Outfitters & Guides Insurance

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Copyright 2000 [Thompson-Gusic Insurance Group, Inc.].  
ALL RIGHTS RESERVED

Outfitters Liability Quote Form

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QUOTE TURNAROUND TIME: This depends on the size & scope of your business and the time of year you request a quote. Feb through May is the busy season. We normally ask for 2 weeks lead time, at the least, however some operations we can quote "in house" and if we have to send your account out for quotes we'll do our best to accommodate your timeline.
Leaving questions blank will delay the quote process.

Click on Question Marks for further Explantions (Pop Ups)

GENERAL INFORMATION

Legal Business Name:

 Phone: This # isCell Biz Home

D/B/A Name:

 Contact:

Mailing Address:

 Fax:

City:

State:  Zip:  Email:

County:

(NOT COUNTRY)

 Website: www.

Type of Entity:

C Corp    S Corp     Partnership   Sole Prop
LLC    Non-Profit    Other:   
 Quote Need by Date EXPLANATION:
   Three
(3) weeks is normal lead time.

Year Business Established:

     Years Experience in Field:  Federal ID #:
 or
Check if SS# Used. Do Not Enter SS#.

List All Owner(s) / Officer(s) Names:

 Trade Associations you Below to:
 
AO  PIA/PPA  Other:
  Brief Description of Your Operations:
 

    -Additional Space is available below in Comments Section.  
 Operations Physical Address you OWN or LEASE (list all):              Description (ie: Base, Office, Store, Storage, Etc)
 1.
   Own   Lease
 2.
   Own   Lease
 3.
   Own   Lease
 Do you have more than 3 addresses your own or lease?
Yes   No

POLICY & REQUIRED LIMITS INFORMATION

 Have you, or anyone else in your company, completed other insurance applications to obtain quotes either in writing or over the phone? Yes   No
 Has an insurance company ever cancelled or non-renewed your insurance? Yes No  Not Applicable - New Business
 What Liability Limit Per Occurrence do you have now OR what do you need? 
 Umbrella - If you require higher than a $1mm Limit, how much add'l limits do you need?
 Are all the activities you are requesting coverage for included on your current policy?Yes  No  N/A- New Business
 Who is your current Insurance "Company" (not your Agent): OR This is a New Business (SEE NEXT)
 FOR A NEW BUSINESS: Briefly describe your experience in your field of outfitting, and also any business related experience you have:
  Click for Example Template
 
 If you have a policy in place, please answer following: 
  Expiration Date:
    Current Premium:    Target Premium:(a competitive quote)

GENERAL LIABILITY RATING INFORMATION
You don't have to enter zero's in for operations that do not apply to you

 PLEASE CLICK FOR RATING INSTRUCTIONS HELP
LAND OPERATIONS # OF
GUIDES

# OF
UNITS

# OF CUSTOMERS
PER YEAR
GROSS SALES
PER YEAR
 ATV / UTV TOURS (GUIDED ONLY) ATVs+UTVs
 BIKES / SEGWAYS RENTALS (UNGUIDED)   Units
 BIKES / SEGWAYS (GUIDED TRIPS) Units
 CLIMBING (GUIDED)  
 DOG SLED TOURS (GUIDED) Sleds
 FISHING (GUIDED) Boats
 HIKING / BACKPACKING (GUIDED)  
 HORSEBACK RIDING (GUIDED) Horses
 HUNTING (GUIDED)  
 RETAIL SALES:  Describe Items Sold      
 ROPES COURSE (Low or High Element)  
 SNOWMOBILES (GUIDED ONLY) Snowmobiles
 ZIP LINE COURSE  

LODGING / CAMPING
Your Owned Units/Sites Only

  # OF UNITS # OF CUSTOMERS
PER YEAR
GROSS SALES
PER YEAR
 LODGING STRUCTURES (Owned)   # Buildings
# Guest Rms
# Guests
or Check if Incl in Trip Price
 CAMPGROUND - RV / TENT SITES
  (Owned)
  # Sites # Guests
or Check if Incl in Trip Price

