Owner Operated Farm & Ranch Liability Insurance

First name

Home Street Address

Is this a business? Name & Type

Last name

City State Zip

Phone

Prior Insurance Company

List any prior losses here

How many horses on the property

Do you provide riding instruction or training on the property?

Please give me the name, age, breed, sex, use & value of each horse you own.

Please list each horse:

What kind of fencing do you have? Who is responsible for maintaining it?

Do you host any events on the property?

Do you host any events off the property? Include dates

Do you transport anyone else's horses? Where, why, how far & how often?

Where is the riding? Check all that apply

Indoor Arena

Outdoor Arena

Open Fields

Trails

Are there any other businesses operating on this property?

I manage and provide the care for the horses belonging to others. I would like to add Care Custody & Control to my policy.

Any vehicles, golf carts or ATVs used by anyone but you, on the property? If yes, who and why?

Do you have dogs on the property? If yes, please describe - Do you let others bring dogs to your property? Please explain rules.

MAIN DWELLING

Year Built

Square Footage

Roof Type & Age

Heating/Cooling type & age

Exterior Construction

Year puchased

Updates

If there is a second dwelling, please add all the info asked above into this box:

Second Dwelling details

Farm Building #1

Year Built

Square Footage

Roof Type & Age

Exterior Construction

Usage

# of stalls

Other farm buildings

Other Farm Buildings

List of Farm Equipment

List of Tack, Equipment & other personal items

What else do I need to know about you, your farm & horses?

For additional building, please provide all the information in this space below:

Read Privacy Agreement

I have read the LB Farm & Equine Insurance Privacy Policy and I OPT IN

Upload pictures of all building & dwellings, waivers & other pertinent documents

Upload File

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