____________________________________
(Date)
GARDEN STATE HORSE SALES
COMPANY
NOTICE OF INSURANCE COVERAGE
The
purchaser, or his duly authorized agent, has
arranged with the firm named below to insure
the following named
horse(s). It was agreed that the horse(s)
will be insured for full mortality (without
any deductible or other exclusions, unless
otherwise agreed in writing) for the sale
price of the named horse(s) purchased at
Garden State Horse Sales Company's
auction. It was further agreed that
Garden State Horse Sales Company will be
named loss payee (beneficiary) until such
time
that all amounts due for the purchase of
said horse(s) is paid in full. The
undersigned insurance company/agency
___________________________
________________________________________
hereby agrees to furnish Garden State
Horse Sales Company with a copy of the
Certificate of Insurance and will, also,
advise Garden State Horse Sales Company of
any changes made to the policy during the
term that Garden State Horse Sales Company
is the loss payee and hereby
agrees to indemnify Garden State Horse
Sales Company for any loss resulting from
its failure to so advise Garden State
Horse Sales Company. The undersigned
insurance company/agency will also notify
Garden State Horse Sales Company, in
writing, of any changes relating to the
policy of insurance as long as Garden State
Horse Sales Company is the loss payee.
HIP
NO.
NAME OF
HORSE
SALE PRICE
__________________
_____________________________
________________________
__________________
_____________________________
________________________
__________________
_____________________________
________________________
Insurance Company/Agency -
Name and Address
___________________________________
___________________________________
___________________________________
___________________________________
(Insurance Company/Agency
Representative)
X_____________________________________
(Signature
