ACORD 408 (2007/09)

Universal wording updates to improve clarity and intent were made to all FIG text for this form on 06/12/2009.
Section Name
Field Name
Field and/or Section Description
TITLE
ACORD 408 (2007/09)
Equine Liability Supplement
ACORD 408, Equine Liability Supplement, is used as a supplement
to ACORD 404, the Agriculture Liability Section (designed as an attachment to the
ACORD 401, the basic agriculture insurance application) to capture underwriting
information specific to horse operations.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION SECTION Loc #:
Enter number: The producer assigned number of the location.
IDENTIFICATION SECTION Date
Enter date: The month/day/year on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION SECTION Agency
Enter text: The full name of the producer/agency.
IDENTIFICATION SECTION Applicant/First Named Insured
Enter text: The named insured(s) as it/they will appear on the policy declarations page.
IDENTIFICATION SECTION Policy Number
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being
referenced exactly as it appears on the policy, including prefix and suffix symbols. If
required for self-insurance, the self-insured license or contract number.
IDENTIFICATION SECTION Company
Enter text: The insurer's full legal company name(s) as found in the file copy of the policy.
Use the actual name of the company within the group to which the policy has been issued.
This is not the insurer's group name or trade name.
IDENTIFICATION SECTION NAIC Code
Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION All Locations: (Y/N)
Information Provided Applies to
Enter Y for a Yes response. Input N for No response. Indicates if the information
provided applies to all locations. As used here, if no, enter the location number at the top
of the form.
SUMMARY OF HORSE
OPERATIONS
Show/Pleasure/Personal Use -
Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for show, pleasure and / or personal use.
SUMMARY OF HORSE
OPERATIONS
Show/Pleasure/Personal Use -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for show, pleasure and / or personal use.
SUMMARY OF HORSE
OPERATIONS
Show/Pleasure/Personal Use - # of
Owned Horses
Enter number: The number of owned horses. As used here, this is for show, pleasure and
/ or personal use.
SUMMARY OF HORSE
OPERATIONS
Show/Pleasure/Personal Use - # of
Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for show, pleasure
and / or personal use.
SUMMARY OF HORSE
OPERATIONS
Training (Race or Show) - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for training (race or show).
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Section Name
Field Name
Field and/or Section Description
SUMMARY OF HORSE
OPERATIONS
Training (Race or Show) -Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for training (race or show).
SUMMARY OF HORSE
OPERATIONS
Training (Race or Show) - # of
Owned Horses
Enter number: The number of owned horses. As used here, this is for training (race or
show).
SUMMARY OF HORSE
OPERATIONS
Training (Race or Show) - # of Non-
Owned Horses
Enter number: The number of non-owned horses. As used here, this is for training (race
or show).
SUMMARY OF HORSE
OPERATIONS
Riding Instructions - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for riding instructions.
SUMMARY OF HORSE
OPERATIONS
Riding Instructions - Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for riding instructions.
SUMMARY OF HORSE
OPERATIONS
Riding Instructions - # of Owned
Horses
Enter number: The number of owned horses. As used here, this is for riding instructions.
SUMMARY OF HORSE
OPERATIONS
Riding Instructions - # of Non-
Owned Horses
Enter number: The number of non-owned horses. As used here, this is for riding
instructions.
SUMMARY OF HORSE
OPERATIONS
Breeding - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for breeding.
SUMMARY OF HORSE
OPERATIONS
Breeding - Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for breeding.
SUMMARY OF HORSE
OPERATIONS
Breeding - # of Owned Horses
Enter number: The number of owned horses. As used here, this is for breeding.
SUMMARY OF HORSE
OPERATIONS
Breeding - # of Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for breeding.
SUMMARY OF HORSE
OPERATIONS
Boarded (Stall or Pasture) - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for boarded (stall or pasture).
SUMMARY OF HORSE
OPERATIONS
Boarded (Stall or Pasture) -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for boarded (stall or pasture).
SUMMARY OF HORSE
OPERATIONS
Boarded (Stall or Pasture) - # of
Owned Horses
Enter number: The number of owned horses. As used here, this is for boarded (stall or
pasture).
