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_____ Great American Ins Co. - Equine Mortality application, related forms
and information _____
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MS Word (38KB)
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EXPLANATION OF COVERAGES & PROCEDURES
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PDF (48KB)
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NEW MEDICAL OPTIONS - PART OF EXPLANATION OF COVERAGES & PROCEDURES |
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MS Word (42KB)
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GA HORSE MORTALITY APPLICATION AND STATEMENT OF CONDITION
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PDF (1.2MB)
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GA JUSTIFICATION OF VALUE FORM
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PDF (45KB)
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GA VET CERT - BLANK
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MS Word (28KB)
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GA 5 QUESTION VETERINARIAN REPORT
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MS Word (22KB)
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GA LOSS OF USE EXAM NEW RISK
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MS Word (22KB)
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GA LOSS OF USE RENEWAL EXAM
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_____ Great American Ins Co. - Applications / forms for an Equine Farm Package
application for ____
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MS Excel (533KB)
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GA EQUINE FARM APP MH
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ABOVE YOU WILL FIND AN APPLICATION FOR EQUINE FARM PROPERTY & LIABILITY
COVERAGE. PLEASE COMPLETE IN FULL AND RETURN BY FAX OR E-MAIL AND WE WILL PROVIDE
YOU WITH A QUOTE FOR COVERAGE. WHEN YOU OPEN THE ATTACHMENT, ONLY THE FIRST PAGE
OF THE APPLICATION WILL SHOW. YOU WILL NEED TO GO TO THE BOTTOM OF THE FIRST PAGE
WHERE YOU WILL SEE GRAY TABS. CLICK ON THE TABS UNTIL YOU GET ALL 13 PAGES OF THE
APPLICATION.
IF A QUESTION IS NOT APPLICABLE TO YOUR OPERATIONS, PLEASE MARK IT N/A. DO NOT JUST
LEAVE IT BLANK. WE WILL ALSO NEED A BLANK COPY OF THE RELEASE THAT ALL OF YOUR CUSTOMERS
ARE REQUIRED TO SIGN. THE RELEASE MUST COMPLY WITH EQUINE LIMITED LIABILITY LAWS
OF EACH STATE THAT YOU DO BUSINESS IN.
The diagram of the property (page 11) must be completed with all structures shown
(insured or not). Each structure should be numbered to correspond to the building
numbers from the schedules (pages 4 & 5). You will also need to provide us with
pictures (4 sides) of all structures which must be numbered to correspond with the
diagram. Good pictures are imperative as the structure rates are based on the type
of structure. We will also need pictures of each type of fencing used on the property
and a description of the locations where it is used. Example: Property perimeter,
paddock fencing, public road perimeter and so on.
TO BE ELIGIBLE FOR THE USDF DISCOUNT, WE WILL ALSO NEED YOU TO PROVIDE A CERTIFICATION
OF THE FOLLOWING:
Eligibility will include all "certified" levels, including USDF Certified
Instructor/Trainer; Training -Second, Third and Fourth Levels and USDF Recognized
Teacher; Training - Second, third and Fourth Levels. Examiners are eligible as well.
Associate Instructors are not eligible as they have not gone through the testing
process and are not certified. Eligibility also requires current USDF membership
and active status in the Program.
IF YOU HAVE ANY QUESTIONS, PLEASE CALL ME.
PAUL H. COHEN
800-822-2202
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MS Word (30KB)
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GA CAMP SUPPLEMENT MH
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PDF (122KB)
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GA ADDITIONAL STRUCTURES E2
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MS Word (33KB)
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GA WOOD STOVE
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PDF (79KB)
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GA BARN EST E2VALUE
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PDF (493KB)
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GA HOME COST EST
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_____ Great American Ins Co. - Umbrella & Excess liability coverage _____
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PDF (19KB)
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GA FARM UMBRELLA APP
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_____ Great American Ins Co. - Care Custody & Control coverage _____
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MS Excel (1MB)
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GA Care Custody & Control APP
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_____ Great American Insurance Co. - LIABILITY applications and forms * _____
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MS Excel (476KB)
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GA EQUINE LIABILITY APP3 MH
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MS Word
(30KB)
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GA CAMP SUPPLEMENT MH
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* Great American
Insurance Co LIABILITY applications and forms. Wording below must be present when
the applications are printed.
