• Please provide the following information:

    First Name
    Last Name
    Street Address
    Address (cont.)
    City
    State/Province
    Zip/Postal Code
    Phone
    E-mail
    Number of years boating
    Have you had any marine losses?
    Date of Birth

    Vessel Information
    Builder
    Model/Type
    Year Built
    Length
    Hull Material
    Mast Manufacturer
    Mast Material
    Engine Manufacturer
    HP Per Engine
    Max Speed
    Engine Year
    Engine Fuel Type
    Requested Hull Value $
    Preferred Deductible %
    Requested Liability Limit $
    Requested Cruising Area/Cruising Schedule
    Primary Summer Mooring Location
    Will the boat be Laid-up?
    If yes, where?
    When was the boat last surveyed?
    Additional Comments:

 

In connection with this insurance, the insurers may review your credit report or obtain or use a credit based insurance score based on information contained in that report. An insurance score uses information from your credit report to help predict how often you are likely to file claims and how expensive those claims will be. Typical items from a credit report that could affect a score include, but are not limited to, the following: payment history, number of revolving accounts, number of new accounts, the presence of collection accounts, bankruptcies and foreclosures. The information used to develop the insurance score comes from several sources. If adverse action is based upon credit information the insurer will notify you.