For any questions regarding form submissions, please call us at 1-800-965-5580.
In order to save the forms with your information, you must download the form prior to completion
Farm & Ranch Submission Forms
Farm Auto Submission Forms
The following are needed for a Farm Auto Submission:
Please submit an ACORD 125 Commercial
Please submit an ACORD 127 Business Auto
State Specific ACORD 137 Forms
Alabama: Please submit an ACORD 137
Arkansas: Please submit an ACORD 137
California: Please submit an ACORD 137
Colorado: Please submit an ACORD 137
Georgia: Please submit an ACORD 137
Idaho: Please submit an ACORD 137
Illinois: Please submit an ACORD 137
Indiana: Please submit an ACORD 137
Kentucky: Please submit an ACORD 137
Maryland: Please submit an ACORD 137
Minnesota: Please submit an ACORD 137
Mississippi: Please submit an ACORD 137
Missouri: Please submit an ACORD 137
Montana: Please submit an ACORD 137
North Carolina: Please submit an ACORD 137
Ohio: Please submit an ACORD 137
Oklahoma: Please submit an ACORD 137
Pennsylvania: Please submit an ACORD 137
South Carolina: Please submit an ACORD 137
Tennessee: Please submit an ACORD 137
Texas: Please submit an ACORD 137
Virginia: Please submit an ACORD 137
Equine Submission Forms
The following are needed for an Equine Submission:
JAI Farm Application
Commercial Equine Liability Quest
Care Custody or Control
Dairy Operations Submission Forms
Hog Submission Forms
Poultry Submission Forms
The following are needed for Poultry Submission:
Excess Farm Pollution Submission Forms
The following are needed for Excess Farm Pollution Submission:
Supplemental Farm Pollution Forms:
Beef Questionnaire
Dairy Questionnaire
Lagoon Questionnaire
Poultry Operations Questionnaire
Underground Tank Questionnaire
Pollution sample policy
Equine/Livestock Mortality Submission Forms
The following are needed for Equine/ Livestock Mortality Submission:
Equine Mortality Application
Substantiation of Value
Breeding Evaluation
Equine Mortality Vet Cert
Mortality (Other than Equine) Application
American Live Stock Submission Forms
The following are needed for American Live Stock Submission:
American Live Stock Brochure
American Live Stock Application
American Live Stock Owner & Vet Statement
Workers Compensation Submission Forms
The following are needed for Farm Work Compensation Submission:
Please submit an ACORD 125 Commercial
Please submit an ACORD 130
Submit 3 years experience mod
Additionally, please submit 5 years loss runs
Supplemental Forms:
Farm Work Comp Custom Farming Suppl
Farm Work Comp Dairy Suppl
Farm Work Comp Eligibility
Farm Work Comp Feed Manufacturing Dealers
Farm Work Comp Horse Boarding
Farm Work Comp Implement Dealers
Farm Work Comp Landscaping
Farm Work Comp Livestock Farm Suppl
Farm Work Comp Milk Haulers
Farm Work Comp Nursery Suppl
Farm Work Comp Orchard Suppl
Farm Work Comp Payment Form
Farm Work Comp Vegetable Suppl
Farm Work Comp Veterinary Suppl
State Specific Forms
Alabama Affidavit
Arkansas SL-3 form
California Affidavit
Colorado Affidavit
Connecticut Affidavit
Delaware Affidavit
Florida Affidavit
Illinois Affidavit
Kansas Affidavit
Louisiana Affidavit
Massachusetts Affidavit
Maryland Affidavit
Mississippi Affidavit
Nebraska Surplus Lines form
New Jersey Affidavit
New Mexico Affidavit
New York Affidavit
North Carolina Form F
Ohio Surplus Lines
Oregon Affidavit
Pennsylvania Affidavit
Tennessee Affidavit
Texas Affidavit
Texas Terrorism Supplemental
Utah Affidavit
Vermont Affidavit
Washington Affidavit
West Virginia Affidavit
Wyoming Statement of Due Diligence
Claims Forms
Please submit an ACORD 1 Property Loss Notice
Please submit an ACORD 2 Auto Loss Notice
Please submit an ACORD 3 General Liability