EQ Group Mortality Easy Quote



The Equestrian Group For a no-obligation mortality insurance quote, please complete the following form Highest Quality, Broadest Coverage & Lowest Prices
*Personal Information*

Name:
Address:
City:
State:
Zip:
Phone:	- (Area + Number)
Fax:	- (Area + Number)
E-mail:

*Equine/Livestock Information*

Horse Name:
Breed:
Age:
Sex:
Use:

*Choose Limits & Coverage Desired*

All Risk Mortality, Colic & Theft		$ Insured Value of Horse
Major Medical - $300 Deductible
Colic & Surgical Only - $5000		(Do not combine with Major Medical)
Loss of Use - External - 2.00%
Loss of Use - Full - 3.75%
Stallion ASD - .50%
Guaranteed Renewal		Included

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*How Did You Find Us?*

*Additional Comments / Questions*


AFIG Producer Contact



P.O. Box 9957 Phoenix, AZ 85068 Fax 602-992-8327 Call Toll Free 1-800-874-9191