Livestock MTC Quote - Winterburn & Associates Insurance, LLC

Name*

First Last

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email*

Coverage Requested*

Livestock Transit/ MTC (Broad Form)
Livestock Transit/ MTC (Specified Perils)
Death Only Coverage (mandatory for horses)
Goods other than animals

Coverage Requested*

Policy Maximum	Per Animal	Per Vehicle

All limits are per occurance

Has any company cancelled or refused to write coverage for you?*

Yes
No

If yes, please provide reason given

Do you own, operate, or have any financial interest in any other livestock operation?*

Yes
No

If yes, please explain

Name and Address of Loss Payee (if applicable)

Name of current cargo coverage provider*

Policy Expiration Date

Are State Filings required?*

Yes
No

If Yes, in what states?

Does applicant transport and high valued animals on a regular basis (purebred, export, genomic, etc.)?*

Yes
No

If yes, please explain*

Indicate the percentage of loads for each type of livestock:*

Cull Cattle	Fat Cattle	Feeder/ Replacement Cattle	Dairy Cattle	All Other Animals

Are any other animals are transported?

Average hauling distance	Maximum Radius	Total Annual Miles

Average Value per Load	Max Value per Load

Vehicle Information:*

Type of Vehicle	Capacity	Make	Year	Last 6 VIN	Limit

Please list all losses in the past 5 years, whether covered by insurance or not.

Date	Cause	Amount

This is not required, but if readily available, please upload your most current insurance policy coverage declarations pages in PDF format so we can see the exact coverage limits you'd like us to compare. These can be easily downloaded from your online profile with your current provider (if you have a login), or from your current agent.

Drop files here or

Max. file size: 39 MB.

Livestock Cargo Quote