SUMMARY OF HORSE
OPERATIONS
Boarded (Stall or Pasture) - # of
Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for boarded (stall
or pasture).
SUMMARY OF HORSE
OPERATIONS
Race - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for horse racing.
SUMMARY OF HORSE
OPERATIONS
Race - Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for horse racing.
SUMMARY OF HORSE
OPERATIONS
Race - # of Owned Horses
Enter number: The number of owned horses. As used here, this is for horse racing.
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Section Name
Field Name
Field and/or Section Description
SUMMARY OF HORSE
OPERATIONS
Race - # of Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for horse racing.
SUMMARY OF HORSE
OPERATIONS
Horse Sales - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for horse sales.
SUMMARY OF HORSE
OPERATIONS
Horse Sales -Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for horse sales.
SUMMARY OF HORSE
OPERATIONS
Horse Sales - # of Owned Horses
Enter number: The number of owned horses. As used here, this is for horse sales.
SUMMARY OF HORSE
OPERATIONS
Horse Sales - # of Non-Owned
Horses
Enter number: The number of non-owned horses. As used here, this is for horse sales.
SUMMARY OF HORSE
OPERATIONS
Sale of Yearlings/Weanlings -
Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for sale of yearlings or weanlings.
SUMMARY OF HORSE
OPERATIONS
Sale of Yearlings/Weanlings -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for sale of yearlings or weanlings.
SUMMARY OF HORSE
OPERATIONS
Sale of Yearlings/Weanlings - # of
Owned Horses
Enter number: The number of owned horses. As used here, this is for sale of yearlings or
weanlings.
SUMMARY OF HORSE
OPERATIONS
Sale of Yearlings/Weanlings - # of
Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for sale of
yearlings or weanlings.
SUMMARY OF HORSE
OPERATIONS
Rentals/Trail Rides and/or Pony
Rides - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for rentals, trail rides and / or pony rides.
SUMMARY OF HORSE
OPERATIONS
Rentals/Trail Rides and/or Pony
Rides - Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for rentals, trail rides and / or pony rides.
SUMMARY OF HORSE
OPERATIONS
Rentals/Trail Rides and/or Pony
Rides - # of Owned Horses
Enter number: The number of owned horses. As used here, this is for rentals, trail rides
and / or pony rides.
SUMMARY OF HORSE
OPERATIONS
Rentals/Trail Rides and/or Pony
Rides - # of Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for rentals, trail
rides and / or pony rides.
SUMMARY OF HORSE
OPERATIONS
Hay/Sleigh/Carriage Rides - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for hay, sleigh or carriage rides.
SUMMARY OF HORSE
OPERATIONS
Hay/Sleigh/Carriage Rides -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for hay, sleigh or carriage rides.
SUMMARY OF HORSE
OPERATIONS
Hay/Sleigh/Carriage Rides - # of
Owned Horses
Enter number: The number of owned horses. As used here, this is for hay, sleigh or
carriage rides.
SUMMARY OF HORSE
OPERATIONS
Hay/Sleigh/Carriage Rides - # of
Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for hay, sleigh or
carriage rides.
SUMMARY OF HORSE
OPERATIONS
Rodeos - Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation. As
used here, this is for rodeos.
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Section Name
Field Name
Field and/or Section Description
SUMMARY OF HORSE
OPERATIONS
Rodeos - Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation. As
used here, this is for rodeos.
SUMMARY OF HORSE
OPERATIONS
Rodeos - # of Owned Horses
Enter number: The number of owned horses. As used here, this is for rodeos.
SUMMARY OF HORSE
OPERATIONS
Rodeos - # of Non-Owned Horses
Enter number: The number of non-owned horses. As used here, this is for rodeos.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Description
Enter code: The code indicating the type of farm operations.
SUMMARY OF HORSE
OPERATIONS
Enter text: The description of operations of the farm.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Owned Horses
Enter number: The number of owned horses.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Non-Owned Horses
Enter number: The number of non-owned horses.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Description
Enter code: The code indicating the type of farm operations.
