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Year

Crop

Area Planted (In Acre)

Area Destroyed (In Acre)

Cause/Perils

Fire

Lightning

Hail

Windstorm

Plain Crash

Impact Damage

Water from Reservoirs / Tanks

Uncontrollable Pests and Diseases

Other

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Expected Yield (In kgs)

Value of Loss (KES)

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Experience and Qualification of Owner / Deputy / Key Staff:

Perils

What would you like to insure ?

Crop

Greenhouse No

Type of Crop

Crop Variety

Date of Planting

Expected Harvetsing Month and Year

Area(Greenhouse Size)

Planting Distance

Plant To Plant

Between Rows

No. of Plants Per Greenhouse (Not applicable for perennial crop)

Market Supply - Local

Market Supply - Export

Sum Insured

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Greenhouse - Construction and Cover

Greenhouse No.

Size of the greenhouse

Length in metres

Width in metres

Area in sq metres

Plastic Cladding

Plastic Gauge (Microns)

Date of Purchase

Total area of Plastic (in M2)

Cost of Plastic per metre

Sum Insured (Kshs)

Steel Structure

Type of Steel

Value of Structure

Greenhouse constructed by

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Greenhouse No.

Machinery Type

Machinery Description

Size/Capacity

Quantity

Year of Manufacture

Value/Item (ksh)

Sum Insured (Quantity * Value/Item (ksh))

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Greenhouse No.

Cold Room No.

Maximum Carrying Capacity (Boxes)

Value per box

Sum Insured (Maximum Carrying Capacity (Boxes) * Value per box )

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Greenhouse No.

Equipment Type

Equipment Description

Size/Capacity

Quantity

Year of Manufacture

Value / Item

Sum Insured (Quantity * Value / Item)

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Greenhouse No.

Equipment Description/ Building

Size/Capacity

Quantity

Year of Manufacture

Value / Item

Sum Insured (Quantity * Value / Item)

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(Note – Loss or damage to crop as a result of fire, overturning and collision of the refrigerated vehicle transporting them from the farm to the port of exit (airport / port) or market.)

Hired Transport

Own Transport

Crop - Green House Quotation

Personal Details

Period of Insurance

Risk Details

Farm Details

Location Details

Cause/Perils

Experience and Qualification of Owner / Deputy / Key Staff:

Perils

What would you like to insure ?

Crop

Planting Distance

Greenhouse - Construction and Cover

Size of the greenhouse

Plastic Cladding

Steel Structure

(Note – Loss or damage to crop as a result of fire, overturning and collision of the refrigerated vehicle transporting them from the farm to the port of exit (airport / port) or market.)