Boat Insurance Quote Form Information needed to commence vessel quotation Step 1 Step 2 Step 3 Step 4 Step 5 Step 6 Step 7 Beneficial Owner's Name Boat Make/Model Length of Boat Address City State Zip Code Phone Email Address Next Date of Birth Driver license Total Yours of Ownership Boaters Safety Courses Select Boaters Safety Courses Yes No Back Next Year Built Hull Value Top Speed Engine(s) Details Trailer Details Back Next New Purchase or you Currently Own Select an option New Purchase Currently Owned Current Policy Renewal Date Other Quotes? Select an option Yes No Quotes from Other Insurers Vessel Purchase Price Back Next Prior Boats Owned Chartered Boat? Select an option Yes No Licensed Captain Select an option Yes No Employ Paid Captain or Crew? Select an option Yes No Back Next Summer Berthing Location Winter Berthing Location Navigation Area Requested Mooring Details Select an option Docked-in-Water Rack Storage Lift Additional Insured Required by Marina? Select an option Yes No Layup Period Back Next Claims/Losses in Last 10 Years? Select an option Yes No Tracking Device Select an option Yes No Most Recent Survey Date Loss Payee Select an option Bank Cash Purchase Coverage Limits Needed Back Submit
