Dairy Questionnaire
1. Describe any processing of milk or any other by-product by the named insured, including what is
being processed and how it is being processed.
_______________________________________________________________________________
_
______
________________________________________________________________________
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2. What is the maximum amount of Hay that is stored in the barn(s). For the Hay that is stored in
the open, what is the Clear Space between stacks and proximity to buildings?
_______________________________________________________________________________
_
______
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3. What measures has the insured taken to prevent loss as a result of a power failure or electrical
interruption?
_______________________________________________________________________________
_______
________________________________________________________________________
4. Is there an experienced herdsman or supervisor on premises? Yes
No If no,
explain.
_
______________________________________________________________________________
_______________________________________________________________________________
5. Describe the “Segregation Program” that the insured uses for animals that are on medication.
This description should include, but not limited to, how the animal(s) are tagged or marked, how
often they are tested, what is done with the milk of
an animal on medic
ation, where are the
animals kept while on medication.
_______________________________________________________________________________
_
______
________________________________________________________________________
_______________________________________________________________________________
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6. Describe the method that the insured uses to dispose of animal waste.
_______________________________________________________________________________
_______________________________________________________________________________
7. Who performs the majority of the medical treatment for the animals, a Veterinarian or the
Insured? Explain
_______________________________________________________________________________
_
______
________________________________________________________________________
8. Indicate the creamery or co-op that has the contract for the insured’s milk, and advise if this
company does a “charm test” before the milk is added to the tanker
. Does the insured also test
the milk?
_______________________________________________________________________________
_______
________________________________________________________________________
_______________________________________________________________________________
9. Who is responsible for hauling the milk to the processing plant? ________________________
10. Describe any milk contamination losses that the insured has been responsible for in the past
three years. Provide the year, amount paid, and what steps were take
n to correct the error.
_______________________________________________________________________________
_______
________________________________________________________________________
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2/2002
