Harris - Auto, Homeowners, Health, life, Motorcyle, Boat

Hunting Lease Liability Quote

You will be contacted within 1 business day by our agent

To help us supply you with the most accurate quote possible, please answer as many questions as you can with the most accurate information available to you. Information submitted will be held confidential and will be used for quote purposes only. Submission of application information in no way obligates you to purchase any product or insurance, nor does it represent any agreement to provide coverage under any insurance policy.

PERSONAL INFORMATION
Hunting Club Name:
Your Name:	First: Last:
E-Mail address:
Phone numbers:	Day Time:
	Evening:
	Fax:
How would you prefer to be contacted regarding your quote?	PhoneFaxEmail
If you would prefer to be contacted by phone, please let us know the best time to call.
Address:
City:
State:	(You must live in Florida)
Zip code:
Desired Effective Date

Coverages
Limits Desired:
Optional: Damge to Rented Premises (Fire Legal Liability)

Number of Members:
Are guests allowed?	YesNoif Yes, average number at any one time
Are Premises Posted or Fenced?	YesNo

THERE MUST BE A WRITTEN LEASE BETWEEN EACH LANDOWNER AND THE HUNTING CLUB
Please list all of your landowners below( incloude name and address). Also list County and State for acres leased.
Property #1
Name and Address of Landowners:
Number of Acres Leased:
Location of Acreage (County, City, State)
Additional Insured:	YesNo

Property #2
Name and Address of Landowners:
Number of Acres Leased:
Location of Acreage (County, City, State)
Additional Insured:	YesNo

Additional Information