United States

Department of

Agriculture WINTER

SQUASH

(PILOT) LOSS

ADJUSTMENT Federal Crop

Insurance

Corporation

STANDARDS

Product

Development

Division HANDBOOK

FCIC-25700 (05-2000) 2000 and Succeeding Crop Years

MAY 2000 SC 1 FCIC-25700 (WINTER SQUASH)

UNITED STATES DEPARTMENT OF AGRICULTURE

WASHINGTON, D.C. 20250

FEDERAL CROP INSURANCE HANDBOOK NUMBER: 25700

SUBJECT: DATE: May 4, 2000 

WINTER SQUASH (PILOT)

LOSS ADJUSTMENT

STANDARDS HANDBOOK

2000 AND SUCCEEDING

CROP YEARS 

OPI: Product Development Division

THIS HANDBOOK CONTAINS THE OFFICIAL FCIC-APPROVED LOSS ADJUSTMENT

STANDARDS FOR THIS CROP FOR THE 2000 AND SUCCEEDING CROP YEARS. IN

THE ABSENCE OF INDUSTRY-DEVELOPED, FCIC-APPROVED PROCEDURE FOR THIS

CROP FOR THE 2000 AND SUCCEEDING CROP YEARS, ALL REINSURED COMPANIES

WILL UTILIZE THESE STANDARDS FOR BOTH LOSS ADJUSTMENT AND LOSS

TRAINING.

SUMMARY OF CHANGES/CONTROL CHART

Major Changes: See changes or additions in text which have been redlined. Three stars (***) identify

information that has been removed.

***

Changes:

A. In section 2 B, added definitions on allowable cost, marketable production, planted acreage, and

pumpkin.

B. Added the word pumpkin, where appropriate throughout the handbook.

C. In section 3 A, added language for loss of production due to inadequate pollination.

D. Added standard language in section 3 C, unit division.

E. In section 3 D, added language for minimum value option.

F. Added language section 5 B and 6 C for sample for pumpkins.

G. Added appraisal worksheet and summary of harvested production worksheet for pumpkins.
FCIC-25700 (WINTER SQUASH) SC 2 MAY 2000

WINTER SQUASH (PILOT) LOSS ADJUSTMENT STANDARDS HANDBOOK

SUMMARY OF CHANGES/CONTROL CHART (Continued)

H. Changed from the TPC production worksheet to the standard production worksheet, and added

the correct verbiage for the standard production worksheet.

Control Chart For: Winter Squash (Pilot) Loss Adjustment Standards Handbook

SC TC Text Reference Directive

Page(s) Page(s) Pages Material Date Number

Remove Entire Handbook

Current 1-2 1-2 1-30 31 05-2000 FCIC-25700

Index
MAY 2000 TC 1 FCIC-25700 (WINTER SQUASH)

WINTER SQUASH (PILOT) LOSS ADJUSTMENT HANDBOOK

TABLE OF CONTENTS

PAGE

1. INTRODUCTION ................................................ 1

2. SPECIAL INSTRUCTIONS ....................................... 1

A. DISTRIBUTION ....................................................... 1

B. TERMS, ABBREVIATIONS, AND DEFINITIONS ............................ 1

3. INSURANCE CONTRACT INFORMATION ......................... 2

A. INSURABILITY ....................................................... 2

B. PROVISIONS NOT APPLICABLE TO CAT COVERAGE ...................... 4

C. UNIT DIVISION ....................................................... 4

D. MINIMUM VALUE OPTION ............................................. 4

4. REPLANTING PAYMENT PROCEDURES .......................... 4

5. WINTER SQUASH APPRAISALS .................................. 5

A. GENERAL INFORMATION ............................................. 5

B. SELECTING REPRESENTATIVE SAMPLES FOR APPRAISALS ................ 6

6. APPRAISAL METHODS .......................................... 6

A. GENERAL INFORMATION ............................................. 6

B. DEFERMENT OF WINTER SQUASH APPRAISALS BEFORE MATURITY ....... 6

C. MATURE WINTER SQUASH APPRAISAL ............................. 7

7. APPRAISAL DEVIATIONS AND MODIFICATIONS .................. 8

A. DEVIATIONS ......................................................... 8

B. MODIFICATIONS ..................................................... 8
FCIC-25700 (WINTER SQUASH) TC 2 MAY 2000

WINTER SQUASH (PILOT) LOSS ADJUSTMENT HANDBOOK

TABLE OF CONTENTS (Continued)

PAGE

8. APPRAISAL WORKSHEET ENTRIES AND COMPLETION

PROCEDURES .................................................. 8

A. GENERAL INFORMATION ............................................. 8

B. WINTER SQUASH WORKSHEET ENTRIES AND COMPLETION INFORMATION 8

WINTER SQUASH APPRAISAL WORKSHEET EXAMPLE ................... 11

C. WINTER SQUASH SUMMARY OF HARVESTED PRODUCTION WORKSHEET

ENTRIES AND COMPLETION INFORMATION ............................ 12

WINTER SQUASH SUMMARY OF HARVESTED PRODUCTION WORKSHEET

EXAMPLE .......................................................... 15

9. CLAIM FORM ENTRIES AND COMPLETION PROCEDURES . . . . . . . 16

A. GENERAL INFORMATION ............................................ 16

B. FORM ENTRIES AND COMPLETION INFORMATION ...................... 17

SECTION I - ACREAGE APPRAISED, PRODUCTION AND ADJUSTMENTS .... 19

SECTION II - HARVESTED PRODUCTION ............................... 25

WINTER SQUASH CLAIM FORM EXAMPLE .............................. 30

10. REFERENCE MATERIAL ............................................. 31

TABLE A - MINIMUM REPRESENTATIVE SAMPLE REQUIREMENTS ............ 31
MAY 2000 1 FCIC-25700 (WINTER SQUASH)

1. INTRODUCTION

This handbook identifies the crop-specific procedural requirements for adjusting Multiple Peril Crop

Insurance (MPCI) losses in a uniform and timely manner. These procedures, which include crop

appraisal methods and claims completion instructions, supplement the general (not crop-specific)

procedures, forms, and manuals for loss adjustment identified in the Loss Adjustment Manual (LAM).

2. SPECIAL INSTRUCTIONS

This handbook remains in effect until superseded by reissuance of either the entire handbook or

selected portions (through slipsheets or bulletins). If slipsheets have been issued for a handbook, the

original handbook as amended by slipsheet pages shall constitute the handbook. A bulletin can

supersede either the original handbook or subsequent slipsheets.

A. DISTRIBUTION

The following is the minimum distribution of forms completed by the adjuster for the loss

adjustment inspection:

One legible copy to insured. The original and all remaining copies as instructed by the

insurance provider.

NOTE: It is the insurance providers’ responsibility to maintain original insurance

documents relative to policyholder servicing as designated in their approved plan of

operations.

B. TERMS, ABBREVIATIONS, AND DEFINITIONS

(1) Terms, abbreviations, and definitions general (not crop specific) to loss adjustment are

identified in the LAM.

(2) Terms, abbreviations, and definitions specific to winter squash loss adjustment and this

handbook, which are not defined in this section, are defined as they appear in the text.

(3) Definition(s):

Allowable The dollar amount per pound for costs the insurance provider estimates to

Cost be incurred during and after harvesting as shown in the Special Provisions.

