Marine Quote Form

    Your e-mail Address
    (the quote will be emailed to this address)

    Primary Storage/Moorage Location

    Is vessel stored/kept at the residence?YesNo

    Zip Code
    If the vessel is not stored/kept at the residence, please provide us with the zip code where it is stored/kept. If in coastal area, it is important that you provide us with the zip code of the vessel location. Some insurance companies rate based only on the zip code and there are areas on the coast where one zip code vs another in the same city can cause dramatic differences in premium. If you only give us the city, our system will select the highest rate for that city.

    Moorage ZIP Code:

    *or* Moorage City:

    Quick Quote Qualifications

    Has the insured had any boating losses in the last 5 years?YesNo

    Does the insured live more than 4 hours from vessel?YesNo

    Is the boat used as the insured's primary residence?YesNo

    Is the hull material other than fiberglass or aluminum?YesNo

    Has the insured had a DUI, reckless driving or any driving violations
    (including at fault accidents) in the last 3 years?

    How many title owners?
    Husband and wife only count as 1 owner.

    Years Experience

    Number of Years Boating Experience?
    (if new to boat ownership but have boated with friends or family or have rented boats, include this in the answer.
    Examples: Insured has boated with family for 2 years then they have two years experience or if they have rented
    boats for 5 years then they have 5 years experience.)

    Number of Years Boat Ownership?
    If no prior ownership, input 0.

    Vessel Information

    Boat Type




    Vessel's Top Speed

    Use of Vessel

    Coverage Requested

    Vessel Value
    (for liability only use 0)

    Trailer Value
    (for liability only use 0)

    Liability Coverage

    Medical Coverage

    Insured's Information

    Is the boat titled in a company name?YesNo

    Does the insured have an existing boat insurance policy on this boat or any boat?YesNo
    For the most accurate quotation use the proper first name (Robert vs. Bob) and resident address. Information is verified
    using name and resident address. Incorrect or made up information will not produce the best premium available.

    First name
    use proper name Robert vs. Bob

    Last name

    Resident Address
    information is verified using the resident address, an incorrect
    or business address will not provide the best premium available.




    Date Of Birth?
    please use format (mm/dd/yyyy)

    Boating CourseNoneUSCG CourseUSCG AuxiliaryUSPSCaptain

    Social Security Number
    Not required but recommended to provide a more accurate quote

    Additional Vessel Information

    Number of Engines

    Type of Engine:InboardInboard/OutboardOutboardJet


    Gasoline Fume Detector InstalledYesNo

    Automatic Firefighting System in Engine CompartmentYesNo

    How many years has the insured owned this vessel?

    What is the Length of the largest prior boat owned by the insured?
    If no prior boats, input 0.

    Lay Up
    This is the time period the vessel is not used (winter months) and a reduction of premium is applied. The vessel can be laid up ashore or afloat. The vessel is fully covered during a stated lay up period if it is not navigated, is not ready for immediate use and is not used to live aboard.

    Select the number of months the vessel is laid up

    Enter the starting month the vessel enters lay up
    Only required if laid up 1 or more months

    Enter the starting day the vessel enters lay up
    Only required if laid up 1 or more months

    Is the vessel laid up Ashore or Afloat?

    Navigation Information

    Navigational Area
    Inland Lakes and Waterways excluding Great Lakes and tidal waters (Southern)Florida Coastal WatersGulf Coastwise between Carrabelle, FL and Brownsville, TX

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