Applications

To obtain an application, please click on a link below. Return the completed application to our office to receive a quote or to begin coverage.

Please note: All coverage is subject to underwriting approval. Submitting an application to our office does not automatically bind coverage. An insurance agent will contact you to confirm when coverage is bound. We cannot accept incomplete applications.

MORTALITY FORMS:

• Full Mortality/Limited Mortality Application for Horses (PDF)
  To be completed for all horses to be insured for Full or Limited Mortality.
• Full Mortality Application for Cattle (PDF)
  To be completed for all cattle to be insured for Full Mortality. A vet exam is required.
• Full Mortality Application for all Animals other than Horses or Cattle (PDF)
  To be completed for all animals to be insured for Full Mortality other than Horses or Cattle. A vet exam is required.
• Full Mortality/Limited Mortality Renewal Application (PDF)
  To be completed on horses at renewal if there have been no health problems and the value of the horses is $50,000 or under.
• Vet Exam (PDF)
  To be completed if the value of the horse is over $50,000 or if the horse has experienced health problems. Please have your vet specifically address any past or current health conditions. If Loss of Use coverage is requested, x-rays are required.
• Statement of Health (PDF)
  To be completed on horses to add coverage or request removal of an exclusion.
• Substantiation of Value (PDF)
  To be completed on horses to justify the insured value.
• Vet Statement Form (PDF)
  To be completed by your veterinarian in the event that the horse has an accident, illness or disease that was treated and/or resolved during the prior 12 months.

PROPERTY FORMS:

• Farm Application (PDF)
  Includes Commercial General Liability section and Replacement Cost Worksheets.
• Mobile Home Supplemental (PDF)
  To be completed on all mobile homes to be insured on a Farm/Ranch policy.
• Wood Burning Stove Supplemental (PDF)
  To be completed if there is a wood burning stove in a dwelling to be insured on a Farm/Ranch policy.
• Replacement Cost Worksheet s (PDF)
  To be completed to estimate the replacement cost on dwellings or farm structures.

LIABILITY FORMS:

• Commercial Equine Liability (PDF)
  Includes Care, Custody and Control section.
• Care Custody and Control Liability (PDF)
  To be completed if Commercial Equine Liability isn’t required. Otherwise, complete the Commercial Equine Liability application which includes this section.
• Horse Show or Event Liability (PDF)
  To be completed for single day events not requiring an annual policy.
• Personal Horse Owner Liability (PDF)
  To be completed for owned horses involved in non-commercial activities.
• Horse Club Liability (PDF)
  To be completed by equine clubs or associations for an annual policy.
• Commercial Equine Liability for Racehorses (PDF)
  To be completed by owners or facilities involved in the boarding, breeding, sales or training of racehorses. Includes Care, Custody and Control section.
• Commercial Liability for Instructors or Trainers (PDF)
  To be completed if riding instruction or training is your only equine activity in lieu of the full Commercial Equine Liability application. Care, Custody and Control section is included.
• Therapeutic Riding Supplement (PDF)
  To be completed in conjunction with the Commercial Equine Liability application if riding instruction involves therapeutic activities.
• Day Camp Supplement (PDF)
  To be completed in conjunction with the Commercial Equine Liability application if Day Camps are conducted.
• Pony Rides Supplement (PDF)
  To be completed in conjunction with the Commercial Equine Liability application if Pony Rides are conducted.
• Driving Horse Personal Liability Supplement (PDF)
  To be completed in conjunction with the Personal Horse Owner application if driving horses are owned.
• Horse Drawn Vehicle Rides Supplement (PDF)
  To be completed in conjunction with the Commercial Equine Liability application if Horse Drawn Vehicle Rides are given.

OTHER FORMS:

• Livestock Transportation (PDF)
  To be completed by haulers of livestock. Provides coverage while cargo is in transit.
• Tack or Equipment (PDF)
  To be completed for coverage on tack or farm equipment/machinery only.
• Auto Insurance Application (PDF)
  Includes section for horse trailers.
• Homeowner Questionnaire (PDF)
  For non-Farm/Ranch dwellings.
• Builders Risk (PDF)
  To insure dwellings or farm buildings under construction or renovation.

Didn’t see what you’re looking for? Contact us to request an application or discuss coverage!