Direct Sale of the insured crop directly to consumers without the intervention of

Marketing an intermediary such as a wholesaler, retailer, packer, processor, shipper or

buyer. Examples of direct marketing include selling through an on-farm or

roadside stand, farmer’s market, and permitting the general public to enter

the field for the purpose of picking all or a portion of the crop.

Harvest The removal of squash or pumpkins from the plant.
FCIC-25700 (WINTER SQUASH) 2 MAY 2000

Marketable Pumpkins or winter squash that meet the standard for grading No. 2

Production or better, or would be accepted by a packer, processor, consumer, or other

handler even if failing to meet grading standards.

Planted In addition to the definition of “planted acreage” contained in the Basic

Acreage Provisions, planted acreage is defined as land in which seeds or transplants

have been placed, by hand or machine at the correct depth, into a seedbed

that has been properly prepared for the planting method and production

practice. Squash or pumpkins must initially be planted in rows far enough

apart to permit mechanical cultivation. Acreage planted in any other

manner will not be insurable unless otherwise provided by the Special

Provisions.

Potential The number of hundredweight of squash or pumpkins that the plants will

Production or would have produced per acre by the end of the insurance period,

assuming normal growing conditions and practices.

Pumpkin The fruit of any plant of the genus Cucurbita and species C. pepo or C.

moschata.

Winter The edible fruit of any plant of the genus Cucurbita produced for human

Squash consumption.

3. INSURANCE CONTRACT INFORMATION

The insurance provider is to determine that the insured has complied with all policy provisions of the

insurance contract. Crop provisions which are to be considered in this determination include (but are

not limited to):

A. INSURABILITY

(1) The crop insured will be all the squash and pumpkins in the county for which a premium rate

is provided by the actuarial documents, in which the insured has a share; and

(a) That is squash planted to be harvested for human consumption or pumpkins planted to

be harvested for human consumption or for ornamental purposes;

(b) That is grown by a person who in at least one of the three previous crop years:

1 Grew squash or pumpkins for commercial sale; or

2 Managed a commercial squash or pumpkin farming operation.

(2) That are not (unless allowed by the Special Provisions):

(a) Interplanted with another crop;
MAY 2000 3 FCIC-25700 (WINTER SQUASH)

(b) Planted into an established grass or legume; or

(c) Grown for direct marketing.

(3) Squash and pumpkin acreage that does not meet the applicable rotation requirements shown

in the Special Provisions will not be insurable.

(4) Any acreage of the insured crop damaged before the final planting date, to the extent that

most producers in the area would not normally further care for the crop, must be replanted

unless the insurance provider agrees that it is not practical to replant. Refer to the LAM for

replanting provision issues.

(5) In addition to the causes of loss excluded in the Basic Provisions, insurance coverage is not

provided against damage or loss of production due to the following:

(a) Failure to harvest in a timely manner; or

(b) Failure to market squash or pumpkins, unless such failure is due to actual physical

damage caused by an insured cause of loss that occurs during the insurance period. For

example, the insurance provider will not pay any indemnity if the insured is unable to

market due to quarantine, boycott, or refusal of any person to accept production.

(c) Loss of production due to inadequate pollination will be uninsurable unless the insured

can prove that he/she caused an adequate number of honeybees to be placed in and

about the field during the entire period of time the squash or pumpkin plants were

flowering.

(6) If the insured intends to claim an indemnity on any unit, he/she is required to file a “notice of

damage or loss” with the insurance provider not later than 72 hours after the earliest of:

(a) The time the insured discontinues harvest of any acreage on the unit;

(b) The date harvest normally would start if any acreage on the unit will not be 

harvested; or

(c) The calendar date for the end of the insurance period.

(7) Any representative samples of the unharvested crop that the insurance provider may require

must be at least 10 feet wide and extend the entire length of each field in the unit. 

(a) The samples must not be harvested or destroyed until the earlier of the inspection or

15 days after harvest of the balance of the unit is completed.

(b) Failure to leave a representative sample will result in an appraised amount of

production to count that is not less than the amount of insurance per acre.

NOTE: Appraisals will be deferred until the earlier of the date the crop reaches maturity or the

calendar date for the end of the insurance period.
FCIC-25700 (WINTER SQUASH) 4 MAY 2000

(8) If direct marketing of the insured crop is allowed by the Special Provisions, the insured must

notify the insurance provider at least 15 days before any production from any unit will be

marketed directly to consumers.

(9) In addition to all other notice requirements, if the insured is a wholesaler, retailer, packer,

processor, shipper, buyer or other handler of squash or pumpkins, the insured must notify

the insurance provider at least 15 days before harvest or the end of the insurance period,

whichever is earlier. 

(10) Any damage effecting the marketability of an insurable type of winter squash which becomes

evident during the first 30 days of storage and is prior to the end of the insurance period and

is attributable to an insurable cause of loss while the squash was still in the field will be

insurable.

B. PROVISIONS NOT APPLICABLE TO CAT COVERAGE

(1) Optional Units.

(2) High Risk Land Exclusion.

(3) Hail and Fire Exclusion provisions (also not applicable to limited coverage).

(4) Minimum Value Option

C. UNIT DIVISION

See the insurance contract for unit provisions. NOTE: Unless limited by the Crop or Special

Provisions, a basic unit, as defined in the Basic and Crop Provisions, may be divided into optional

units if, for each optional unit, all the conditions stated in the applicable provisions are met.

D. MINIMUM VALUE OPTION

The total value of harvested production will be as follows:

(1) For sold production, the dollar amount obtained by subtracting the allowable cost contained

in the Special Provisions from the price received for each hundredweight of squash or

pumpkins (this result may not be less than zero), and multiplying this result by the number of

hundredweight of squash or pumpkins sold.

(2) For marketable production that is not sold, the dollar amount obtained by multiplying the

number of hundredweight of squash or pumpkins by the minimum value shown in the

Special Provisions (harvested production that is damaged or defective due to insurable

causes and is not marketable will not be counted as production).

4. REPLANTING PAYMENT PROCEDURES

There is currently no replanting payment available for winter squash. Refer to the Basic Provisions and

the crop provisions for this crop for replanting requirements prior to the final planting date.
MAY 2000 5 FCIC-25700 (WINTER SQUASH)

5. WINTER SQUASH APPRAISALS

A. GENERAL INFORMATION

Potential production will be appraised in accordance with procedures specified in this handbook

and the LAM.

(1) Appraisals are to be made:

(a) When production remains on acreage that has been harvested.

(b) When the insured does not intend to harvest the squash or pumpkin acreage, or which

remains unharvested at the end of the insurance period.

(c) When directed by the insurance provider.

(d) If the crop is to be direct marketed as allowed by the Special Provisions. (See crop

provisions for specifics).

(e) When uninsured cause of loss is applicable. See additional instructions in the LAM.

(f) If the insured is a wholesaler, retailer, packer, processor, shipper, buyer or other

handler of squash or pumpkins. (See crop provisions for specifics).

NOTE: See the LAM for additional reasons for appraisals.

(2) Make separate appraisals for each squash and pumpkin variety grown in the field or subfield,

as applicable.

(3) Appraise squash and pumpkins before removal from the plant.

(4) Timing of appraisals:

(a) The adjuster should arrange to inspect the plants when the squash or pumpkins have

reached harvestable maturity. Samples are selected according to subsection B below.

