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 at our agency. If we have to send your account out for quotes we will do our best to accommodate your timeline.
Leaving questions blank will delay the quote process.

GENERAL INFORMATION

Legal business name:

 Phone: This # isCell Biz Home

D/B/A Name:

 Contact:

Mailing address:

 Email:

City:

State:  Zip:  Website:Site will be reviewed

County:

(NOT COUNTRY)

 Quote need by date:

Type of entity:

C Corp  S Corp  LLC  Partnership  Individual  Non Profit   Other:

Year business established:

     Years experience in field:  Federal ID #: orUse SS#, Do Not Enter SS#

List all owner(s) / officer(s) names:

 Trade Associations you belong to:
 
AO  PIA/PPA  CROA  Other:
  Brief description of your operations:
 
 
 -Additional space is available below in Comments Section.  
 Operations Physical Address you OWN or RENT / LEASE (list all):
      Address, City, State, Zip                                             Description (ie: Base, Office, Store, Storage, Etc)

 1.    Own   Lease / Rent
 2.
   Own   Lease / Rent
 3.
   Own   Lease / Rent
 Do you have more than 3 addresses your own or rent / lease?
Yes   No

POLICY & REQUIRED LIMITS INFORMATION

 Have you, or others in your company, completed other insurance applications in writing or over the phone to obtain quotes?Yes  No
 Has an insurance company ever cancelled or non-renewed your insurance? Yes No  Not Applicable - New Business
 What total Liability Limit Per Occurrence do you have now OR what do you need? 
 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:

 If you have a policy in place, please answer following: 
  Expiration Date:
    Current Premium:    Target Premium:(a competitive quote)
GENERAL LIABILITY RATING INFORMATION
*** If gross sales are left blank we will not be able to quote. Use your best estimates. ***
LAND OPERATIONS # OF
GUIDES

# OF
UNITS

# OF CUSTOMERS
PER YEAR
GROSS SALES
PER YEAR
 ATV / UTV TOURS (GUIDED) Units
 ATV / UTV RENTALS (UNGUIDED)   Units
 BIKES / SEGWAYS RENTALS (UNGUIDED)   Units
 BIKES / SEGWAYS TOURS (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) Courses
 SNOWMOBILES (GUIDED ONLY) Snowmobiles
 ZIP LINE COURSE Courses

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 / Pedal Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Flat or Tidal water, Class 1 & 2 Rivers, Ocean (Coastline)
   
 RENTALS - Paddle / Pedal Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Class 3 Rivers
   
 RENTALS - Paddle / Pedal Type Boats (Kayak, Canoe, SUP, Raft, etc) No Guides
- Class 4, Class 5 Rivers
   
 GUIDED TRIPS - Paddle / Pedal Type Boats (Kayak, Canoe, SUP, Raft, etc)
- Flat water, Tidal water, Class 1 & 2 Rivers, Ocean (Coastline)
 
 GUIDED TRIPS - Paddle / Pedal Type Boats (Kayak, Canoe, SUP, Raft, etc)
- Class 3 Rivers
 
 GUIDED TRIPS - Paddle / Pedal 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

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

 GENERAL INFORMATION
 Are all activities you offer scheduled in above rating section? N  If No, please explain why not?
 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
 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? orNone  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 others vehicles in any way? N
 Any use of Motorized Equipment other than autos? N  Total # of Employees?
 Do you provide transportation for people / customers as part of your own operations? N  Do you provide transportation for people or property not associated with your operations? N
 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 SectionYes orNo, they are in addition to above sales
 SAFETY EQUIPMENT & PROCEDURES
 Check items taken on each trip?Satt Phone  First Aid Kit  Flares   Radios   Cell Phones   Heart Defibrillator  Whistles
 Is a safety speech given to customers prior to activities explaining the hazards of your operations and proper use of 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 do not 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 guides references checked? 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 have advanced 1st Aid Training Y   N
 What is average Guide to Customer ratio? #:#  Are any of your guides working as "Independent Contractors"? Y   N
 Have any owners or guides ever been involved in an incident which resulted in a fatality? Y  N  If a State or Govt 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)
If you have more than 6 guides leave blank but enter total # of guides below.
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.

 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:  Check if Used: ATVs/UTVs   Snowmobiles   Other:
 ANIMALS:  Check if Used:Dogs   Horses    Other
 BIKES / SEGWAYS QUESTIONS         NOT APPLICABLE (Skip Section)
 Please check all that apply to what you use. Units are powered by:  Pedal   Electric   Gas
 Briefly describe your fleet of units (Example: 10 Singles, 5 Tandems, 5 Electric Singles, 1 - 2 Seat Pedal 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 (Even if customers are rented units as long as a guide is present on the tour they are considered guided 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 (Rentals are when you rent units and customer(s) go out on their own without a guide.)
    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
 WATER / 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 SUPs, 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 TripsHunting   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:

  Are any of your water activities done more than 1 mile from a shoreline? Yes   No
  If Rivers are used, check all Rivers class types used. 
  NOTE: Rivers are classed by section, not by particular rapids. American Whitewater (Link)
  Please check all that are used:   River Class Definitions
  Tidal Rivers (Flat Water)   Class 1    Class 2    Class 3    Class 4    Class 5    Class 6 EXCLUDED
 Are Life Vests (PFDs) required? Yes   No
 Are Life Vests (PFDs) offered?  
Yes   No
 Are Helmets required?Yes   No  If Yes, starting at what class river?
 Are Helmets offered? Yes   No
 Are Wetsuits required? Yes   No
 Are Wetsuits offered? 
Yes   No
 Total # of Guides for on Water Operations?
 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:
 Please explain minimum age requirements?   If none, check here:
ATV / UTV QUESTIONS         NOT APPLICABLE
 Please check the type of units driven / used by customers:  ATVs (Handlebars, 3 wheeled)   UTVs (bucket seats, steering wheel)
 For guided tours, are customers allowed to use their "owned" units?Yes  No  N/A, No Guided Tours
 What is ratio for guide driven units to customer driven units (Example 1:8 or 2:12)?  or N/A, No Guided Tours
 What equipment is offered: Helmets  Goggles  Rain Gear  Maps  Two-Way Radio  First Aid Kit
 Are helmets required to be worn while unit in use?Yes  No  What is highest CC engine size for customer driven units?
 What is maximum MPH for for customer driven units?  Do customer driven units have governors?Yes  No
 Do customer driven units have GPS Tracking?Yes  No  Are the units licensed for public road use?Yes  No
 What is minimum age to drive?  Do you repair units for the general public?Yes  No

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

Date of Loss

NO CLAIMS PAST FOUR (4) YEARS    or Enter Below
Description of Loss

Amount Paid

  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 check who: Robb  Russ  Missy  Michelle  Pat  Other / Not Sure
 NOTE: General Liability (this quote form) does not cover your Property / Equipment, Auto, or Workers Compensation.
  Please Check if you would also like a quote for:
    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 - Quote form is available however check with us first as available States are limited
 Final Item Needed
     1.  Copy of your Waiver, Release of Liability, or Assumption of Risk Form
     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: June 03, 2020.