Whitewater, WI 53190
Complete Grain Handling Livestock Mortality Insurance Drying & Storage Systems Complete Grain Handling PAULA BOVRE LIVESTOCK INSURANCE Custom Fabrication Drying & Steel Storage Systems W4226 Hwy 23 East, Fond du Lac, WI 54937 PH: 920.923.6991 CELL: 920.960.0655 email: grnorth81@gmail.com Dairy & Livestock Facilities SteelCOMPANY Fabrication APPLICATION FOR INSURANCE WITH AMERICANCustom LIVESTOCK INSURANCE REMOVE AND HAND TO COMPANY REPRESENTATIVE Conveying Equipment Dairy & Livestock Facilities
Drying I/WeGrain Conveying Equipment Of Grain Storage &ZipHandling Grain Address DryingState 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 or animals. Millwright Work Grain Storage & Handling Concrete Millwright Work Work Concrete Work Motors Electric Electric Motors Steel Buildings Dairy Cattle Rates Steel Buildings The Scharine Group, Inc. Lot
Registration and/or Tattoo Number
Name of Animal
CALVES 2 weeks – 7 weeks of age 7 weeks – 3 months of age BULLS Up to 6 years of age 7 years 8 years
Annual 12.0% 10.0%
Breed Sex
1 Month 3 Months 6 Months 4.8% 7.2% 8.0% 4.0% 6.0% 6.7%
The Scharine Group, N4213 Scharine Rd.Inc. N4213 Scharine 6.0% 2.4% Rd. 3.6% 4.0% Whitewater, WI 53190 7.0% 2.8% 4.2% 4.7% Whitewater,8.0% WI 3.2% 53190 4.8% 5.3%
Birthdate
Purchase Price Purchase Date
Amount of Insurance
Rate
5 5 Premium
COWS Annual 1 Month 3 Months 6 Months Up to 5 years of age 8.0% 3.2% 4.8% 5.3% 6 years 9.0% 3.6% 5.4% 6.0% 7 years 10.0% 4.0% 6.0% 6.7% Minimum Policy Premium is $150.00 Term must be a minimum of 60 days to cover any loss resulting from calving.
This is not a Binder until accepted by Insurance Company Representative
Complete Milking Facilities Complete Milking Facilities Manure & Grain Handling Manure & Grain Handling Custom SteelFabrication Fabrication Custom Steel
Milking Parlors Milking Parlors Barn Remodeling Barn Remodeling Free FreeStalls Stalls Dairy DairyEquipment Equipment Cooling Cooling Equipment Equipment Feeding Equipment Feeding & & Conveying Conveying Equipment Grain & Storage Storage Grain Drying Drying & Millwright Work Millwright Work Air Hammer Hammer Service Service ConcreteWork Work Concrete ManureStorage Storage&&Handling Handling Manure TheScharine ScharineGroup, Group, Inc. Inc. The Electric ElectricMotors Motors N4213Scharine Scharine Rd. Rd. N4213
66
Whitewater,WI WI 53190 53190 Whitewater,
800-472-2880