(b) If there are seriously damaged squash or pumpkins, and it appears that the damaged

squash or pumpkins (especially fresh-market production) are not saleable through

regular channels, but there is a possibility that the squash or pumpkins will be

harvested (as U-pick or for roadside market), do NOT complete the claim until harvest

is completed and the squash or pumpkins are marketed in order to determine the value

of harvested production.
FCIC-25700 (WINTER SQUASH) 6 MAY 2000

B. SELECTING REPRESENTATIVE SAMPLES FOR APPRAISALS

(1) Determine the minimum number of required samples for a field or subfield by the field size,

the age (size) and general capabilities of the plants, and variability of potential production

and plant damage within the field or subfield.

(2) Split the field into subfields when:

(a) variable damage causes the crop potential to appear to be significantly different within

the same field; or

(b) the insured wishes to destroy a portion of a field.

(3) Each subfield must be appraised separately.

(4) Sample size. 

(a) For squash, each sample equals a six foot square grid (36 square feet).

(b) For pumpkins, each sample equals a ten foot square grid (100 square feet).

(5) Take not less than the minimum number (count) of representative samples required in 

TABLE A.

6. APPRAISAL METHODS

A. GENERAL INFORMATION

These instructions provide information on appraisal methods for:

Appraisal Method... Use...

Mature Winter Squash Appraisal When squash or pumpkins have

reached maturity.

B. DEFERMENT OF WINTER SQUASH APPRAISALS BEFORE

MATURITY

(1) Defer all appraisals until the earlier of the date the crop reaches maturity or the calendar date

for the end of the insurance period unless there is no production potential. If there is no

production potential, enter “0" appraised potential in the applicable entry on the claim form

and complete the claim.

(2) Complete the preliminary inspection with special attention to the type of damage and its

severity.
MAY 2000 7 FCIC-25700 (WINTER SQUASH)

(3) If acreage will be released to go to another use:

(a) Look at all fields thoroughly. It is important to note the acreage that is not damaged.

(b) Explain to the insured that, at this time, the amount of loss cannot be determined

accurately.

(c) Do not attempt to estimate the damage for the insured.

(d) Mark an area (or areas) in the field that can be used as a representative sample(s). The

area should be at least ten feet wide and extend the entire length of the field, as

specified in the policy.

(e) Advise the insured that if the crop is destroyed, the specified samples must be

preserved and cared for.

(4) Refer to the LAM for additional instructions regarding deferred appraisals.

C. MATURE WINTER SQUASH APPRAISAL

(1) Pick all “Marketable” fruit and determine the weight of each sample in pound to tenths.

(2) Multiply the sample area size dimensions (e.g. 6' x 6', 10' x 10', etc.) to obtain the square

footage area in the sample area, then divide 43,560 by the result to determine the acreage

factor. Record results in tenths.

(a) Squash in each six-foot square grid sample (36 square feet).

Example: 43,560 ÷ 36 = 12.1.

(b) Pumpkins in each 10-foot square grid sample (100 square feet).

Example: 43,560 ÷ 100 = 4.4.

(3) Total the sample weights and divide by the number of samples taken. The result is the

average number of pounds per sample.

(4) Multiply the average number of pounds per sample by 12.1 (factor) for squash and 4.4

(factor) for pumpkins to determine the per acre appraisal in HUNDREDWEIGHT, rounded

to tenths.
FCIC-25700 (WINTER SQUASH) 8 MAY 2000

7. APPRAISAL DEVIATIONS AND MODIFICATIONS

A. DEVIATIONS

Deviations in appraisal methods require FCIC written authorization (as described in the LAM)

prior to implementation.

B. MODIFICATIONS

There are no pre-established modifications contained in this handbook. See the LAM for

additional information.

8. APPRAISAL WORKSHEET ENTRIES AND COMPLETION

PROCEDURES

A. GENERAL INFORMATION

(1) Include the insurance provider’s name in the appraisal worksheet title if not preprinted on

the insurance provider’s worksheet or when a worksheet entry is not provided.

(2) Include the claim number on the appraisal worksheet (when required by the insurance

provider), when a worksheet entry is not provided.

(3) Separate appraisal worksheets are required for each unit appraised. Refer to section 5 for

sampling requirements.

(4) The minimum value option is applicable only to harvested production.

NOTE: Standard appraisal worksheet items are numbered consecutively in subsection B. An

example appraisal worksheet is also provided to illustrate how to complete entries.

B. WINTER SQUASH WORKSHEET ENTRIES AND COMPLETION

INFORMATION

Verify or make the following entries:

Item

No. Information Required

Company Name: Name of insurance provider if not pre-printed on the worksheet

(Company Name).

Claim Number: Claim number as assigned by the insurance provider.
MAY 2000 9 FCIC-25700 (WINTER SQUASH)

1. Insured’s Name: Name of the insured that identifies EXACTLY the person (legal entity)

to whom the policy is issued.

2. Policy Number: Insured’s assigned policy number.

3. Crop Year: Crop year, as defined in the policy, for which the claim has been filed.

4. Unit Number: Five-digit unit number from the Summary of Coverage after it is verified to

be correct (e.g., 00100).

5. Cause of Damage: Name of insured cause of loss for this crop as listed in the LAM. If it

is evident that no indemnity is due, enter “NONE.” If an insured cause of loss is coded as

“Other,” explain in the “Remarks.”

6. Farm Serial No.: FSA Farm serial number.

7. Field ID: Field identification symbol.

8. Plot Acres: Number of determined acres, to tenths, in field or sub-field being appraised.

9. Code No. Type: Three-digit code number, entered exactly as specified on the actuarial

documents, for the type grown by the insured. If “No Type Specified,” enter appropriate 3-

digit code number from the actuarial documents. Enter the type name, as shown on the

Special Provisions, in the remarks (item 16).

10. Sample Weight in Pounds:

a. Squash - Weight of each sample in pounds to tenths. A sample is all marketable squash

counted in the six square foot frame.

b. Pumpkins - Weight of each sample in pounds to tenths. A sample is all marketable

pumpkins counted in the ten square foot frame.

11. Total From All Samples: Sum of all sample weights recorded in item 10.

12. No. of Samples: Number of samples taken in item 10.

13. Avg. No. of Pounds Per Sample: Divide “Total From All Samples” (item 11) by “Number

of Samples” (item 12) to calculate the “Average No. of Pounds per Sample,” rounded to

tenths.

14. Factor:

a. Squash - MAKE NO ENTRY. 12.1 factor preprinted on appraisal worksheet.

b. Pumpkins - Line through 12.1 factor and enter 4.4.
FCIC-25700 (WINTER SQUASH) 10 MAY 2000

15. Production in Cwt: Multiply “Average No. of Pounds per Sample” (item 13) by

“Factor,” (item 14) to calculate the per acre appraisal in hundredweight (CWT.), rounded to

tenths.

16. Remarks: Remarks pertinent to the appraisal, sampling, conditions in general (e.g. - very

hot dry, type of winter squash, i.e. pumpkins,) etc.

17. Adjuster’s Signature, Code Number, and Date: Signature of adjuster, code number, and

date signed after the insured (or insured’s authorized representative) has signed. If the

appraisal is performed prior to signature date, document the date of appraisal in the Remarks

section of the Appraisal Worksheet (if available); otherwise, document the appraisal date in

the Narrative of the Production Worksheet.

