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Your Boat
Phone Number
Email Address
Boat Make
Boat Model
Boat Length (ft)
Year Built
Estimated Hull Value
?
Enter the current market value of your boat's hull
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Ownership & Financing
Beneficial Owner's Full Name
Mailing Address
Total Years of Boat Ownership
Titled Owner Name (if owned by entity/LLC please list that name)
Date of Birth
Any additional owners?
No
Yes
Add Owner
Driver's License #
State of Driver's License issuance
Select state...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
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Kansas
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Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Outside the U.S.
Any Claims/Losses in the last 10 years?
No
Yes
Date of incident, claim amount in USD, describe the incident and what happened
Loss Payee
Cash Purchase
Bank-financed
Bank Name
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Boating Experience
Prior Boats Owned
Have you taken any boater safety courses?
No
Yes
Select Courses Taken
None
US Coast Guard
US Power Squadron
Other
Are you a licensed captain?
No
Yes
Does this vessel employ any paid captain or crew?
No
Yes
Crew Members
Add Crew Member
Florida Residency Status
Full-time Resident
Part-time Resident
Non-resident
Marital Status
Single
Married
Occupation
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Where You Boat
Summer Berthing Location
Winter Berthing Location
Does the boat have a layup?
No
Yes
Layup Start Date
Layup End Date
Primary Navigation Area
Mooring Details
Select mooring type...
Docked in Water
Rack Storage
Lift
Other
Does your marina need to be listed as an additional insured?
No
Yes
Marina Name
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About Your Boat
Engine Make
Engine Year
Engine Horsepower
Does the boat have a tracking device?
No
Yes
Tracker Make/Model
Boat Usage
Private Pleasure
Commercial
Number of charter days annually
Boat Top Speed (mph)
Do you participate in poker runs or races?
No
Yes
Have you taken the Tres Martin Performance Boating Course?
No
Yes
Most Recent Survey Date
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Choose Your Coverage
Hull Deductible
?
Higher deductibles may lower your premiums
1% of Hull Value
2% of Hull Value
3% of Hull Value
4% of Hull Value
5% of Hull Value
Liability Limit
$300,000
$500,000
$1,000,000
$2,000,000
$3,000,000
$4,000,000
$5,000,000
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