Boat Insurance Quote

Contact Information

Name

Address

Address Line 1

Address Line 2

City

State

Zip Code

Email

Phone

Watercraft Information

What is the current watercraft ownership?

Own
Purchasing

What was or will be the date of purchase?

What is the engine type?

What is the hull type?

What is the hull material?

What is the year, make and model of the watercraft?

What is the value?

What is the length?

What is the maximum speed?

How many engines?

What is the year, make and model of engine(s)?

What is the engine fuel type?

What is the horsepower of the engine(s)?

If you have an outboard motor, what is the value of it?

Will you be insuring a watercraft trailer?

Yes
No

Additional Equipment

How many hand-held extinguishers?

Check off any additional equipment onboard.

Watercraft Usage and Storage

Is the watercraft for personal use only, i.e. no renting or commercial use?

Yes
No

Is the watercraft used a residence?

Yes
No

Describe your typical cruising/navigational area? (e.g., inland waters, other than inland waters, # of miles from any point of land)

Where is the watercraft stored?

Primary residence
Secondary residence
Marina
Storage facility

How is the watercraft stored?

What is the address of the mooring/storage location?

Address Line 1

Address Line 2

City

State

Zip Code

What is the lay-up period? (When you are not using the watercraft, list date to date)

How is watercraft stored during lay-up?

If other storage, please describe.

What is the lay-up address?

Address Line 1

Address Line 2

City

State

Zip Code

Watercraft History

Is the watercraft currently insured?

Yes
No

If no, why isn't it insured?

New purchase
In storage/not in use
Self-insured
Cancelled/non-renewal by insurance company

Is there currently any damage to the watercraft?

Yes
No

If yes, please describe damage.

Any losses in the last 3 years?

Yes
No

Is there a lien holder?

Yes
No

Lien holder name

Lien holder address

Address Line 1

Address Line 2

City

State

Zip Code

Owner and Operator Information

What is the name of the primary operator?

What the primary operator's birthday?

What is the primary operator's driver's license state and number?

How many years has the primary operator been boating?

What percentage watercraft use by the primary operator?

Is there a secondary watercraft operator?

Yes
No

What is the name of the secondary operator?

What is the secondary operator birthday?

What is the secondary operator's driver's license state and number?

What is the percentage of secondary operator watercraft use?

Are there a tertiary watercraft operator?

Yes
No

What is the name of the tertiary operator?

What is the tertiary operator's birthday?

What is the tertiary operator's driver's license state and number?

What is the percentage of tertiary operator watercraft use?

Have all operators completed boating safety courses?

Yes
No

Check off all the safety courses and inspections completed.

Please provide any additional information that is relevant about the watercraft, equipment, or operators.

Note: Insurance coverage is not binding until confirmed.

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Contact Information

Watercraft Information

Additional Equipment

Watercraft Usage and Storage

Watercraft History

Owner and Operator Information

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