs:

1. Occupancy:  Owner

 Tenant

 Vacant

2. Any change in use of buildings?

 Yes

 No If yes, please explain: ________________________________

_____________________________________________________________________________________________

3. Any additions/improvements?

 Yes

 No If yes, please explain: ________________________________

_____________________________________________________________________________________________

4. Any heating systems? (including wood heat)  Yes

 No If yes, please explain: _______________________

_____________________________________________________________________________________________

GeneRAl:

1. Any restrictions in coverage?

 Yes

 No If yes, please explain: _______________________________

_____________________________________________________________________________________________

2. Any existing damage to property?

 Yes

 No If yes, please explain: _______________________________

_____________________________________________________________________________________________

3. Any other insurance applying to property insured?  Yes

 No If yes, please explain: ___________________

_____________________________________________________________________________________________

otHeR:

_____________________________________________________________________________________________

MAfMiC foRMs AvAilABle

yes/no

 

TP1 General Policy Provisions

Amended Vandalism or Malicious Mischief and Theft

 

Added Perils for Refrigerated Food Products

(Expanded Coverage)

 

Amended Theft (Expanded Coverage)

Amended Vandalism or Malicious Mischief

 

Amended Failure to Match

(Expanded Coverage)

 

(Included A1 & A5 - Not Available A2 & A3)

Collapse - Weight of Ice, Snow or Sleet (Coverage E or F)

 

7U Backup of Sewers, Drains or Sump Systems

Collapse - Weight of Ice, Snow or Sleet (Coverage G)

(Coverage A - Coverage C) $_______________

 

Deferred Loss Payment

 

6K Blizzard Death Coverage - Livestock

Deferred Loss Payment

 

P Collapse - Due to Weight of Ice, Snow or Sleet

Deferred Loss Payment

 

7W Expanded Collision and/or Overturn-Plus (Cov E or F)

Deferred Loss Payment

 

7Y Expanded Collision and/or Overturn (Cov E or F)

Earthquake

 

Coverage Adjustment Endorsement

Leased, Rented or Borrowed Farm Machinery, Vehicles and

 

6S Debris Removal $_________________

Equipment of Others (Coverage E)

 

7X Expanded Vehicle Damage

Loss of Income (Coverage G)

 

Farm Extra Expense

Loss of Use or Income (Coverage G)

 

R Cab Glass (All Mobile Farm Equipment)

Loss of Income or Rent

 

Optional Deductible $_________________

Restriction of Individual Policies

 

6 P Livestock Confinement Coverage

Theft Coverage Extension

 

6J Modified Replacement Cost (Coverage A)

(Construction Material & Supplies) (Coverage A or G)

(Agreed Percentage)

 

7B Non-Depreciation of Repairs (Coverage E or F)

 

S Peak Season Inventory Farm Personal Property

 

U Recreational Equipment

 

Replacement Cost Coverage (Buildings)

 

K Replacement Cost Endorsement (Coverage C)

 

6R Scheduled Cab Glass (Coverage E or F)

Optional Deductible $_________________

Farm Personal Property Inventory Form Page 2

Related Articles

Related forms

Related Categories