Equine Liability Quote « Horse Insurance with Smith-Embry

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COMMERCIAL EQUINE LIABILITY

Complete Information below for a more accurate quote

How did you hear about us?

List of other sources

Farm/Business Name

Name

Address

City

State

Zip Code

Phone

Fax Number

Contact Preference

Phone

Mail

Click here to learn more about Equine Liability Insurance

Enter location of Operation if different from above address

Click here to learn more about Farm/Ranch Insurance

Address

City

Zip Code

State

Do you Own or Lease this property?

Own

Lease

How many Acres?

Can we also provide you with a quote to insure your property?

Click here to learn more about Farm/Ranch Insurance

Select Coverage Limit:

$500,000 per occurrence/$1,000,000 aggregate

$1,000,000 per occurrence/$2,000,000 aggregate

Excess over $1,000,000 – Provide Limit required below:

Provide Limit Required

Describe your Horse Operation.

Does someone reside on the premises?

Yes

Describe fencing and security measures to prevent horse(s) from having access to public roads.

Maximum Number of Horses (owned or non-owned) that can be kept on the premises?

Total Number of Horses you OWN or LEASE

Total Number of NON-OWNED Horses in your care

Click here for Care Custody & Control Liability Insurance

Are you required to Name the Property Owner as an Additional Insured?

What is the total number of Stallions (owned or non owned) standing stud?

# On Premises

# Off Premises

Average Stud Fee Charged

How many mares are bred annually on the premises?

How many owned mares are bred annually off the premises?

How many Non-Owned mares kept on your premises until foaling?

Maximum Number of horses on Full Board monthly?

Full Board Fee

Maximum Number of horses on Pasture Board monthly?

Pasture Board Fee

What is the Minimum Number of horses boarded monthly?

List the Type of instructions provided:

Anyone under 21 giving riding instructions?

Yes

Maximum Number of Lesson Horses Available.

Number of Lesson Horses used at any one time.

Total instructions given weekly on Lesson Horses

Total instructions given weekly on Client Owned Horses.

Average Cost per lesson.

Are Stallions used for instructions?

Yes

Provide details of Safety Gear Required.

Do you provide instructions to the handicapped or operate a Therapeutic Equine Program?

Yes

If yes:

You must complete Therapeutic Equine Program Supplemental form

Do you attend off premises shows with your students?

Yes

How Many per year

Charge per show

Are independent instructors part of your riding program?

Yes

Name, Age, Experience of Independent Instructor

Do you hold equine day camps?

Yes

If Yes:

You must complete Equestrian Day Camp Supplemental form

Do you have On-Premises Horse Clinics?

Yes

Total Number of Clinic Days

Number of participants

Charge for Clinics

Description of Clinics

Dates Scheduled

Do you have Off-Premises Horse Clinic?

Yes

Total Number of Clinic Days

Number of participants

Charge for Clinics

Description of Clinics

Dates Scheduled

Will the owner of the premises where the clinic is held be required to be named as an additional insured with respect to the clinics conducted on their property? Provide Name, Address of premises owner

Average number of horses in full training, monthly

Average number of rides weekly on horses NOT in full training

Do you have an Independent Trainer operating on your premises?

Description of equine event

Do you host equine related events on your premises?

Yes

Name, Age, Experience of Independent Instructor

How many event days per year?

Average number of participants?

Average number of spectators?

Do you host horse shows on your premises?

Yes

If sanctioned by what Organization(s)

Average number of participants?

How many show dates per year?

Average number of spectators?

Scheduled Dates

Breed of Horses

Average price of horses sold

Average number of Owned Horses sold per year

Average number of Non-Owned Horses sold per year

Average price of non-owned horses sold

Is prospect allowed to test ride?

Yes

Where on Premises?

Do boarders & students sign liability waivers?

Yes

Is everyone provided with safety & barn rules?

Yes

Do you have your State Equine Law posted?

Yes

Copies of these documents will be required upon placement of your liability insurance.

Do you rent your arena or facility to others?

Yes

Do you operate a tack store or sell tack?

Yes

Do you offer Pony Rides?

Yes

if answer yes:

Please complete supplemental form

Do you offer Horse Drawn Vehicle Rides?

Yes

if answer yes:

Please complete supplemental form

Is anyone other than a boarder allowed to ride on your premises?

Yes

Do you repair riding equipment?

Yes

Do you perform any type of farrier service?

Yes

Is hunting allowed on the premises?

Yes

Is there a swimming pool on the premises?

Yes

Do you own dogs?

Yes

Breed?

How Many?

Are other dogs allowed on your premises?

Yes

Any prior problems?

Yes

Any other animals on the premises?

Yes

If so describe, giving numbers

Provide details of any other equine activities not included above.

Name of Insurance Company

Expiration date of current policy?

Do you currently have an Equine Liability Policy?

Yes

Any prior losses?

Yes

Have you had any prior insurance cancelled or non renewed?

Yes

Comments / Questions

With the information you have provided in this questionnaire, we will submit an application to the insurance companies we represent to obtain the most competitive quote for your Commercial Equine Liability Insurance. The quote and the application will be sent to you for review and signing should you want the insurance placed.

Questions? Call Smith-Embry Insurance Associates, Inc. (502) 493-9911