Equisport Agency, Inc.


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POLICIES

LIABILITY POLICIES

ADDITIONAL ITEMS

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Customer Info

Name:
E-mail:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:
Fax:

Horse to be insured:

Breed:
Value:
Gender:
Year Born:
Horse's Use:
  

Coverages Desired:

Horse Coverage:
Full Mortality (mandatory with any optional coverages)
Major Medical & Surgical
Surgical Only
Full Loss of Use Including Economic destruction (Accident, Injury, Illness or Disease)
Loss of Use Accidental only (external injury)
Stallion Infertility (Accident, Sickness and Disease)
Specified Perils (acts of God i.e. fire, wind, lightning, etc.)
Other:

Does your horse have any pre-existing medical conditions?

Equine Liability:
Trainer/Boarding & Lesson Stable
Care, Custody & Control Liability
Farm and Ranch Packages (Commercial & Private)
Riding Club and Association Liability
Horse Show and Equestrian Event Liability
Individual Horse Owner
Race Horse Owner
Therapeutic Riding Organization

How would you like to be notified?
Phone E-mail Fax

Questions/Comments box