18. Insured’s Signature and Date: Insured’s (or insured’s authorized representative’s)

signature and date. BEFORE obtaining insured’s signature, REVIEW ALL ENTRIES on

the Appraisal Worksheet WITH THE INSURED, particularly explaining codes, etc., which

may not be readily understood.

19. Page Number: Page numbers - (Example: Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.).
MAY 2000 11 FCIC-25700 (WINTER SQUASH)

Company Name: Any Company FOR ILLUSTRATION PURPOSES ONLY Claim Number: XXXXXXX

1 INSURED'S NAME 2 POLICY NUMBER 3 CROP YEAR

APPRAISAL WORKSHEET

WINTER SQUASH

(Mature Stage)

I.M. INSURED XXXXXXX YYYY

4 UNIT NUMBER 5 CAUSE OF DAMAGE 6 FARM SERIAL NO.

00100 FREEZE 10

FIELD ID ACRES TYPE SAMPLE WEIGHT IN POUNDS ALL SAMPLES SAMPLES SAMPLE FACTOR IN CWT.

7 8 9 10 11 12 13 14 15

PLOT CODE NO. TOTAL FROM NO. OF POUNDS PER PRODUCTION

AVG. NO. OF

1A 20.0 192 2.1 1.3 3.0 1.8 2.5 10.7 ÷ 5 = 2.1 x 12.1 = 25.4

1D 20.0 192 2.5 1.9 2.8 2.1 3.2 12.5 ÷ 5 = 2.5 x 12.1 = 30.3

÷ = x 12.1 =

÷ = x 12.1 =

÷ = x 12.1 =

÷ = x 12.1 =

16 REMARKS

 type 192 acorn

17 ADJUSTER’S SIGNATURE & CODE NUMBER DATE 18 INSURED’S SIGNATURE DATE

I. M. ADJUSTER XXXXX MM/DD/YYYY I. M. INSURED MM/DD/YYYY

19 Page 1 of 1 
FCIC-25700 (WINTER SQUASH) 12 MAY 2000

C. WINTER SQUASH SUMMARY OF HARVESTED PRODUCTION

WORKSHEET ENTRIES AND COMPLETION INFORMATION

(1) Use this worksheet to record production of marketable squash and pumpkins which are

harvested. Use separate Summary of Harvested Production Worksheets for:

(a) Harvested production, U-Pick production, other types of direct marketing, and

unsold production. 

(b) Each packer or processor.

(c) Use a separate Summary of Harvested Production Worksheet for each buyer and

type of winter squash.

NOTE: Scavenged winter squash and other production harvested and sold to other than

the packing house is to be reported as “U-pick.”

(2) Packout computer printout sheets may be used to record harvested production in lieu of

Summary of Harvested Production Worksheets, provided that they establish the total

value per load in the same manner with no load valued at less than zero after subtracting

allowable costs. (See Special Provisions for allowable costs.) File a copy of the printout

sheets in the contract folder.

(3) Allowable cost of harvested production will include only those allowable costs shown in

the Special Provisions including picking, grading, and selling, not to exceed the amount

shown in the Special Provisions. The actual allowable costs can be obtained from the

grower.

NOTE: This worksheet is used to determine average value (per hundredweight) actually

received for harvested production. Actual value according to the crop provisions or Minimum

Value Option, if applicable, is recorded on the Production Worksheet.

Verify or make the following entries:

Company Name: Name of insurance provider, if not preprinted on the worksheet. (Company

Name).

Claim No.: Claim number as assigned by the insurance provider, if required.

1. Insured’s Name: Name of the insured that identifies EXACTLY the person (legal entity) to

whom the policy is issued.

2. Crop: “Winter Squash” (0065).

3. Crop Year: Crop year, as defined in the policy, for which the claim has been filed. 

4. Policy No: Insured’s assigned policy number.

5. Planting: MAKE NO ENTRY.
MAY 2000 13 FCIC-25700 (WINTER SQUASH)

6. Unit Number: Five-digit unit number from the Summary of Coverage after it is verified to be

correct. (e.g., 00100).

7. Name, Address, and Phone No. of Buyer/Packer: Name, address, and telephone number of

the buyer/packer of the production, processor, shipper, location of U-Pick field, roadside stand,

or name and location of farmers market. Enter type of winter squash. MAKE NO ENTRY for

unsold production.

8. Sale Date: Enter date the load was sold. Enter “unsold” for unsold production (harvested

and/or packed but could not be sold due to insured causes).

9. Load Number: Ticket number of the load. For unsold production enter the number of the

USDA certificate of inspection, if available, and attach a copy of the certificate. Enter “Upick” for U-Pick production, or type of direct marketing, (e.g.,farmers market).

10. No. of Total CWT. Sold: For packed production, enter the number of CWT. per load. For

U-pick, and unsold production, enter the CWT. of such production. Round CWT. production

to tenths.

11. Value Per CWT.: Enter the Value Per CWT., determined by dividing the gross value of sales

(from the sales invoice) by the number of CWT. sold, rounded to dollars and cents. For unsold

production, MAKE NO ENTRY. 

12. Allowable Cost: Enter the allowable cost (for packed production only) from the Special

Provisions. If the actual allowable cost is less than the value provided in the Special

Provisions, enter the actual allowable cost. For U-Pick production and other types of direct

marketed production, enter “0." For unsold production, MAKE NO ENTRY.

13. Net Value: Subtract Allowable Cost (item 12) from Value Per CWT. (item 11). If the value is

negative enter “0.00." MAKE NO ENTRY for unsold production. 

14. Total Value Per Load: Multiply No. of Total CWT. Sold (item 10) by Net Value (item 13). 

Enter the results, rounded to dollars and cents. MAKE NO ENTRY for unsold production. 

15. Total CWT.: Sum the number of cwt. for all loads from “No. of Total CWT. Sold” column

(item 10).

16. Total ($) All Loads: Sum the total dollar and cents value for all loads from “Total Value Per

Load” column (item 14).

17. Total ($) All Loads: Dollar amount determined in Total ($) All Loads (item 16). 

18. Total CWT.: Total CWT. determined for all loads (item 15).

19. Average Value per CWT.: Divide Total ($) All Loads (item 17) by Total CWT (item 18).

Enter result, rounded to dollars and cents. 
FCIC-25700 (WINTER SQUASH) 14 MAY 2000

NOTE: The entry in Column Q , Section II of the Production Worksheet will be the greater of 1

(a) the Average Value Per CWT. from item 19, or (b) Minimum Value Per CWT. shown in the

Special Provisions.

20. Adjuster’s Signature and Date: Signature of adjuster, code number, and date signed after

the insured (or insured’s authorized representative) has signed.

21. Insured’s Signature and Date: Insured's (or insured’s authorized representative’s) signature

and date. BEFORE obtaining insured’s signature, REVIEW ALL ENTRIES on the appraisal

worksheet WITH THE INSURED, particularly explaining codes, etc., which may not be

readily understood. 

