COMMERCIAL
Check us first for all your business vehicle insurance, general business insurance and general liability insurance needs.
MOTORCYCLE
Enjoy the thrill of freedom even more knowing you got the best policy for your needs with us. You’ll be in hog heaven.
MARINE VESSEL
Before you hit the high seas, check out the most competitive rates on insurance for your boat or yacht. Then sail away!
HOMEOWNERS
InsuranceQuoter can find the best rate for your homeowners and flood insurance for your house or manufactured home.
AUTOMOBILE
Keep your auto insurance rates low with a periodic check of competitive companies. Let us help you find the best rate possible.
LESSORS RISK
(property rented to others)
Looking for insurance for your rental property? Look no further than here for all types of rental property insurance.


Client Info

Name    Address

City    State     Zip

Daytime phone     Best time to call    AM    PM 

eMail

Occupation     For how long?

Current Boat Insurance Info

Company name     Policy expiration

Premium amount $    Term

Coverages

TYPE

SUMS INSURED TYPE SUMS INSURED
Hull - Physical damage $ Tender/Dingy $
Liability coverage $ Crew Liability $
Owner/Operator M&C $ Medical payments $
Commercial passenger $ Uninsured boater $
Trailer $ Personal property $
Non-emergency towing $ Other $

Vessel Info

Vessel name     Manufacturer

Year     Length     Date of purchase     Model

Purchase price $     Present value     Max speed

Registration #    Hull ID#

Waters to be navigated

Tenders     Dingies     Stored on trailer     Will be trailered over 100 miles

Storage address     City     State

Zip

Laid up from to     On-shore     Afloat

Vessel Equipment

Please select all equipment on your boat/watercraft

Bilge pump Fume detector Other (listed below)
EPIRB Fire extinguisher
Sonar Cooking stove
Depth sounder Engine alarm
LORAN/Direction Finder Anti-theft devices
GPS Life raft
Radar Ship-to-shore radio
SATNAV/OMEGA Aux generator, diesel
CO2/Halon Aux generator, gas

Additional Vessel Information

Check all that apply

PRIMARY POWER TYPE OF HULL HULL MATERIAL FUEL TANK
Sail Sailboat Wood
Metal
Outboard Performance Metal
Fiberglass
Inboard Runabout Fiberglass
Plastic
Inboard/Outdrive Pontoon    
Other      

Engine Info

Please complete for each engine

ENGINE 1

Horsepower     Gas     Diesel     Year     Purchase date

Purchase price $     Present value $

Manufacturer     Model

 

ENGINE 2

Horsepower     Gas     Diesel     Year     Purchase date

Purchase price $     Present value $

Manufacturer     Model

 

ENGINE 3

Horsepower     Gas     Diesel     Year     Purchase date

Purchase price $     Present value $

Manufacturer     Model

Trailer Info

Year     Date purchased    Purchase price $

Present value $

Manufacturer     Model

Serial #

Operator

Always list insured as Operator 1

OPERATOR 1

Name     Date of birth     Auto D.L#

State     SS#     Years boat ownership

Auto violations/suspension in past 5 years

USCG/Power Squadron certificate

 

OPERATOR 2

Name     Date of birth     Auto D.L#

State     SS#     Years boat ownership

Auto violations/suspension in past 5 years

USCG/Power Squadron certificate

 

OPERATOR 3

Name     Date of birth     Auto D.L#

State     SS#     Years boat ownership

Auto violations/suspension in past 5 years

USCG/Power Squadron certificate

Boat Usage Info

Explain all yes responses in remarks

USAGE QUESTIONS
YES NO

1. Is the boat chartered to others with captain?

2. Is the boat chartered to others without captain?

3. Is the boat used for racing?

4. Is the boat used for water skiing or diving?

5. Is the boat used commercially or for business purposes?

6. Does the applicant employ a paid crew? (If yes, how many?)

7. Any operator involved in a marine loss in the last 10 years? (Insured or not)

8. Any coverage denied, cancelled or not renewed during the past 5 years?

9. If used for fare paying passenger charters, what's the avg. passengers per trip?

10. If used for fare paying passenger charters, what's the avg. passengers per year?

Remarks

Only click Send Request once. May take up to 60 seconds to process.