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Email
Phone
FAX
Postal
Contact me by:
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Yes
No
Does your organization currently have a policy?
Policy Re-Newal Date?
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Yes
No
Has there been any claims or incidents in the past three years?
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Yes
No
Has coverage been denied in the past three Years?
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Individual
Partnership
Association
Corporation
Type Ownership
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Rent
Own
Does your organization
Maximun # of Club members?
Maximum # of Club members at any one event?
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$300,000 per occurrence, $600,000 annual
$500,000 per occurrence, $600,000 annual
$1,000,000 per occurrence,$2,000,000 per occurrence
Limit of Liability?
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Yes
No
Is alcohol sold, served or furnished at your events ?
Description of your organization and the benefits/activities you offer your members.
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Yes
No
Does your organization conduct any fund raising, community service or promotional or similar activities?
If yes:
Date?
Description of Event
Location of Event
Description of Activities
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Yes
No
Does your organization host any awardss banquets, dinners or similar events?
If yes:
Date?
Description of Event
Location of Event
Description of Activities
Provide Public Events/ Show Days Below (Do not show activities limited to members only except for parades)
Public Event dates?
Description of Event
Location of Event
Average # of Competitors
per show/event
?
Maximum # of Competitors per show/event ?
Average # of spectators per show/event ?
Maximum # of spectators per show/event ?
Sanctioning Organization(s)?
Description of Event (s)?
Describe any non-equestrian activities your club engages in (i.e. meetings, award dinners, fund raisers, etc)
Description of other activities
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Yes
No
Is alcohol permitted, served or sold at any events?
If yes please explain
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Yes
No
Are dogs permitted at any events?
If yes please explain
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Yes
No
Do you have any bleachers or grandstands?
If yes:
Type of construction?
Year built?
Seating capacity?
Exact dates of each event will be required, but it is not essential for providing a quote. If exact dates have not been set, notice will be required of the actual date for coverage to apply.
Public Event Days are defined as those events or activities to which Non-Club members and/or general public are invited. Standard policy includes one day of set-up and one day for take down per event.
