Horse & Carriage Insurance Inquiry Form Home Horse & Carriage Insurance Inquiry Form Fill out the form and our account manager will be in contact with you soon! Name* First Last Business / Farm Name*If not applicable put NAEntity Type*Select Type of EntityIndividualDBALLCPartnershipCorporationPhone*Email* Mailing Address* Street Address Address Line 2 City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Location of Primary Operations (If different than Mailing Address): Street Address Address Line 2 City Select StateAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Effective Date of Insurance (Need by date)* MM slash DD slash YYYY Years in Business*Type of Operation (Select all activities that apply)*Carriage / Wagon RidesTours / HackingTrail RidesPony RidesBoardingRiding LessonsOtherEstimated Annual Receipts from this Past Year*Activity (Enter Activities Selected Above)Activity Receipts *Please list all activities & receipts. Click on the + to add more rows.Please list any activities your involved in that were not listed above?**Skip to next question if this is a new inquiry** For Current Clients Renewing Coverage:Please Note if there have been any Changes to your Operation:Estimated Gross Annual Income**If you do not know, make an estimate based on what you hope to make within the first year of businessAre you currently insured?*Select AnswerYesNoWhat is the name of your current insurance company?Have you received a quote from any other insurance companies?* Yes No Upload Loss Runs from Current Carrier:Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 128 MB.*If currently insured, loss runs must be provided in order to receive a quote. If you have any questions about obtaining a copy of your loss runs, please call our office at (800) 547-6860.Questions/Comments/Concerns?Please note that by hitting the submit button you HAVE NOT placed your insurance coverage. No coverage can be bound or changed via this website. One of our account managers will be in touch to go over the next steps in the quoting process. If this is your first time requesting coverage information from Ruhl Insurance, you must provide us with a copy of your loss history by either uploading it above or emailing copies to Equinedocs@iruhl.com. Δ Ruhl Insurance