22. Page: Page numbers - (Example: Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.). 
MAY 2000 15 FCIC-25700 (WINTER SQUASH)

Company Name: Any Company Claim No.: XXXXX

For Illustration Purposes only 1. INSURED’S NAME 2. CROP 3. CROP YEAR

(Winter Squash)

SUMMARY OF

 HARVESTED PRODUCTION

I.M. Insured Winter Squash 0065 YYYY

4. POLICY NO. 5. PLANTING 6. UNIT NUMBER

XXXXXXX 00100

7. NAME, ADDRESS, AND PHONE NO. OF BUYER/PACKER

Tel (XXX) XXX-XXXX

ABC Packing Co. Box xx, Any Town, Any State Acorn 192

PART I - PRODUCTION

SALE DATE LOAD NUMBER NET VALUE NO. OF TOTAL VALUE PER ALLOWABLE TOTAL VALUE

CWT. SOLD CWT. COST PER LOAD

8 9 10 11 12 13 14

MM/DD/YYYY xxxx 98.6 $20.00 $7.00 $13.00 $1,281.80

MM/DD/YYYY xxxx 113.5 $28.00 $7.00 $21.00 $2,383.50

MM/DD/YYYY xxxx 124.8 $19.00 $7.00 $12.00 $1,497.60

MM/DD/YYYY xxxx 128.5 $23.00 $7.00 $16.00 $2,056.00

15. TOTAL CWT. 465.4 $7,218.90 16. TOTAL ($) ALL LOADS 

PART II - WEIGHTED VALUE

17. TOTAL ($) ALL LOADS 18. TOTAL CWT. 19. AVERAGE VALUE PER CWT. 

$7,218.90 465.4 $15.51

 20. ADJUSTER’S SIGNATURE & CODE NO. DATE 21. INSURED’S SIGNATURE DATE

I.M. ADJUSTER XXXXX MM-DD-YYYY I.M. INSURED MM-DD-YYYY

 22. Page 1 of 1 
FCIC-25700 (WINTER SQUASH) 16 MAY 2000

9. CLAIM FORM ENTRIES AND COMPLETION PROCEDURES

A. GENERAL INFORMATION

(1) The claim form (hereafter referred to as “ Production Worksheet”) is a progressive form

containing all notices of damage for all preliminary and final inspections on a unit.

(2) If a Production Worksheet has been prepared on a prior inspection, verify each entry and

enter additional information as needed. If a change or correction is necessary, strike out all

entries on the line and re-enter correct entries on a new line. The adjuster and insured should

initial any line deletions.

(3) Refer to the LAM for instructions regarding the following:

(a) Acreage report errors.

(b) Delayed notices and delayed claims.

(c) Corrected claims or fire losses (double coverage) and cases involving uninsured causes

of loss, unusual situations, controversial claims, concealment, or misrepresentation.

(d) Claims involving a Certification Form (when all the acreage of the unit has been

appraised to be put to other use, or other reasons described in the LAM).

NOTE: Certification Forms for release of acreage for other use will not be used since claims

cannot be completed until an appraisal of mature production is done using representative

samples.

(e) “No Indemnity Due” claims (which must be verified by an APPRAISAL or

NOTIFICATION from the insured that the production exceeded the guarantee).

(4) The adjuster is responsible for determining if the insured has complied with all of their

requirements under the notice and claim provisions of the policy. If they have not, the

adjuster should contact the insurance provider.

(5) Instructions labeled “PRELIMINARY” apply to preliminary inspections only. Instructions

labeled “FINAL” apply to final inspections only. Instructions not labeled apply to ALL

inspections.
MAY 2000 17 FCIC-25700 (WINTER SQUASH)

B. FORM ENTRIES AND COMPLETION INFORMATION

Verify or make the following entries:

Item

No. Information Required

1. Crop/Code #: “Winter Squash” (0065).

2. Unit #: Five-digit unit number from the Summary of Coverage after it is verified to be

correct (e.g., 00100).

3. Legal Description: Section, township, and range number or other legal description that

identifies the location of the unit.

4. Date of Damage: First three letters of the month during which MOST of the insured

damage (including progressive damage) occurred for each inspection. Include the

SPECIFIC DATE where applicable as in the case of hail damage (e.g., AUG 11).

5. Cause of Damage: Name of insured cause of loss for this crop as listed in the LAM. If it

is evident that no indemnity is due, enter “NONE.” If an insured cause of loss is coded as

“Other,” explain in the “Narrative.”

NOTE: See the Basic Provisions and the Crop Provisions for this crop for information

pertaining to insured and uninsured causes of loss.

6. Primary Cause %:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Percent of damage for the cause of damage listed in item 5 above that is

determined to be the primary cause of damage, to the nearest whole percent. The primary

cause of damage must exceed 50 percent (e.g., 51%). Enter an “X” for the major secondary

cause of damage.

7. Company/Agency: Name of company and agency servicing the contract.

8. Name of Insured: Name of the insured that identifies EXACTLY the person (legal entity)

to whom the policy is issued.

9. Claim #: Claim number as assigned by the insurance provider.

10. Policy #: Insured’s assigned policy number.
FCIC-25700 (WINTER SQUASH) 18 MAY 2000

11. Crop Year: Crop year, as defined in the policy, for which the claim is filed.

12. Additional Units:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Unit number(s) for ALL non-loss units for the crop at the time of final inspection.

A non-loss unit is any unit for which a Production Worksheet has not been completed.

Additional non-loss units may be entered on a single Production Worksheet.

NOTE: If more spaces are needed for non-loss units, enter the unit numbers, identified as

“Non-Loss Units,” in the Narrative or on an attached Special Report.

13. Est. Prod. Per Acre:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Estimated yield per acre, in whole hundredweight, of all non-loss units for the crop

at the time of final inspection.

14. Date(s) Notice of Loss:

PRELIMINARY:

a. Date the notice of damage was given for the unit in item 2.

b. A third preliminary inspection (if needed) requires an additional set of Production

Worksheets. Enter the date of notice for a third preliminary inspection in the 1st space

of item 14 on the second set.

c. Reserve the "Final" space on the first page of the first set of Production Worksheets

for the date of notice for the final inspection.

d. If the inspection is initiated by the insurance provider, enter "Company Insp." instead

of the date.

FINAL: Transfer the last date in the 1st or 2nd space to the FINAL space if a final

inspection should be made as a result of the notice. Always enter the complete date of

notice (month, day, year) for the FINAL inspection in the FINAL space on the first page of

the first set of Production Worksheets. For a delayed notice of loss or delayed claim, refer

to the LAM.
MAY 2000 19 FCIC-25700 (WINTER SQUASH)

15. Companion Policy(s):

a. If no other person has a share in the unit (insured has 100 percent share), MAKE NO

ENTRY.

b. In all cases where the insured has LESS than a 100 percent share of a loss-affected

unit, ask the insured if the OTHER person sharing in the unit has a multiple-peril crop

insurance contract (i.e., not crop-hail, fire, etc.). If the other person does not, enter

"NONE."

(1) If the other person has a multiple-peril crop insurance contract and it can be

determined that the SAME insurance provider services it, enter the contract

number. Handle these companion policies according to insurance provider

instructions.

(2) If the OTHER person has a multiple-peril crop insurance contract and a

DIFFERENT insurance provider or agent services it, enter the name of the

insurance provider and/or agent (and contract number) if known.

(3) If unable to verify the existence of a companion contract, enter “Unknown” and

contact the insurance provider for further instructions.

NOTE: See the LAM for further information regarding companion contracts.

