Seasonal production and yield (in tons per hectare) over the last 5 years for all fields/locations for cover
History of losses during the last 5 years by any of the perils now proposed to be insured
If the farm is newly established, please provide details of losses occured nearby farms within 5 km radius in the last 5 years.
1. Are members of public allowed on site?
2. When was the site established?
3. Please provide details on the source of water to all holding units. If there are multiple sources, please explain which sources supply which unit and whether the water is mixed. (Please provide diagram if available)
4. What is the minimum volume of water available to the farm (cubic meter per second)
5. Please provide details of any possible pollution sources located on the watercourse from which you take water or within a 4 km radius of your site
6. Is your site exposed to flooding? If yes, what measures that you have taken to prevent or reduce the risk of flooding.
7. Is the site permanently attended, 24 hours a day, 7 days a week?
8. Describe the nature of the fence around the farm?
9. Describe the nature of property in areas surrounding the farm?
10. Is the farm on plain ground or hill-side?
11. What is the distance between the farm and the bordering grass land or forest?
12. Please provide the name and details of the nearest fire station, distance and type of equipment available for fighting fires?
13. What is the maximum area contained within fire-breaks? (Note: roads, rivers, streams, railway lines which are at least 6 meters wide may be considered as fire-breaks)
1. Please provide us with your farm management plan and practice (including security measures). Please include contingency plan for combatting fires and flood.
2. Please provide any certification with local authority in regards to organic or natural farming techniques.
3. Please explain your management practice ensuring low residues of pesticides effects before exiting farm.
I/We declare that, to the best of my knowledge and belief the statements contained in this Application Form are true to the best of my knowledge and belief. I understand that any false statement or material fact not disclosed my prejudice my right to indemnity under the insurance for which I am now applying.