ATTACHED YOU WILL FIND AN APPLICATION FOR COMMERCIAL
EQUINE LIABILITY COVERAGE. PLEASE COMPLETE IN FULL AND RETURN BY FAX OR E-MAIL AND
WE WILL PROVIDE YOU WITH A QUOTE FOR COVERAGE. WHEN YOU OPEN THE ATTACHMENT, ONLY
THE FIRST PAGE OF THE APPLICATION WILL SHOW. YOU WILL NEED TO GO TO THE BOTTOM OF
THE FIRST PAGE WHERE YOU WILL SEE GRAY TABS. CLICK ON THE TABS UNTIL YOU GET ALL
9 PAGES OF THE APPLICATION.
IF A QUESTION IS NOT APPLICABLE TO YOUR OPERATIONS,
PLEASE MARK IT N/A. DO NOT JUST LEAVE IT BLANK. WE WILL ALSO NEED A BLANK COPY OF
THE RELEASE THAT ALL OF YOUR CUSTOMERS ARE REQUIRED TO SIGN. THE RELEASE MUST COMPLY
WITH EQUINE LIMITED LIABILITY LAWS OF EACH STATE THAT YOU DO BUSINESS IN. ** We
will also need pictures of each type of fencing used on the property and a description
of the locations where it is used. Example: Property perimeter, paddock fencing,
public road perimeter, round pen or arena and so on.
TO BE ELIGIBLE FOR THE USDF DISCOUNT, WE WILL ALSO
NEED YOU TO PROVIDE A CERTIFICATION OF THE FOLLOWING:
Eligibility will include all "certified"
levels, including USDF Certified Instructor/Trainer; Training -Second, Third and
Fourth Levels and USDF Recognized Teacher; Training - Second, third and Fourth Levels.
Examiners are eligible as well. Associate Instructors are not eligible as they have
not gone through the testing process and are not certified. Eligibility also requires
current USDF membership and active status in the Program.
IF YOU HAVE ANY QUESTIONS, PLEASE CALL ME.
PAUL H. COHEN
ASSOCIATIONS UNDERWRITERS, INC. & ZIPLOW HORSE
INSURANCE AGENCY
1430 WAREHIME RD.
WESTMINSTER, MD 21158
800-822-2202
FAX 410-871-9748
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_____ StarNet - Farm application forms _____
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PDF (573KB)
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New business farm application
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MS Word (145KB)
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Care Custody & Control application
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PDF (27KB)
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Umbrella application
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PDF (138KB)
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Farm renewal application
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_____ StarNet - forms for equine liability _____
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PDF
(60KB)
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Commercial equine liability for Boarding, Breeding, Training, Riding Instruction,
Clinics and Horse Shows
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MS Word (145KB)
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Care custody & control
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PDF (109KB)
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Commercial equine liability renewal application
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PDF (86KB)
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Equine club and association application
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MS Word (149KB)
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Equine show and event liability application
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MS Word (32KB)
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Terrorism risk insurance waiver. TRIA
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_____ StarNet - equine mortality forms _____
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PDF (161KB)
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Application
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PDF
(264KB)
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Statement of condition
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PDF
(233KB)
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Veterinary certificate for horses with values greater then $25,000.00
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PDF
(1.2MB)
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Justification of value form
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MS Word
(36KB)
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Loss Of Use veterinary certificate
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MS Word (49KB)
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StarNet Veterinary Services
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MS Word (47KB)
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Surgical benefits
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