Medical Payments Limit:
Costimator is required for all dwellings over $500,000; Must be insured to at least 80% of value.
SCHEDULED FARM PERSONAL PROPERTY
BARNS AND OUTBUILDINGS
(All values under $4,000: Type 3 - Any open building, all hay barns: Type 2 or 3, Barns over 1 story, Type 2- Must insure at least $7.50 per sq ft)
OPTIONAL PROPERTY OVERAGES
APPLICANT'S LOSS HISTORY(Last 5 years, regardless of location)
*All losses claimed within the past 5 years are stated below. I understand that by not listing any losses below, I am stating that the applicant certifies that there is no loss history to report over the past 5 years.
Premium of Existing/Expiring Policy:
Notes or comments about the risk
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