Boatowners Insurance Quote

For California residents only.

After you've completed this form, click on the SUBMIT button to receive your free Boat Insurance quote. You'll be given an opportunity to specify U.S. Postal Service, e-mail or fax. Or phone (760) 644-0351.

Customer Information
Name
E-mail
Street address
City
County
State
Zip Code
Home Phone
Work Phone
FAX

Boat Description
Make of Boat
Year Built
Boat Length
Present Hull Value
Purchase Date:
Hull Type	-- select -- Fiberglass Wood
Territory	-- select -- Inland Lakes Pacific Ocean
Class	-- select -- Type of Boat...Type of Power Runabout.......Outboard or none Runabout.......Inboard Runabout.......Inboard/Outboard Runabout.......Jet Drive Cabin Cruiser..Outboard Cabin Cruiser..Inboard Cabin Cruiser..Inboard/Outboard Cabin Cruiser..Jet Drive Canoe,Dinghie..All Sailboat.......Any Type of Supplemental Power Sailboat.......None Catamaran......Any Type of Supplemental Power Catamaran......None Houseboat......Outboard or None Houseboat......Inboard Houseboat......Inboard/Outboard Pontoon........Outboard Personal Watercraft....0-300 CC's Personal Watercraft..301-500 CC's Personal Watercraft..501-700 CC's Personal Watercraft..701 & over Personal Watercraft..Jet Drive Boat(under 16')

Components Description
Component	Make	Year	Value	HP
Inboard or In/Outboard
Outboard 1
Outboard 2
Trailer

Additional Rating Information
Simultaneous Motor Use?	Yes No
Diesel Engine?	Yes No
Automatic Fire Extinguishing System?	Yes No
Additional Boat Equipment $
Personal Effects Coverage $
Maximum Speed (MPH)
Operators Age
Operator Class	Primary OPR Years Exp........Under 21 OPR? 3 or More Years...................No More than 1 but less than 3.......No 1 or Less.........................No 3 or More.........................Yes More than 1 but less than 3.......Yes 1 or Less.........................Yes
Boating Education	Organization................Course U.S.Coast Guard.............Boating, Sailing & Seamanship U.S.Coast Guard Auxiliary...Boating Skills & Seamanship U.S.Coast Guard Auxiliary...Advanced Boating Classes U.S. Power Squadron.........Boating (outboard,inboard,sail) U.S. Power Squadron.........Advanced Boating Classes Captain's License NASBLA......................Boating Safety

Requested Coverages
Liability Limits	Medical	Physical Damage Deductible
-- select -- $100,000 $250,000 $300,000	-- select -- $1,000 $2,000 $5,000	-- select -- $50 $100 $250 $500 $1,000 $2,500

Have you had any losses within the last three years?

Underwriting Information
Current Insurance
Expiration Date
Ever Filed for Bankruptcy?	Yes No
Is your Credit Rating?	Excellent Good Fair Poor

Reporting Method
How would you like to receive your free Boat Insurance quote?	U.S.Postal E-mail Fax

 

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