SECTION I - ACREAGE APPRAISED, PRODUCTION AND ADJUSTMENTS

Make separate line entries for varying:

(1) Rate classes, types, or farming practices;

(2) Appraisals;

(3) Stages or intended use(s) of acreage;

(4) Shares (e.g., 50 percent and 75 percent shares on the same unit); or

(5) Appraisals for damage due to hail or fire if Hail and Fire Exclusion is in effect.

Verify or make the following entries:

Item

No. Information Required

A. Field ID: The field identification symbol from a sketch map or an aerial photo. See the

Narrative. In the margin (or in a separate column), enter the date of inspection for the last

line entry of each inspection.
FCIC-25700 (WINTER SQUASH) 20 MAY 2000

B. Preliminary Acres:

PRELIMINARY: The number of acres, to tenths, (include “E” if estimated), for which

consent for other use has been given. Determine actual acreage, to tenths, when the

boundaries of the appraised acreage may not be determined later.

FINAL: MAKE NO ENTRY.

C. Final Acres: See the LAM for definition of acceptable determined acres used herein.

Determined acres to tenths (include “E” if estimated) for which consent is given for other

use and/or:

a. Put to other use without consent.

b. Abandoned.

c. Damaged by uninsured causes.

d. For which the insured failed to provide acceptable records of production.

e. From which production was sold by direct marketing if the insured failed to meet the

requirements contained in the crop provisions.

FINAL: Determined acres to tenths.

NOTE: Acreage breakdowns WITHIN a unit may be estimated (enter “E” in front of the

acres) if a determination is impractical AND if authorization was received from the insurance

provider. Document authorization in the Narrative.

ACCOUNT FOR ALL ACREAGE IN THE UNIT. In the event of over-reported acres,

handle in accordance with individual insurance provider’s instructions. In the event of

under-reported acres, draw a diagonal line in Column “C” as shown.

C Enter the ACTUAL acres for the field or subfield. 1

C Enter the REPORTED acres for the field or subfield. 2

D. Interest or Share: Insured’s interest in the crop to three decimal places as determined at

the time of inspection. If shares vary on the same UNIT, use separate line entries.

E. Risk: The correct rate class from the actuarial documents. Verify with the Summary of

Coverage and if the rate class is found to be incorrect, revise according to the insurance

provider’s instructions. Refer to the LAM.

NOTE: Unrated land is uninsurable without a written agreement.
MAY 2000 21 FCIC-25700 (WINTER SQUASH)

F. Practice: Three-digit code number, entered exactly as specified on the actuarial documents,

for the practice carried out by the insured. If “No Practice Specified,” enter appropriate 3-

digit code number from the actuarial documents.

G. Type/Class/Variety: Three-digit code number, entered exactly as specified on the actuarial

documents, for the type grown by the insured. If “No Type Specified,” enter appropriate 3-

digit code number from the actuarial documents.

H. Stage:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Stage abbreviation as shown below.

STAGE EXPLANATION

“P” . . . . . . . . . . . . . . .Acreage abandoned without consent, put to other use without

consent, damaged solely by uninsured causes, for which the insured

failed to provide records of production which are acceptable to the

insurance provider, from which production was sold by direct

marketing if the insured failed to meet the notice requirements

contained in the crop provisions, or if the insured is a wholesaler,

packer, processor, broker or other handler and failed to meet the

notice requirements contained in the crop provisions.

"H". . . . . . . . . . . . . . . Harvested.

"UH" . . . . . . . . . . . . . Unharvested or put to other use with consent.

GLEANED ACREAGE: Refer to the LAM for information on gleaning.

I. Intended or Final Use: Use of Acreage. Use the following “Intended Use” abbreviations.

USE EXPLANATION

“To Millet,” etc. . . . . .Use made of the acreage

"WOC". . . . . . . . . . . . Other use without consent

"SU". . . . . . . . . . . . . . Solely uninsured

"ABA". . . . . . . . . . . . Abandoned without consent 

"H". . . . . . . . . . . . . . . Harvested

"UH". . . . . . . . . . . . . .Unharvested
FCIC-25700 (WINTER SQUASH) 22 MAY 2000

Verify any “Intended Use” entry. If the final use of the acreage was not as indicated, strike

out the original line and initial it. Enter all data on a new line showing the correct “Final

Use.”

GLEANED ACREAGE: Refer to the LAM for information on gleaning.

J. Appraised Potential: Per-acre appraisal in hundredweight to tenths of POTENTIAL

production for the acreage appraised. See appraisal methods for additional instructions.

NOTE: If there is no potential on UH acreage, enter "0."

K . - K . MAKE NO ENTRY. 1 2

L. Shell and/or Quality Factor: Line out the heading and enter “Value.”

a. For appraised production enter the greater of:

(1) Actual value per hundredweight (determined from a sample provided to the

buyer); or

(2) Minimum value per hundredweight shown in the Special Provisions.

b. Do not allow any reduction in price due to UNINSURABLE causes. Identify in the

Narrative which factors were and were not allowed in establishing the price. If

appraised mature squash has no value enter “.000."

NOTE: Do not use the Minimum Value Option from the Special Provisions for this

entry.

M. + Uninsured Causes: EXPLAIN IN THE NARRATIVE.

a. Hail and Fire exclusion NOT in effect.

(1) Enter NOT LESS than the insured’s amount of insurance per acre in dollars and

cents for any “P” stage acreage.

NOTE: On preliminary inspections, advise the insured to keep the harvested

production from any acreage damaged SOLELY by uninsured causes separate

from other production.

(2) For acreage that is damaged PARTLY by uninsured causes, enter the

APPRAISED UNINSURED loss of production per acre, in dollar and cents, for

any such acreage.
MAY 2000 23 FCIC-25700 (WINTER SQUASH)

b. Refer to the LAM when a Hail and Fire Exclusion is in effect and damage is from hail

or fire.

c. Enter the result of adding uninsured cause appraisals to hail and fire exclusion

appraisals.

NOTE: For fire losses, if the insured also has other fire insurance (double coverage), refer

to the LAM.

N. Adjusted Potential: The result of column “J” times column “L” plus column “M,” rounded

to dollars and cents.

O. Total to Count: Column “C” or “C1" (actual acres) times Column “N,” rounded to whole

dollars.

NOTE: For CAT policies multiply result times .55, unless otherwise instructed by the

insurance provider because adjustment will be made by other manual or automated

computation process.

P. Per Acre: Enter the insured’s amount of insurance per acre.

Q. Total: Column “C2" (reported acres; “C” if acreage is not under-reported) times Column

“P.” Round to whole dollars.

16. Total Acres:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Total Actual Acres [Column “C” (or “C1” if there are under-reported acres)], to

tenths.

NOTE: FOR ITEM 17. WHEN SEPARATE LINE ENTRIES ARE MADE FOR VARYING

SHARES, STAGES, PRICE ELECTIONS, TYPES, ETC., WITHIN THE UNIT, AND TOTALS

NEED TO BE KEPT SEPARATE FOR CALCULATING INDEMNITIES, MAKE NO ENTRY AND

FOLLOW THE INSURANCE PROVIDER’S INSTRUCTIONS; OTHERWISE, MAKE THE

FOLLOWING ENTRIES.

17. Totals: 

PRELIMINARY: MAKE NO ENTRY.

