Type of Policy.........................	Spectator Liability - Horse Show
Named Insured
Name...........................................
Street Address........................
City, State Zip.........................	,
Phone Number........................
Fax Number............................
E-Mail Address........................
Web Site.................................
Historical Info
Previous Carrier......................
Additional Insureds
1) Name of Additional Insured...................
Street Address........................
City, State Zip.........................	,
Phone Number........................
Fax Number............................
Type.......................................	Landowner Sponsor Other
2) Name of Additional Insured...................
Street Address........................
City, State Zip.........................	,
Phone Number........................
Fax Number............................
Type.......................................	Landowner Sponsor Other
Name of Show..............................
Location of Show.......................
......Date Insured(s) will assume........ control of premises........	/ /20
Show Dates...............................	From: / /20   To: / /20 Total Days:
Limit of Liability..........................	$500,000 $1,000,000
Comments:
Total Premium Due:_	(May be subject to minimum policy premuims.)
PLEASE CONTACT SPI FOR PREMIUM AMOUNT.

For a list of policy exclusions that will apply to you coverage, Please Click Here or call and speak with a SPI representative at 800-338-3313.