Name

This field is for validation purposes and should be left unchanged.

Tell us about yourself

Primary Contact Name*

Business Name

(if Insured is a Company, Corporation, Trust, or LLC)

Insured's Occupation

Mailing Address*

Street Address Line 1 Street Line 2 City State / Province / Region ZIP / Postal Code Country

Engine/Outboard Motor Information

Engine(s) Information

For main vessel only

HP

Fuel

Year Built/Overhaul

Manufacturer & Model

Serial #

Date Purchased

Purchase Price

Tender/Dinghy Information

Is there any tender or dinghy?

Yes

No

Tender / Dinghy Information

Year

Engine Make/Model

HP

HID

Reg #

Tender/Dinghy anit-theft precautions*

Coverage Options

If you are unsure about these coverage limits, skip this section. Your agent will talk to you about recommending the proper coverage limits needed.

Hull Physical Damage Amount

Tender/Dinghy Amount

Liability Amount or Watercraft Liability Amount

Crew Liability Amount

Commercial Passenger Coverage

Medical Payments Coverage

Personal Property Coverage

Uninsured Boaters Coverage

Trailer Coverage Amount

Non-Emergency Towing Coverage

Other Coverage

Final Questions

Have you had any boat insurance losses in the past 5 years?*

Yes

No

Please describe the loss (what happened, when, how much was paid)

Was any coverage declined, cancelled, or non-renewed in the last 5 years?*

Yes

No

Is your watercraft currently insured?*

Yes

No

Name of current insurance carrier*

Additional Named Insured(s) - If any

Comments or Questions

File Attachment(s)

Drop files here or

Accepted file types: pdf, jpg, Max. file size: 20 MB, Max. files: 5.

Contact Information

Email*

Phone*

How did you hear about us?

Date you want this policy to start*

Watercraft Insurance Quote

Tell us about yourself

Watercraft Information

A SURVEY WILL BE REQUIRED. Liability only policies will need an In Water Survey. To include Hull Coverage, an Out of Water Survey will be required. To find a local survey visit the Society of Accredited Marine Surveyors.

Mooring and Usage

Engine/Outboard Motor Information

Tender/Dinghy Information

Operator 1

Prior Boating Experience

Operator 2

Operator 3

General Information

Coverage Options

Final Questions

Contact Information

Our knowledgable agents are experts at finding the right coverage for your business or family. Get your insurance quote today.

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Watercraft Insurance Quote

Tell us about yourself

Watercraft Information

A SURVEY WILL BE REQUIRED. Liability only policies will need an In Water Survey. To include Hull Coverage, an Out of Water Survey will be required. To find a local survey visit the Society of Accredited Marine Surveyors.

Mooring and Usage

Engine/Outboard Motor Information

Tender/Dinghy Information

Operator 1

Prior Boating Experience

Operator 2

Operator 3

General Information

Coverage Options

Final Questions

Contact Information

Our knowledgable agents are experts at finding the right coverage for your business or family. Get your insurance quote today.

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