Policy Review - Farm Insurance - North Town Insurance

Accepting Coverages*

Your input is essential to eliminate gaps in your insurance coverage. Please accept that you have reviewed your policy, you accept your coverages and you have addressed any questions you have had with our team and/or insurance carrier. This checklist is used prior to the renewal of your insurance policy(ies) for the purpose of verifying your coverage is up to date to protect against losses. This checklist does not cover every situation, but it is a good starting point to prompt you to consider major items or questions.

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Phone*

Email

Preferred Contact Method*

Please confirm your preferred method of contact.

Equipment/Machinery*

Have you sold or acquired any new equipment or machinery? If so, please let us know: Year, Make, Model, VIN/Serial#, Value.

Parcels/Properties*

Have you sold or acquired any properties or parcels? If so, please describe.

Building Updates*

Have you made any updates or upgrades to your buildings? If so, please describe.

Additional Information

Are you interested in: "It COULD happen to me coverage"?*

Are there any other coverages we can answer questions about or quote for you?

Community Partnerships

Did you know that for all referrals we receive, we donate to a local nonprofit? Is there an organization that is close to your heart that you want to share with us?

Feedback

Do you have any feedback for us? Is there an area we can improve your experience? Is there a team member you'd like to give kudos to for their effort?