WATER OPERATIONS
Non-Motorized Boats
River Classification Scale

# OF
GUIDES

 

# OF CUSTOMERS
PER YEAR
GROSS SALES
PER YEAR
 RENTALS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Flat water, Tidal water, Class 1 & 2 Rivers, Ocean (Coastline)
   
 RENTALS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Class 3 Rivers
   
 RENTALS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Class 4, Class 5 Rivers
   
 GUIDED TRIPS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc)
- Flat water, Tidal water, Class 1 & 2 Rivers, Ocean (Coastline)
 
 GUIDED TRIPS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc)
- Class 3 Rivers
 
 GUIDED TRIPS - Paddle / Peddle Type Boats (Kayak, Canoe, SUP, Raft, etc)
- Class 4, Class 5 Rivers
 

OTHER OPERATIONS
Not Listed Above

# OF
GUIDES

# OF UNITS
(if applicable)

# OF CUSTOMERS
PER YEAR
GROSS SALES
PER YEAR
 OTHER: Units
 OTHER: Units
 OTHER: Units
 OTHER: Units
 IMPORTANT:  Insurance Companies normally offer quotes based on either estimated # of Customers, # of Units, or Gross Sales or a combination of them.  If you did not enter the figures above, please explain in the COMMENTS Section at the bottom of this form.
 
YES, estimated # Units, # of Customers, and Sales have been entered above for our offered activities.
  NO, estimated # of Customers and Sales have NOT been entered.  Please elaborate in COMMENTS section below.

SUPPLEMENTAL INFORMATION
- This Section Must Be Completed For All. Leaving Questions Blank Will Delay Quote -

 GENERAL INFORMATION
Are all activities you provide listed in above rating section? N   If NO, please explain in comments section (bottom form).
Check if Any of the Following Apply to Your Trips: Prepared Meals  Packaged Snacks   Beverage   No Food / Beverage
General area of where you operate such as what Park(s), County(s), State(s)?
What is your normal operating season?   (month)  to  (month)    or   Full Year
Do you sell or offer alcoholic beverages? N  Is a signed Waiver / Release / Assumption
 of Risk form obtained from all customers?
Y  
What % of trips / operations are overnight or multi-days?  Enter "0" if none % Does a responsible adult sign for all minors? Y  N
If overnight operations, what % is open tent camping? %   N/A Regarding Certificates of Insurance, approx how many do you need issued each year?
Do you require your guests to complete a Health & Physical Fitness Form? N
What is the minimum age of participants? or None Any use of animals (horses, dogs, mules, etc.)? N
Do you use trailers to transport equipment? N Do you provide car rack installation or alter other's vehicles in any way? N
Any use of Motorized Equipment? N Total # of Employees?
Do you plan to sponsor, hold, or be involved in any type of event, other than participation (exhibiting) in trade shows? N
 If Yes, please describe:
 FOREIGN OPERATIONS
Any operations conducted outside the U.S?  No, SKIP Next #1-5 Questions.   If YES, Complete Next #1-5 Questions
  1. Describe foreign operations activities?

  2. What countries are you operating in?

  3. Do your employees guide the trips, or are the trips subcontracted?  Please elaborate:

  4. How much annual sales are generated from these trips?

  5. Were these sales included in the above General Liability Rating Section
Yes orNo, they are in addition to above sales
 SAFETY EQUIPMENT & PROCEDURES
 Which of the following is taken on each trip?Satellite Phone   First Aid Kit   Flares    Radios    Cell Phones   Heart Defibrillator
 Is a safety "Talk Up" speech given to customers by a qualified guide prior to all trips explaining the hazards of your operations, and the proper use of all equipment? Y  N
 Is a short training program, or course, used to determine the customers ability using your equipment? Y   N
 GUIDES / OWNERS Questions (Guided Trips / Instruction)
 
NOT APPLICABLE - No Guides Used & Owners Don't Guide (Skip Section)
 
