Providing Quality Products, Experienced Underwriting and Incomparable Service

in the Animal Mortality, Farm and Liability Ag Market Place

 

 
 

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Forms and Applications

 

Animal Mortality Insurance Application

Use this form for all horses and other animals, to be completed and signed by applicant

MortalityApp.pdf - Size: 208 KB

 

Statement of Health

Use this form for all horses being insured $25,000 and under, ages 6 months – 15 years, no treatment for any accident, illness, injury within the last 12 months, not being used for racing or race training, to be completed and signed by applicant

HealthStmt.pdf - Size: 77 KB

 

Veterinary Certificate

Use this form for all horses being insured over $25,000 or horses under 6 months of age, or over 15 years of age, or any animal that has received veterinary treatment within the last 12 months for any accident, illness, or injury, or any animal used for racing or race training, to be competed and signed by veterinarian

VetCert.pdf - Size: 71 KB

 

Justification of Value Form

Use this form for all animals to detail show, breeding, training or race records, if you want to insure your horse for more than its purchase price or on renewal of a policy to justify the current value

JOVForm.pdf - Size: 69 KB

 

Fertility Examination Form

Use this form for all stallions when requesting coverage for Accident, Sickness and Disease, to be competed and signed by veterinarian

ASDForm.pdf - Size: 68 KB

 

Equine Liability Application

Use this form for boarding, training and breeding facilities, independent instructors and trainers

EquineLiabilityApp.pdf - Size: 201 KB

 

Care Custody or Control Application

Use this form for liability associated with the Care, Custody or Control of non-owned horses in your care.

CCC App.pdf - Size: 110 KB

 

Horse Show and Event Liability Application

Use this form for horse shows, clinics and auctions, or single event and annual event coverage

ShowEventLiab.pdf - Size: 121 KB

 

Riding Clubs and Associations Liability Application

Use this form for riding clubs and equine associations

ClubAssocLiab.pdf - Size: 148 KB

 

Farm Package Application

Use this form for equine farm/ranch coverages including Property coverage, Liability and Care, Custody and Control

FarmPackApp.pdf - Size: 531 KB

 

All forms are Adobe Portable Document Format (PDF) Files. If you cannot access these forms, you can download Adobe Reader for free.

 
   

Global Insurance Alliance, Inc.

13633 N. Catclaw Ct. Fountain Hills, AZ 85268

480-816-5665 (Fax)480-837-5641

www.globalinsaz.com

 

Copyright © 2004 Global Insurance Alliance, Inc