SPI - Non-Rough Stock Liability Application

Type of Policy.........................	Non-Rough Stock Spectator Liability

Primary Insured
Name of Rodeo Association.....
Street Address........................
City, State Zip.........................	,
Phone Number........................
Fax Number............................
Contact e-Mail.........................

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 Event...........................
Type of Event............................
Location of Event.......................
......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 premiums)
PLEASE CONTACT SPI FOR PREMIUM AMOUNT.