SUMMARY OF HORSE
OPERATIONS
Enter text: The description of operations of the farm.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Owned Horses
Enter number: The number of owned horses.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Non-Owned Horses
Enter number: The number of non-owned horses.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Description
Enter code: The code indicating the type of farm operations.
SUMMARY OF HORSE
OPERATIONS
Enter text: The description of operations of the farm.
SUMMARY OF HORSE
OPERATIONS
Description of Operations - Blank
Payroll
Enter amount: The amount of annual payroll generated by this type of farm operation.
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Section Name
Field Name
Field and/or Section Description
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Receipts
Enter amount: The amount of annual receipts generated by this type of farm operation.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Owned Horses
Enter number: The number of owned horses.
SUMMARY OF HORSE
OPERATIONS
Description of Operations -
Number of Non-Owned Horses
Enter number: The number of non-owned horses.
RATING/UNDERWRITING
Description of All Farming or
Horse-Related Operations
Enter text: The description of what business each applicant performs and the way it is
conducted by premises. Operations which may not be apparent in a general description
of operations may be segmented by location (e.g., location #1 is a sales office in Paris,
France, location #2 is a warehouse in Berlin, Germany). Include number of leased and
owned premises outside of the United States. The section should be completed in
enough detail to enable the underwriter to understand and classify each operation. Do not
use the classification wording from the Commercial Lines Manual or Workers
Compensation Manual. They do not provide adequate detail. Example: a manufacturer of
pulley wheels used in sewing machines should be described as such and not as Metal
Goods Mfg. N.O.C..
RATING/UNDERWRITING
Total Stalls:
Enter number: The number of stalls.
RATING/UNDERWRITING
Monthly Boarding Rate : ($)
Enter amount: The monthly boarding rate.
RATING/UNDERWRITING
Number of Events in Which You
Participate Annualy:
Enter number: The number of events in which the applicant participates in annually.
RATING/UNDERWRITING
Workers' Compensation Insurance
None (checkbox)
Check the box (if applicable): Indicates the applicant / named insured does not have
workers compensation insurance.
RATING/UNDERWRITING
Policy Number
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being
referenced exactly as it appears on the policy, including prefix and suffix symbols. If
required for self-insurance, the self-insured license or contract number. As used here, this
is the workers' compensation insurance policy number.
RATING/UNDERWRITING
Company Name
Enter text: The insurer's full legal company name(s) as found in the file copy of the policy.
Use the actual name of the company within the group to which the policy has been issued.
This is not the insurer's group name or trade name. As used here, this is the workers'
compensation insurance company name.
RATING/UNDERWRITING
Pasture Fencing None (checkbox)
Check the box (if applicable): Indicates that no pasture fencing exists.
RATING/UNDERWRITING
Totally Fenced (Y/N)
Enter Y for a Yes response. Input N for No response. Indicates if all pastures are totally
fenced.
RATING/UNDERWRITING
Type of Fencing
Enter text: The description of the type of fencing used.
RATING/UNDERWRITING
Fence Maintaining Schedule
Enter text: The description of the maintenance schedule for the pasture fencing.
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Section Name
Field Name
Field and/or Section Description
RATING/UNDERWRITING
Fence Condition
Enter text: The condition of the pasture fencing.
RATING/UNDERWRITING
Riding Facilities None (checkbox)
Check the box (if applicable): Indicates that there are no riding facilities.
RATING/UNDERWRITING
Indoor (check box)
Check the box (if applicable): Indicates there are inside riding facilities.
RATING/UNDERWRITING
Outdoor (checkbox)
Check the box (if applicable): Indicates there are outdoor riding facilities.
RATING/UNDERWRITING
Open Fields (checkbox)
Check the box (if applicable): Indicates the riding facilities include open fields.
RATING/UNDERWRITING
Trails (checkbox)
Check the box (if applicable): Indicates the riding facilities include trails.
RATING/UNDERWRITING
Riding Instruction None
(checkbox)
Check the box (if applicable): Indicates that no riding instruction is provided.
RATING/UNDERWRITING
Annual Student Count
Enter number: The number of students provided instruction annually.