NOTE: If you have no employed guides, but you guide as an Owner, complete this section pertaining to your information.
 Are new guide's references check? N Are all guides certified in CPR? Y   N
 Is there a guide training program in place? N Have all guides completed 1st Aid Training? Y   N
 Do you subcontract any trips or services? Y  N Does one guide per trip carry an Advanced First Aid Card or Wilderness EMT? Y   N
 What is average Guide to Customer ratio? # : # Are any of your guides working as "Independent Contractors"?
Click
HERE for ramifications
Y   N
 Have any owners or guides ever been involved in an incident which resulted in a fatality? Y  N If a State or Gov't Authority requires guides to be licensed, are all your guides licensed? Y   N
N/A Not Required
 Any employees under age of 18?  No    Yes, what are their duties?
NAME OF GUIDE (Include Owners) AGE QUALIFICATIONS
(1st Aid, CPR, WFR, EMT, etc)
YEARS
EXPERIENCE

 Total # of Guides?  If more than six guides, we can obtain a full guide list at a later time or HERE is a link to a fillable guide schedule which shows the information needed. This can be faxed 877-271-8898 or emailed insurance@thompsongusic.com

 HUNTING QUESTIONS          NOT APPLICABLE (Skip Section)
 Briefly describe where you operate?
  What is the maximum # of hunters at any one time?
  Do you operate Drop Camps?    Yes    No
  What % of your hunting operations are unguided?  Enter "0" if NONE
  What type of game is being hunted?    Elk     Deer     Exotics     Bear     Turkey     Waterfowl   
      
Upland Birds     Hogs     Other:
  Are Tree Stands used?    Yes    No        If Yes, are Safety Harnesses required?    Yes    No
  What type of weapons are used? Bows Rifles  Pistols Muzzle Loaders Modified Weapons 
  Other, Please Describe:
 MOBILE Equipment Questions:    
  If NONE USED Check Here:

  Check if Used: 
ATV's    How Many Owned:    Who is allowed to drive? Employees  Clients   Both
  Check if Used: 
Snowmobiles    How Many Owned:    Who is allowed to drive? Employees  Clients   Both
  Other:
   How Many Owned:    Who is allowed to drive? Employees  Clients   Both

 ANIMAL Questions:
  If NONE USED Check Here:

  Check if Used:
Dogs    # Owned:     What Breed(s):
  Check if Used:
Horses     # Owned:   Who is allowed to ride? Employees Clients Both No Riders, Pack Only
   If Other types, describe other and if ridden:
  Are Helmets offered with above use of Mobile Equipment, Horses, or other riding animals? Yes  No   not appl: No Riding
  Are Helmets required with above use of Mobile Equipment, Horses, or other riding animals? Yes  No   not appl: No Riding
 BIKES / SEGWAYS QUESTIONS         NOT APPLICABLE (Skip Section)
 Please check all that apply to what you use. Units are powered by:  Peddle   Electric   Gas 
 Briefly describe your fleet of units (Example: 10 Singles, 5 Tandems, 5 Electric Singles, 1 - 2 Seat Peddle Car, 5 Segways):
 
  Do you pre-screen guests to determine ability prior to riding?  Yes    No
  Are Helmets required?Yes    No        If not required, are Helmets offered to each rider?Yes    No
  Please breakout % of each area where activity is done
  
Off Road Bike Trails  Off Road (dirt, uneven)  Auto Roads with Bike Lanes  Auto Roads without Bike Lanes
  GUIDED TRIPS / TOURS
   Maximum # of customers on a tour?
   Number of Guides on a tour?   Maximum # of tours offered in one day?

