Farmer’s Market Quote Form

January 11, 2013

Application for Oregon Farmer’s Market Liability Insurance

For insurance purposes, a farmers market is defined as an organization that provides a direct retail sales opportunity on a consistent basis at a specific location for at least  five (5) farmers/fisherman over the season; and its intent is to support Oregon agriculture by actively seeking to include more farmers/fisherman.  Agriculture and marine products must be grown/caught in Oregon or in areas adjacent to Oregon borders.  Each farmer/fisherman handles their own sales in a farmer’s market.

Standard limits Farmers’ Market Policy are stated below and the premium is based on anticipated annual gross market receipts.  Policy does not cover storage sheds, other buildings, special events without underwriting approval, carnival or wagon rides or animals of any kind.  Higher limits are available.

General Aggregate Limits $2,000,000
Product Comprehensive / Operations Aggregate $2,000,000
Personal & Advertising Injury $1,000,000
Each Occurrence $1,000,000
Fire Damage $100,000
Medical Expense $10,000

Pacific Insurance Partners also offer Vendor Liability Insurance and Director & Officers Insurance.  Please contact us for more information.

Name of Farmer's Market:  *
Please describe type: *
Federal ID Number:  *
Desired Effective Date: *
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Where is the market held? *
If multiple locations, please list addresses and descriptions of each location:
Market Mailing Address: *
Name of Contact:
E-mail: *
Phone: *
Indoor or outdoor market? *
Number of vendors anticipated? *
Duration of the market:  *
Anticipated Gross Market Receipts:  *
Types of goods that will be sold? *
Any liquor being served or sold? *
If yes, do you and the vendor have liquor liability insurance in place?
Do you require your vendors to carry insurance? *
Do you monitor certificates? *
Do you have a written contract between your market and your vendors? *
Are the vendors required to name you as an additional insured on their policies?  *
Is there a fee charged for parking? *
Are sporting or social events sponsored? *
Do you lease employees?  *
Is there a formal, written safety policy in effect? *
Do you require liability limits of $1,000,000 or more?  *
Does your market need to insure any property including buildings, sheds, trailers, equipment, etc?  *
If yes, please describe and include the combined value:
Any claims or potential claims in the last 5 years?  *
Where does your market's policy stand on pets?  *
Prior Insurer: *
Expiration Date of Previous Insurance: *
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Are there any additional insureds that you need to list on your policy? If so, please include their name, their relationship to you, and their address:
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