Timberland Liability Application
click here to download a PDF application that can be mailed or faxed.
If you have any questions, problems, or concerns
please contact Outdoor Underwriters at 1-866-961-4101.
Landowner Information |
|||
Name of Landowner* | Email Address* | ||
Representative* | Main Number* | ||
Mailing Address* | Mobile | ||
Fax | |||
City* | |||
State* | How did you find us?* | ||
Zip* | Please describe | ||
Desired Effective Date* | |||
Location of Acres | |||
Number of Acres* | |||
What is this property used for? | |||
Present Carrier | |||
Expiration Date | |||
Premium | |||
Past Losses |
Are locations fenced or posted? | * | ||
Any leased hunting or commercial hunting? | * | ||
Are certificates of insurance required for any leased or commercial hunting? |
* | ||
Any watercraft or docks? | * | ||
Any buildings? | * | ||
Any lakes or ponds? | * | ||
Any dams, spillways, or bridges? | * | ||
Any property used for mining? | * | ||
Any property containing gas or oil wells? | * | ||
Any of the property leased for farming? | * |
Payments are accepted over the phone via Visa, MasterCard, or by Check/Money Order in the mail.