3059787218  |  11102 NW South River Dr, Medley, FL 33178  |  230 Madonna Blvd. Tierra Verde, Florida 33715

Excel where excellence is standard

marine insurance Quote

"*" indicates required fields

MM slash DD slash YYYY
Are you the only owner in the vessel*
Spouses do not count as a additional Owner
Address*
Gender*
Marital Status*
Homeownership*

Boat Information*
Year of Boat
Make & Model
Length
Year Purchased
 
Please Provide information on boat to be insured
Motor Information
Motor Year
Make & Model
Number of Motors
Horsepower Per Motor
 
please list motor information for boat being insured
Boating Courses or Safety Qualifications*
Previously Owned Boats*
Year of Boat
Make & Model
Length
Year Bought
Year Sold (if applicable)
 
Click the + sign on the right to add boats
Please list name, date of birth, years of experience and driver license #
please list Details of loss, Date, Cause of loss, Amount Paid
Any Auto Tickets/Accidents in the last 4 years?*
Some carriers run Motor Vehicle Reports to determine pricing
Tracking Device*
Trailer information (if applicable)
Year of Trailer
Trailer Make
Trailer Value
 
Please list all locations the boat will spend significant time at
Boat Storage Method*
Ex: September - February
Lay up storage method
Navigation Area*
please select the Navigational Area that the boat will be used in
Have you ever been convicted of a felony or DUI*
Has any carrier cancelled or non-renewed coverage?*
How will the boat be used?*
Do you own, rent or have a business more than 150 miles away from the boats storage location*
Example: if you have a vacation or secondary home
Example would be your secondary or primary home location that is 150 miles or more away from the boat storage location.
Have you had Boat insurance in the last 30 days?*
If referred by someone please list so that i can thank them personally ( if not referred put N/A)
Max. file size: 50 MB.
you can also email [email protected]
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