RATING/UNDERWRITING
Annual Receipts ($)
Enter amount: The amount of annual receipts generated by the riding instruction
operation.
RATING/UNDERWRITING
# of Horses Used at One Time
Enter number: The number of horses used for riding instruction at one time.
RATING/UNDERWRITING
Horse Sales - Annual Count of
Horses Sold
Enter number: The number of horses sold annually.
RATING/UNDERWRITING
Horse Sales - Breeds Sold
Enter text: The breed names of the horses sold.
RATING/UNDERWRITING
Annual Public Events Conducted /
Sponsored- # Events
Enter number: The number of public events conducted or sponsored annually.
RATING/UNDERWRITING
Exposure Location - On Premises
(checkbox)
Check the box (if applicable): Indicates that events are held on premises.
RATING/UNDERWRITING
Exposure Location - Off Premises
(checkbox)
Check the box (if applicable): Indicates that events are held off premises.
RATING/UNDERWRITING
Counts - Participants :
Enter number: The number of participants.
RATING/UNDERWRITING
Counts - Spectators:
Enter number: The number of spectators.
RATING/UNDERWRITING
Are Releases Secured From All
Entrants: (Y/N)
Enter Y for a Yes response. Input N for No response. Indicates if signed releases
secured from all participants.
RATING/UNDERWRITING
Tack Sales - None
Check the box (if applicable): Indicates there are no tack sales.
RATING/UNDERWRITING
Annual Receipts ($)
Enter amount: The amount of annual receipts generated by the tack sales operation.
RATING/UNDERWRITING
Items Sold
Enter text: The description of tack items sold.
GENERAL INFORMATION
1. Do you conduct or sponsor any
horse events on premises such as
shows or rodeos?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you conduct or sponsor any horse events on premises such as shows or
rodeos?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
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Section Name
Field Name
Field and/or Section Description
GENERAL INFORMATION
2. Are signed releases obtained?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Are signed releases obtained?. As used here, applies to various activities
including but not limited to training, test rides, hay rides, etc.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
3. Do you post rules and/or
warning signs?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you post rules and/or warning signs?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
IDENTIFICATION SECTION Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g.
agency or brokerage).
IDENTIFICATION SECTION Loc #:
Enter number: The producer assigned number of the location.
GENERAL INFORMATION
4. Is any safety program in
existence?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Is there a formal safety program in existence?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation. As used here, if yes, describe program
and attach any relevant information.
GENERAL INFORMATION
5. Do independent trainers or
instructors operate on your
premises?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do independent trainers or instructors operate on your premises?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation. As used here, if yes, enter the number
of independent trainers.
GENERAL INFORMATION
5.a. Do they carry their own
insurance?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do they carry their own insurance?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
5.b. Are you named an an
additional insured on their policy?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Are you named an additional insured on their policy?. As used here, if yes,
provide a copy of the certificate of insurance obtained.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
6. Is buyer allowed to test ride?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Is buyer allowed to test ride?.
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Section Name
Field Name
Field and/or Section Description
GENERAL INFORMATION
6. Is buyer allowed to test ride in
an arena?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Is buyer allowed to test ride in an arena?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
6. Is buyer allowed to test ride in
an open field?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Is buyer allowed to test ride in an open field?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
7. Do you sell from premises other
than your own?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you sell from premises other than your own?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
8. Do you repair riding equipment
for others?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you repair riding equipment for others?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
9. Do you provide riding for the
handicapped?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you provide riding for the handicapped?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
GENERAL INFORMATION
10. Do you transport horses for
others?
Enter Y for a Yes response. Input N for No response. Indicates the response to the
question, Do you transport horses for others?.
GENERAL INFORMATION
Remarks
Enter text: An explanation of a response to a general information or underwriting question.
Normally, Yes responses require an explanation.
REMARKS
Remarks
Enter text: The general remarks associated with the farm policy. Use this section to
provide any additional information required for underwriting or rating. Attach additional
sheets if more space is required.
Edition
Date
The edition identifier of the form including the form number and edition (the date is
typically formatted YYYY/MM).
ACORD 408 (2007/09)
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