Equine Care, Custody or Control Application
Name: ________________________________ Website : www.________________________
Years in Equine business: _________________ Equine Associations (member): __________________
Describe your Equine operation: ___________________________________________________________
• Breed of non-owned Horses: ____________________________________________________________
• Minimum # of non-owned horses in your care: ______
• _Maximum # of non-owned horses in your care: _____
• Average # of non-owned horses in your care: ______
• Will the number of non-owned horses ever increase above the maximum? Yes No
If Yes, explain ________________________________________________________________________
sibilities in case of a stable fire? Yes No
Are health statements from a licensed veterinarian obtain before accepting any non-owned horses? Yes No
Do you have an emergency procedure in place for an ill horse, if the owner is unreachable? Yes No
LIMIT OF INSURANCE –
orse Per e Limit Annu Limit
- $ 25,000 $100,000 $100,000
- $ 50,000 $250,000 $250,000
Ed. 05/2012
• Are shelters provided in runs or pastures? Yes No
• Where are the horses kept in the evening? Stable or pasture? __________________________________
• Do your employees (if any) have instructions, in writing, on their respon
Do you have a veterinarian available for emergencies? Yes No
•
• Are stallions kept separated from the mares? Yes No
•
•
Limit per H Occurrenc al Aggregate
- $ 5,000 $ 25,000 $ 25,000
- $ 5,000 $ 50,000 $ 50,000
- $ 10,000 $ 50,000 $ 50,000
- $ 10,000 $100,000 $100,000
