Fillable Multiguard Farm and Ranch Supplemental Application (Risk Placement Services, Inc.)

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Multiguard Farm and Ranch Supplemental Application (Risk Placement Services, Inc.)

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Multiguard Farm and Ranch Supplemental Application
Property – Optional Coverage Endorsements
Extended Replacement Cost Coverage – Coverage “A” – Dwelling – FP7435
Location: ________ Dwelling # _______
________ _______
AgriCover for Property – FP7405
Special Hay Endorsement – 134204
Additional Coverage Pollutant Cleanup and Removal Expense – FP7422
$50,000 $100,000
Orchard Endorsement – FP7403
Extended Property Coverage For Orchard and Vineyard Growers – FP7404
Extended Property Coverage for Dairy Operations – FP7409
Equipment Breakdown Coverage For Dairy Operations – FP7411
$50,000 $150,000
Scheduled Farm Machinery Glass – FP7402 (Describe machinery)
________________ _______________ _______________
________________ _______________ _______________
Functional Building Valuation – FP0478
Location: _____ Description: _______________ Limit of Insurance: __________
_____ _______________ __________
Functional Farm Personal Property, Machinery and Equipment Valuation – FP0479
Description: _______________ Limit of Insurance: __________
_______________ __________
Mobile Agricultural Machinery and Equipment Replacement Cost Valuation – FP7406
Description: _______________ Limit of Insurance: __________
_______________ __________
Disruption of Farming Operations (Income and Expenses Coverage) – FP1501
Location Description of Description of Limit of Percent of Cause of Extended Period
Farming Op.
Property Insurance Exposure Loss of Indemnity Option
_______ ___________ ___________ ________ ________ _______ _____________
_______ ___________ ___________ ________ ________ _______ _____________
Liability – Optional Coverage Endorsements
AgriCover for Liability – FL8417
Chemical Drift Degradation to Crops and Domesticated Animals (PD only) – FL8404
($100,000 included) Optional Aggregate Limits - $300,000 $500,000
Limited Agricultural Chemical Drift Coverage (BI and PD) – 141869
Optional Aggregate Limits - $100,000 $300,000 $500,000
Limited Agricultural Pollution Amendment – FL9053
Optional Aggregate Limits - $100,000 $300,000 $500,000
Auto – Optional Coverage Endorsements
FleetCover Endorsement – CA7018
Limited Auto Pollution Liability Endorsement – CA7042
These are the most common optional endorsements used, however these are not all the optional endorsements offered by
FFAB. Please refer to your Multiguard Farm and Ranch manual for all optional coverage endorsements.
Ed (10-01) ISO-98
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Multiguard Farm and Ranch Supplemental Application (Risk Placement Services, Inc.)

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Completed 30 July 2020

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