FINAL: Total of Column “O” and total of Column “Q.”
FCIC-25700 (WINTER SQUASH) 24 MAY 2000

NARRATIVE:

If more space is needed, document on a Special Report, and enter “See Special Report.” Attach the

Special Report to the Production Worksheet.

a. If no acreage is released on the unit, enter "No acreage released," adjuster’s initials, and

date.

b. If notice of damage was given and "No Inspection" is necessary, enter the unit number(s),

"No Inspection," date, and adjuster’s initials. The insured's signature is not required.

c. Explain any uninsured causes, unusual, or controversial cases.

d. If there is an appraisal in Section I, item M for uninsured causes due to a hail/fire exclusion,

show the original hail/fire liability per acre and the hail/fire indemnity per acre.

e. Document the actual appraisal date if an appraisal was performed prior to the adjuster’s

signature date on the appraisal worksheet, and the date of the appraisal is not recorded on

the appraisal worksheet.

f. State that there is "No other fire insurance" when fire damages or destroys the insured crop,

and it is determined that the insured has no other fire insurance. Also refer to the LAM.

g. Explain any errors found on the Summary of Coverage.

h. Explain any commingled production. Refer to the LAM.

i. Explain any entry for "Production Not to Count" in Section II, item “O,” and/or any

production not included in Section II, item I or item B - E entries (e.g., harvested

production from uninsured acreage that can be identified separately from the insured acreage

in the unit.

j. Explain a "NO" checked in item 19.

k. Attach a sketch map or aerial photograph to identify the total unit:

(1) If consent is or has been given to put part of the unit to another use;

(2) If uninsured causes are present; or

(3) For unusual or controversial cases.

NOTE: Indicate on the aerial photo or sketch map, the disposition of acreage destroyed or

put to other use with or without consent.
MAY 2000 25 FCIC-25700 (WINTER SQUASH)

l. Explain any difference between date of inspection and signature dates. For an ABSENTEE

insured, enter the date of the inspection AND the date of mailing the Production Worksheet

for signature.

m. When any other adjuster or supervisor accompanied the adjuster on the inspection, enter the

code number of the other adjuster or supervisor and date of inspection.

n. Explain the reason for a “No Indemnity Due” claim. “No Indemnity Due” claims are to be

distributed in accordance with the insurance provider’s instructions.

o. Explain any delayed notices or delayed claims as instructed in the LAM.

p. Document any authorized estimated acres shown in Section I, item C as follows: "Line 3

‘E’ acres authorized by the insurance provider MM/DD/YYYY."

q. Document the method and calculation used to determine acres for the unit. Refer to the

LAM.

r. Specify the type of insects or disease when the insured cause of damage or loss is listed as

insects or disease. Explain why control measures did not work.

s. Document the name and address of the charitable organization when gleaned acreage is

applicable. Refer to the LAM for more information on gleaning.

t. Document any other pertinent information, including any data to support any factors used to

calculate the production.

SECTION II - HARVESTED PRODUCTION

GENERAL INFORMATION:

(1) Account for ALL HARVESTED PRODUCTION (for ALL ENTITIES sharing in the

crop) except production appraised BEFORE harvest and shown in Section I because

the quantity cannot be determined later (e.g., released for other use, etc.).

(2) For production commercially stored, sold, (including direct-marketed when acceptable

production records are provided), etc., make entries in items B through E for the name

and address of the processor or buyer.

(3) If acceptable sales or weight tickets are not available, refer to the LAM.
FCIC-25700 (WINTER SQUASH) 26 MAY 2000

(4) If additional lines are necessary, the data may be entered on a continuation sheet. USE

SEPARATE LINES FOR:

(a) Separate storage facilities.

(b) Different FIRST handlers (buyers, packinghouse, or processors). The insured

must have maintained satisfactory records of ALL production sold or stored. 

Verify any packinghouse or processor records.

(c) Varying names and addresses of buyers of sold production.

(d) Varying shares; e.g., 50 percent and 75 percent shares on the same unit.

(5) There will generally be no harvested production entries in items A through S for

preliminary inspections.

Verify or make the following entries:

Item

No. Information Required

18. Date Harvest Completed: (Used to determine if there is a delayed notice or a delayed

claim. See the LAM.)

PRELIMINARY: MAKE NO ENTRY.

FINAL:

a. The earlier of the date the ENTIRE acreage on the unit was (1) harvested, (2) totally

destroyed, (3) put to other use, (4) a combination of harvested, destroyed, or put to

other use, or (5) the calendar date for the end of the insurance period.

b. If at the time of final inspection (if prior to the end of the insurance period), there is

any unharvested insured acreage remaining on the unit that the insured does not intend

to harvest, enter “Incomplete.”

c. If at the time of final inspection (if prior to the end of the insurance period), none of

the insured acreage on the unit has been harvested, and the insured does not intend to

harvest such acreage, enter “No Harvest.”

d. If the case involves a certification form, enter the date from the certification form when

the entire unit is put to another use, etc. Refer to the LAM.
MAY 2000 27 FCIC-25700 (WINTER SQUASH)

19. Similar Damage:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Check “Yes” or “No.” Check “Yes” if amount and cause of damage due to

insurable causes is similar to the experience of other farms in the area. If “No” is checked,

explain in the Narrative.

20. Assignment of Indemnity: Check “Yes” only if an assignment of indemnity is in effect for

the crop year; otherwise, check “No.” Refer to the LAM.

21. Transfer of Right to Indemnity: Check “Yes” only if a transfer of right to indemnity is in

effect for the unit for the crop year; otherwise, check “No.” Refer to the LAM.

A1. Share: RECORD ONLY VARYING SHARES on SAME unit to three decimal places.

A2. Field ID:

a. If only one practice, variety, or type of harvested production is listed in Section I,

MAKE NO ENTRY.

b. If more than one practice, variety, or type of harvested production is listed in Section

I, indicate for each practice, variety, or type the corresponding Field ID (from Section

I, item “A”).

B. - E. Length or Diameter, Width, Depth, and Deduction: 

a. For production sold, enter the name and address of the processor. For fruit otherwise

disposed of, indicate the disposition (sold at roadside stand, etc.).

b. For unsold marketable production enter “UNSOLD.”

c. For U-pick production sold off insurable acreage, enter “U-PICK.”

F. - H. MAKE NO ENTRY.

I. Bu, Ton, Lbs., Cwt.: Circle “Cwt.” in column heading. Production, in hundredweight, to

tenths.

J. - M. MAKE NO ENTRY.

N. Adjusted Production: Enter hundredweight to tenths from column “I.”
FCIC-25700 (WINTER SQUASH) 28 MAY 2000

O. Prod. Not to Count: Net production NOT to count in hundredweight to tenths, WHEN

ACCEPTABLE RECORDS IDENTIFYING SUCH PRODUCTION ARE AVAILABLE,

from harvested acreage which has been assessed an appraisal of not less than the guarantee

per acre.

THIS ENTRY MUST NEVER EXCEED PRODUCTION SHOWN ON THE SAME

LINE. EXPLAIN ANY “PRODUCTION NOT TO COUNT” IN THE NARRATIVE.

P. Production: Result of subtracting the entry in Column “O” from Column “N,” to tenths.

Q1. Value: Enter dollar-and-cents value per hundredweight for SOLD and UNSOLD

marketable winter squash.

a. For SOLD production, enter the GREATER OF:

(1) the average value per hundredweight from item 19 of the Summary of Harvested

Production; or

(2) The applicable of the following:

(a) The minimum value per hundredweight shown in the Special Provisions, if

a minimum value option is not in effect.

