Request a Quote - Boat Insurance

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Contact Information

Name: *
Mailing Address:



Please provide an email address or phone number to be contacted *
E-mail Address:
Daytime Phone:

Your Boat:

Description of Property:
Motor type * Number of Engines *
Boat Type * Other Boat Type
Fuel * Maximum Speed *
Hull Material * Other Hull Material
Insured Watercraft:
Model Manufacturer Year
* * *
Serial Number Length TotalHP
* * *
Outboard Motor
Model Manufacturer Year
Serial Number TotalHP
Manufacturer Serial Number Year
Coverages & Limits:
Boat (Including Auxiliary Equipment, please break down o/b information)
Outboard Motor 1 (ACV Coverage)
Outboard Motor 2 (ACV Coverage)
Boat Trailer
Personal Property($500 Automatic)
Commercial Towing($400 Automatic)
Boat Liability(ACV Coverage)
Medical Payments($1000 Automatic with Liability)
Uninsured Boater
Optional Coverages
Agreed Value Endorsement YesNo
Actual Cash ValueYesNo
Fishing EquipmentYesNo  Limit:  
Safety Equipment: Check all that apply:
GPS Yes No Automatic CO2 (Halon) Yes No
Ship to Shore Radio (VHF) Yes No Depth Sounder Yes No
Electronic Burglar Alarm Yes No Radar Yes No
Plotter Yes No EPIRB Yes No
Vapor Detector Alarm Yes No
Primary Operator Information:
Date of Birth *
Years of Boating Experience: *
Secondary Operator Information:
Date of Birth *
Years of Boating Experience: *
Waters to be Navigated:
Inland waters of the following states:
Coastal waters of the following states:
Is the boat chartered or used for anything other than private purposes? Yes No*
Previous Loss Information:
Please describe any losses or claims filed on your Boat Insurance in the last 3 years. Include the following information: date of loss, type of loss and amount of claim.
Additional Comments:
Please use the box below to enter any additional information you wish to include.