   Are any tours over 50 miles in length?  Yes    No
  BIKE / SEGWAY RENTALS
    Maximum # of units rented per day?
     Average # of units rented per day?
    Units are rented (check which apply):  One Day or Less (Hourly)    Multi-Days
 What is minimum age to rent a unit?     What is minimum age to ride a unit?
 Units are inspected by employees / owners (Check which apply)?Prior to Each Use   After Each Use   Not Checked 
 Do you offer child or pet carriers or trailers that attach to bikes?Yes    No
 Do you offer any repair for bikes / segways you do not own (ie Walk-In Customers)?Yes    No
 WATERCRAFT QUESTIONS          NOT APPLICABLE (Skip Section)
  Briefly describe fleet of Non-Motorized Boats (Include # of each and Capacity)
  EXAMPLE: 8 6-Person Rafts, 5 Single Kayaks, 4 Tandem Kayaks, 3 SUP's, 4 Water Peddle Bikes, 3 2-Person Canoes
  Briefly describe fleet of Motorized Boats (Please List: Year, Make, Model, Length, Motor Size, Capacity of Guests):
  What type of operation do you have on water?   Boat Rentals    Fishing Trips    Water Tours / Guided Trips   Hunting      Other:
  On what bodies of water do you operate? Rivers   Streams/Creeks  Lakes   Ocean (coastline)   Bays/Inlets
   List primary rivers, lakes, bays, oceans operated on:
  CLASS OF RIVERS
    If Rivers are used, check all River's Classes being used? (as determined by Nat'l River Rating System)
    One source for this information is
American Whitewater (Link).  NOTE: Rivers are classed by section. Please use the River's "Section" Class. Example: A river may have one class V Rapid, however the section you use might only be rated Class IV
    Please check all that are used:
    
Tidal Rivers (Flat Water)     Class 1     Class 2     Class 3     Class 4     Class 5     Class 6 EXCLUDED
    
River Classification Definitions
 Are Life Vests (PFD's) required?  Yes   No
 Are Life Vests (PFD's) offered?   
Yes   No
 Are Helmets required?   Yes    No
  Are Helmets offered?    
Yes    No
   If helmets are required, advise what class of water trips this applies to:
 
 Are Wetsuits required? Yes   No
 Are Wetsuits offered?  
Yes   No
 What % of your boating operations are "Guided"?  Enter "0" if NONE
   "Guided" = A Guide is in the boat w/ the customers, or Guide(s) accompany / lead the trip with the customers.
 If boats are rented, are controls in place so the customer cannot take the boat to a dangerous area?  Controls could be such as the customers are shuttled to designated areas, customers are in sight the entire time.  Please describe or check NONE below:
 
NONE Rented  or DESCRIBE:
 Total # of Guides for on Water Operations?
 Please explain minimum age requirements?
      If none, check here:

LOSS INFORMATION
Enter all reported liability claims for the past four (4) years, or check "NO CLAIMS" below.

Date of Loss

Description of Loss

Amount Paid

 

   NO CLAIMS PAST FOUR (4) YEARS

 

  The above information is correct to the best of my knowledge.  Check:   Initials:
  
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COMMENTS / INFORMATION

 To Help us route your submission to the correct person in our office (if applicable):
    If you were referred to us, please tell us what company or person referred you:

    If you spoke / emailed to someone in our office, please tell us who:
   Please Check if you would also like a quote for:
   
NOTE: General Liability (this quote form) is NOT intended to cover your "owned" Property / Equipment, Auto, or Workers Compensation.
    PROPERTY - Quote Form is available on our site.  "PROPERTY" Quote Form.
  
 AUTO - Quote Form is available on our site.  "COMMERCIAL AUTO" Quote Form
  
WORKERS COMPENSATION
 Final Item
     1.  Copy of your current Waiver, Release of Liability, or Assumption of Risk Form if you have one.
     
This item will be: 
Faxed    Emailed
   Do Not Yet Have One (Sample Here - MS Word & PDF)
          - FAX to:      (877) 271-8898
          - EMAIL to:  
insurance@thompsongusic.com

QUESTIONS / HELP

 Call our staff and ask for help for an Outfitters Quote
 Thompson - Gusic Insurance Group
 4067 Greensburg Pike
 Pittsburgh PA 15221

Email:

  insurance@thompsongusic.com

Phone:

  (412) 271-8888    8:30am-4:30pm EST   Monday-Friday

Fax:

  (877) 271-8898

 CREATED 6/00 by
T.R.G.
Copyright 2000 [Thompson-Gusic Insurance Group, Inc.].  ALL RIGHTS RESERVED
Revised: August 09, 2017 .