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Livestock Mortality Insurance MERRY RAMA INSURANCE

4236 County Highway 18, Delhi, NY 13753 Ph: (607) 746-2226 ~ Fax: (607) 746-2911 E-mail: merryrama@cattlexchange.com www.cattlexhange.com

Remove and Hand to Company Representative Application For Insurance with American Livestock Insurance Company

I/We ______________________________________________________________ of ______________________________________________________________

Address City State Zip Code Telephone

hereby apply for insurance against loss by death resulting from disease or accidental injuries for the term of ________________________, on the following described animal(s). This is not a Binder until accepted by Insurance Company Representative Lot Name of Animal

Registration and/or Tattoo Number

Purchase Price Amount of Breed Rate Birthdate Sex Purchase Date Insurance

Dairy Cattle Rates

Calves Annual 1 Month 3 Months 6 Months 2 weeks to 7 weeks of age............... 12.0% 4.8% 3.2% 8.0% 7 weeks to 3 months of age............. 10.0% 4.0% 6.0% 6.7%

Bulls

Up to 6 years of age......................... 6.0% 7 years............................................. 7.0% 8 years............................................. 8.0%

3.6% 4.2% 4.8%

4.0% 4.7% 5.3%

Up to 5 years of age........................ 8.0% 3.2% 4.8% 6 years............................................. 9.0% 3.6% 5.4% 7 years............................................. 10.0% 4.0% 6.0% ~Minimum Policy Premium is $100.00

5.3% 6.0% 6.7%

Cows

2.4% 2.8% 3.2%

This is not a Binder until accepted by Insurance Company Representative

Premium

New York Convention ET Sale  

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