Online Application Form

Seed Industry Plus Error & Omissions Application Form

To obtain your quotation please complete the application below. If, during the process, you have any questions please feel free to contact our office utilizing our toll-free number and a farm representative will be happy to assist you.

Call us toll-free at 1-800-268-3675.

If you prefer, you may download and/or print the Seed Grower E&O application form, and mail or fax it to: Farrell Agencies Ltd., PO Box 758, 131 Palliser Way, Yorkton SK S3N 4C6. Fax 306-786-7577.

Business Information


Full Name:*

Form of Entity:

Corporation Name:



Contact Phone Number:*



Are you a CSGA or CSI member?


Seed Sales:*
Canada $:
USA $:
Other $:


Forage Seed Sales:
Canada $:
USA $:
Other $:


Custom Cleaning Receipts (if applicable):

Bagged Seed Sales:


Additional Insured's:
NutrienFTP GeneticsRichardson InternationalOther



Has applicant ever carried seed Errors & Omissions Insurance?:

Are you aware of any occurance, fact, circumstance, or allegation, which may give rise to a claim, whether insured or not?:

Any previous losses in the past 5 years? If you've had two or more claims please call our office:

Is your seed plant or farm policy with Farrell Agencies? (Further 15% discount applies)

Limits Required:


I (We) hereby acknowledge that it is a direct consideration of the granting of insurance coverage provided by this program that all requirements and procedures set down by Canadian Seed Institute regarding grading, sale, handling, shipping and storage of seed/seed products are adhered to.

Comments and questions:

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