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Boat and Personal Watercraft Insurance Quote

One simple form takes only a few minutes

 

YOUR PERSONAL DATA:

Your Name:  
Street Address:  
City:  
*State:  
Zip/Postal:  
*E-Mail  
Re enter your E-Mail  
Phone:  
Fax (optional):  
Marital Status:  
Homeowner?  
Boat Currently Insured?   (If yes, list carrier, and #
of years continuous.
If none, type N/C)
     
 

OPERATOR INFORMATION #1 (if none, leave blank)

Be specific to tell if accidents are “at-fault” or “NOT-at-fault” -(carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:

Name:  
Sex:  
Cycle Safety Course:  
Number & Type of Accidents within last 3 years:  
Number & Type of Major violations within last 3 years:  
     
Birthdate:  
Years U.S. Auto License:  
Number of Years Boating Experience:  
     
 

OPERATOR INFORMATION #2 (if none, leave blank)

Be specific to tell if accidents are “at-fault” or “NOT-at-fault” -(carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:

Name:  
Sex:  
Cycle Safety Course:  
Number & Type of Accidents within last 3 years:  
Number & Type of Major violations within last 3 years:  
     
Birthdate:  
Years U.S. Auto License:  
Number of Years Boating Experience:  
     
 

VESSEL & UNDERWRITING INFORMATION

Year of Boat::  
Boat Length:  
Hull # (If available)::  
Max, Speed
(in MPH)::
 
Engine Make:  
Outboard Motor Serial #
(If available):
 
Engine Horse Power  
Trailer Cov. Needed?  
Trailer Value: ($)  
Describe waters boat taken on?  
Make & Model:
(be specific):
 
Hull Type
(wood, Metal, fiberglass, etc)::
 
Market Value: ($)  
Engine Type:
(Inboard, 110, Jet)
 
.Fuel Type:
(Gas, Diesel, etc.)
 
Year/Make/Model of Trailer:  
Address/Marina Where is boat moored/stored?  
Describe boat general usage?
(fishing, ski, etc.)
 
     
 

VESSEL COVERAGES:

Limits of Liability:  
$250/500 BI/ 100 PO
 
Hull Coverage :  
     
Uninsured Motorists Coverage?   Yes No
Comments or Remarks:
(List additional drivers, special coverages, etc. here)
 
 
 
 

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