Quality Equine Insurance
PO Box 339
Peculiar, MO 64078
800-581-7020
FAX 816-758-7475
Karen@qualityequineinsurance.com

 

Commercial Farm Quote
Protection for your home, barns, outbuildings, farm equipment, tack and Commercial Liability coverage including Care, Custody and Control of non-owned horses.
To receive a free quote for your farm including commercial liability, complete the entire questionnaire and submit. Please allow up to three business days to obtain a quote.
 

Name
Farm Name
Property Address
City
State
County
Zip Code
Home Phone
Work Phone
Fax Phone
Email
Mailing  Address
(if different from above. Please include City, State and Zip)
Number of Acres
Have you had any claims in the past 3  years?
Name of Nearest Fire Dept
Distance to nearest Fire Dept

 

Home/Dwelling Information:

Deductible Requested
Occupied By
Insured Value
Year Built
Type of Roof Age of Roof:
Type of Heating Age of Unit:
Wood Stove? yes     no
Mobile Home? yes     no
Describe Fencing:
   
Please let us know if you need coverage for special personal property items such as jewelry, furs, artwork, etc... We will be happy to quote that with your policy.  Enter description below if applicable.

Barns/Outbuildings:

Building Number 1  
Description or Use
Width and Length
Year Built
Insured Value    
Type of Roof Age of Roof:
Hay Storage? yes     no
   
Building Number 2  
Description or Use
Width and Length
Year Built
Insured Value
Type of Roof Age of Roof:
Hay Storage? yes     no
   
Building Number 3  
Description or Use
Width and Length
Year Built
Insured Value
Type of Roof Age of Roof:
Hay Storage? yes     no
   
To list additional buildings please use the space below providing the same information as above:

 

Scheduled Farm Property:

Individual items must not exceed $2,500 per item.
Description: Total Amount to Be Insured:
Tack, Grooming Equipment:
Small Tools & Supplies:
Office Equipment:
Barn Contents
Please list below all tractors, Implements and farm machinery or any items in the categories above valued over $2,500.
Please include description, year, serial number and insured amount for each item where applicable.
Note: Hay and grain coverage provided only while stored in a building.

Liability Section:

Liability Limit (per occurrence):
Double Aggregate?
Personal Endorsement?  (Provides coverage for personal horses both on & off premises)
Professional Endorsement?  (Professional Equestrian Errors & Omissions coverage)
Products & Completed Operations?  (Provides coverage when a product you are responsible for causes bodily injury or property damage)
Total Number of Horses Owned / Leased by You or your Business:
Do you own dogs?
If Yes, how many? What breeds?
Are other dogs permitted at your facility?
If yes,  please describe your policy regarding dogs:
Any other animals on premises?
If yes, provide type, how many, and for what purpose:
Any hunting on premises?
If yes, please describe:
Swimming Pool on premises? Is it fenced?
Is alcohol permitted on the premises?
If yes, please describe:
Is alcohol sold on the premises?
(Alcohol sales is not covered by this type of policy)

 

Breeding:
Total number of stallions standing stud:
What is average stud fee charged?
Total number of stallions standing off premise:
Total number of mares covered annually on premise
:Total number of owned mares covered annually off premise:

 

Horse Sales:
Average number of horses sold annually:
Average annual revenue from horse sales:

 

Boarding:
Average number of horses boarded monthly:
Average monthly charge for stalled horses:
Average monthly charge for pastured horses:

 

Training:
Average number of horses in training monthly:
Average monthly charge for training:

 

Riding Lessons:
Type of instruction:
Average number of weekly lessons given on client's horse(s):
Average number of weekly lessons on Insured's horse(s):
Maximum number of students in group lesson:
Maximum number of horses used in group lesson:
Average charge per individual lesson: Per Group Lesson:
Total annual revenues for riding lessons:
Any Day Camp Activities?
*If yes, please ask for additional Day Camp Form.

 

Independent Trainers / Instructors:
Do they carry their own insurance?
(If yes, provide proof of insurance at policy inception)
Name: Years of Experience:
Name: Years of Experience:
Name: Years of Experience:

 

Clinics:  
Do you offer clinics on premise?
Do you offer clinics off premise?
Annual revenues from clinics:

 

Hosted Shows / Events:
How many show/event days per year?
Sanctioning organization:
Does above need to be listed as Additional Insured?
Description of show/event activities:  
Maximum number of participants
Maximum number of spectators:
Annual revenues from hosted shows/events:

 

Tack / Retail Sales:
Describe type and method of sales:  
Annual revenues from above sales:

 

Care, Custody, and Control:
Protects you in the event a non-owned horse is injured or dies due to your negligence.
Maximum Limit per Horse/Aggregate Limit per Year

 

Quality Equine Insurance
PO Box 339
Peculiar, MO 64078
800-581-7020
FAX 816-758-7475
Karen@qualityequineinsurance.com

We are horse people insuring the interests of horse people.
We represent only “A Rated” Insurance Companies to find the
coverage to personally fit your needs at a reasonable cost.

*** Licensed in all states except Alaska, Hawaii and Wyoming ***
(Trailer insurance not available in Florida)


 A subsidiary of My Chance, LLC 

Quality Equine Insurance, Inc. All rights reserved.