Horse & Carriage Insurance Inquiry Form

Name: Ruhl Insurance
Address: 26-28 MARKET SQUARE, MANHEIM, PA, 17545

Fill out the form and our account manager will be in contact with you soon!

Name*
First Last
Business / Farm Name*
If not applicable put NA
Entity Type*
Phone*
Email
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Location of Primary Operations (If different than Mailing Address):
Street Address Address Line 2 City State ZIP Code
Effective Date of Insurance (Need by date)*
MM slash DD slash YYYY
Years in Business*
Type of Operation (Select all activities that apply)*

Estimated Annual Receipts from this Past Year*

Activity (Enter Activities Selected Above)	Activity Receipts

*Please list all activities & receipts. Click on the + to add more rows.

Please list any activities your involved in that were not listed above?
**Skip to next question if this is a new inquiry** For Current Clients Renewing Coverage:
Please Note if there have been any Changes to your Operation:
Estimated Gross Annual Income*
*If you do not know, make an estimate based on what you hope to make within the first year of business
Are you currently insured?*
What is the name of your current insurance company?
Have you received a quote from any other insurance companies?*
- Yes
- No
Upload Loss Runs from Current Carrier:
Accepted file types: jpg, gif, png, pdf, doc, docx, Max. file size: 64 MB.
*If currently insured, loss runs must be provided in order to receive a quote. If you have any questions about obtaining a copy of your loss runs, please call our office at (800) 547-6860.
Questions/Comments/Concerns?
Please note that by hitting the submit button you HAVE NOT placed your insurance coverage. No coverage can be bound or changed via this website. One of our account managers will be in touch to go over the next steps in the quoting process. If this is your first time requesting coverage information from Ruhl Insurance, you must provide us with a copy of your loss history by either uploading it above or emailing copies to Equinedocs@iruhl.com.