**
Fill in all the boxed fields on the screen
-you can use the tab key to move to the next box - and then print the filled in
form sign it and fax to: 347-214-7440 or scan and email it back to us**
Client Information
Address 1:
Address 2:
City: State :ZIP:
Email:
Phone:
Alt. Phone:
Description of Horses
Horse #1
Name:
Breed:
Registration Number:
Sex: Age:Height
Horse #2
Name:
Breed:
Registration Number:
Sex: Age:Height
Pickup Information:
Transport pickup on or about the day of
, 2007 (pick-up)
Address
Address
, (Phone)
, (Alternate Phone)
Delivery Information:
Transport delivery on or about the day of
, 2007 (pick-up)
Address
Address
, (Phone)
, (Alternate Phone)
Acknowledgement of Reciept of Horse(s) on the ___ day of
______, 2007
___________________________________________________________(Signature at
delivery)You or your representative must be present upon
delivery. If no one is available to recieve the horse a fee of $50/hour will be
charged while waiting for a responsible party to care for the horse.
Transport Provider Obligations
To provide the following services-
- We delivery your horse to you or your representative.
- Horses have constant access to water and hay.
- Limit horses to 10 hours of actual travel plus water stops
before stopping for the night. Horses are unloaded if
current weather permits access to horse stables. In serious
weather conditions horses may remain in trailer.
- The price is to deliver your horse. Tack or
other item transport requires
special permission and will incur an additional charge.
- Additional Agreements/Information (use this space for any
special needs/care requirements and or insurance information):
Client Obligations
Provide the following
- Hay for travel (grain if you wish for
grain snacks - please include instructions)
- Interstate Health Certificate
(**ORIGINAL** NO copies or faxes for health certificate
accepted)
- Negative Coggins (EIA) Test (Required)
Delivery and Pickup Dates
These are estimates. About 20% of the time arrival is prior to this date.
Seldom is it later. One example is to get ahead of a snow storm thus transporter might get an
early start. In heat there might be extra travel at night. Or it may simply have
been too conservative an estimate. So it could be a full day or more early.
Delivery times are from 8 am to 10 pm. If a horse has traveled several thousand
miles there is no need for the horses on the trailer to spend an extra day on
the road because your boarding facility doesn't want to come to the barn after 6
pm. There is a $400 surcharge if your barn will not take your horse at least up
until 8 pm. On the road there is no trouble finding facilities willing to take
late arrivals. They will never see the horses again. Surely his home barn can
show as much concern.
Inital__________Date
Emergency Care
Horses can hurt themselves in the best of circumstances.In the unlikely event
of an Emergency requiring veterinary care , Transport Provider is authorized to
contact any available Veterinarian and the client agrees to be responsible for
all costs and pay such costs at time service is rendered. Transport Provider is not
liable for such costs. Transport Provider shall be entitled to a lien against the
transported horse(s) for the value of the services rendered and $25/day board
until such fees are paid.
Inital__________Date
Hold Harmless Release - Death or Injury
The Client understands that Insurance on the horses is not provided by
Transport Provider. To obtain Mortality or Loss of Use Insurance on a horse, the value of
that horse must be proven to the Insurance Company. You cannot simply insure a
horse for a value you deem correct or would like in the event of loss. The value
of the horse must be proven via purchase price, breeding records, etc.
Establishing value is not possible or practical for the transporter. Hence, it
is the responsibility of the client to obtain mortality and loss of use
insurance. The client understands and acknowledges this, and if he/she elects
not to secure such insurance, then he/she agrees to assume all expenses and/or
losses. Regardless of insurance, the client agrees to hold Transport Provider harmless in the event of death or injury and to voluntarily release and forever
discharge Transport Provider from any and all liabilities, claims, demands, actions
or rights of actions, which are in any way connected with the transport of the
aforementioned horse(s), including, but not limited to the negligent acts or
omissions of the Transporter.
Inital__________Date
Cancellation Policy
NO REFUNDS ON Cancellations.
Total Agreement
This document represents the entire agreement between
Transport Provider and the
client requesting transportation. The fee of $_______________ is the price for
transport. If the trip cost is under $500 then entire payment is due at booking.
For longer trips you may opt to use the payment schedule. All mileages
used to calculate your fee are 'estimates' based on the address' you provide, if at the time of pickup
or delivery there is a variance due to poor information provided we will at that time notify
you of any variance from the estimated mileage !
Payment Schedule
- 25% to Reserve Space
- Additional 25% 1 week prior to pickup
- Final payment upon delivery. This must be
cash or cc.
Signature___________________________________________________Date
Signature for Transport Provider _________________________________Date
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