(b) The Minimum Value Option value per hundredweight shown in the Special

Provisions, if the Minimum Value Option is in effect.

b. For UNSOLD, MARKETABLE (stored) winter squash, enter the applicable minimum

value per hundredweight as listed in the Special Provisions.

c. For UNSOLD, UNMARKETABLE production that is damaged or defective due to

insurable causes, enter “0.00".

Q . - R. MAKE NO ENTRY. 2

S. Production to Count: Production from Column “P” times Column “Q1

," rounded to whole

dollars.

NOTE: For CAT policies multiply result times .55 unless otherwise instructed by insurance

provider because adjustment will be made by other manual or automated computation

process.
MAY 2000 29 FCIC-25700 (WINTER SQUASH)

NOTE: FOR ITEMS 22 - 24. WHEN SEPARATE LINE ENTRIES ARE MADE FOR VARYING

SHARES, STAGES, PRICE ELECTIONS, TYPES, ETC., WITHIN THE UNIT, AND TOTALS

NEED TO BE KEPT SEPARATE FOR CALCULATING INDEMNITIES, MAKE NO ENTRY AND

FOLLOW THE INSURANCE PROVIDER’S INSTRUCTIONS; OTHERWISE, MAKE THE

FOLLOWING ENTRIES.

22. Section II Total:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Total of Column “S,” in whole dollars.

23. Section I Total:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Enter figure from Section I, Column “O” total, in whole dollars.

24. Unit Total:

PRELIMINARY: MAKE NO ENTRY.

FINAL: Total of items 22 and 23, in whole dollars.

25. Adjuster’s Signature, Code #, and Date: Signature of adjuster, code number, and date

signed after the insured (or insured’s authorized representative) has signed. For an absentee

insured, enter adjuster’s code number ONLY. The signature and date will be entered

AFTER the absentee has signed and returned the Production Worksheet.

NOTE: Final indemnity inspections should be signed on bottom line.

26. Insured’s Signature and Date: Insured’s (or insured’s authorized representative’s)

signature and date. BEFORE obtaining insured’s signature, REVIEW ALL ENTRIES on

the Production Worksheet WITH THE INSURED, particularly explaining codes, etc., that

may not be readily understood.

NOTE: Final indemnity inspections should be signed on bottom line.

27. Page Numbers:

PRELIMINARY: Page numbers - “1,” “2,” etc., at the time of inspection.

FINAL: Page numbers - (Example: Page 1 of 1, Page 1 of 2, Page 2 of 2, etc.).
FCIC-25700 (WINTER SQUASH) 30 MAY 2000

PRODUCTION WORKSHEET

1 Crop/Code 2 Unit 3 Legal Description 8 Name of Insured (FOR ILLUSTRATION PURPOSES ONLY)

Winter Squash 00100 SEC-3 TWP-4N RNG-5W I.M.Insured

0065 FSA FSN 10 9 Claim Number 11 Crop Year

4 Date of Damage AUG 7 Company Any Company XXXXXXXX YYYY

5 Cause of Damage FREEZE Agency Any Agency 10 Policy Number XXXXXX

6 Primary Cause % 100% 14 Date(s) 1st 2nd Final

12 Additional Units 00200 Notice of Loss MM/DD/YYYY MM/DD/YYYY

13 Est. Prod Per Acre 38 15 Companion Policy(s) P 

SECTION I - ACREAGE APPRAISED, PRODUCTION AND ADJUSTMENTS

ACTUARIAL POTENTIAL YIELD STAGE GUARANTEE

A B C D E F G H I J M N O P Q

K 1 L

K 2 Value

Field Prelim Final Interest or Type Intended or Appraised Moisture % Shell and/or Uninsured Adjusted Total To Count Per Total

ID Acres Acres Share Class Final Use Potential Quality Factor Cause Potential (C x N) Acre (C x P)

Risk Practice Stage Factor

1A

MM/DD

20.0 20.0 1.000 002 997 192 UH UH 25.4 13.00 330.20 6604 520 10400

1B 8.0 1.000 002 997 192 P WOC 520.00 520.00 4160 520 4160

1C

MM/DD 19.0 1.000 002 997 192 H H 520 9880

1D

MM/DD

20.0 1.000 002 997 192 UH UH 30.3 13.00 393.90 7878 520 10400

16 TOTAL 67.0 17 TOTALS 18642 34840

NARRATIVE (If more space is needed, attach a Special Report) 

See attached aerial photos for field ID’S - Field 1A - Price of damaged winter squash = $8.50, Field 1B disked W/O consent.

Acreage determined by wheel measurements.

SECTION II - HARVESTED PRODUCTION

18 Date Harvest Completed 19 Is damage similar to other farms in the area? 20 Assignment of 21 Transfer of Right To Indemnity?

MM/DD/YYYY Yes X No Yes No X Yes No X

MEASUREMENTS GROSS PRODUCTION ADJUSTMENTS TO HARVESTED PRODUCTION

A 1 K 1 L 1 M 1 Q 1 B C D E F G H I J N O P R S

A 2 K 2 L 2 M 2 Q 2

Share FM % Moisture % Test WT Value Length of

Diameter Width Depth

Deduc Conver- Gross Bu. Ton Shell/ Production

-

tion

Net Cubic Prod. Not Production Quality Factor

Feet to Count (N - O) (Q1 ÷ Q2) sion Prod. Lbs. Sugar to Count

Factor (F x G) (CWT) Factor (P x R)

Adjusted

Production

(HorI)xJxK2xL2xM2 Field ID Factor Factor Factor Mkt. Price

ABC Packing CO. 15.51

Any Town Any State

465.4 465.4 465.4 7218

Unsold 192.1 192.1 192.1 2497 13.00

I certify the information provided above, to the best of my knowledge, to be true and complete and that it will be used to determine my loss, if any, to my insured crops I understand that this Production Worksheet

and supporting papers are subject to audit and approval by the company. I understand that this crop insurance is subsidized and reinsured by the Federal Crop Insurance Corporation, an agency of the United

States. I understand that a ny false or inaccurate information may result in the sanctions outlined in my policy and administrative, civil, and criminal sanctions under 18 U.S.C. §§ 1006 1014, 7 U.S.C. § 1506;

31 U.S.C. §§ 3729 and 3730 and other federal statutes.

22 Section II Total 9715

23 Section I Total 18642

24 Unit Total 28357

25 Adjuster’s Signature Code # Date 26 Insured’s Signature Date

1st Inspection I.M. Adjuster XXXXX MM/DD/YYYY 1st Inspection I.M. Insured MM/DD/YYYY

2nd Inspection 2nd Inspection 27 Page

Final Inspection I.M. Adjuster XXXXX MM/DD/YYYY Final Inspection I.M. Insured MM/DD/YYYY 1 of 1
MAY 2000 31 FCIC-25700 (WINTER SQUASH)

10. REFERENCE MATERIAL

TABLE A - MINIMUM REPRESENTATIVE SAMPLE REQUIREMENTS

ACRES IN FIELD OR SUB-FIELD MINIMUM NO. OF SAMPLES

0.1 - 10.0 3

10.1 - 40.0 4

Add one additional sample for each additional 40.0 acres (or fraction thereof) in the field or subfield.