Boat Insurance Quote

Boat Insurance Quote Request

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Hello, What Is Your Full Name?*

First NameLast Name
Date Of Birth*

MonthDayYear
Date
Drivers License Number (optional)
Occupation *
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Primary Residence*

OwnRent
Phone Number

Area CodePhone Number
Email*
example@example.com
Boat Type:*

SailboatCruiserCenter ConsoleTrawlerWake / SkiOther
Boats Year, Make and Model (Please include all details)*
# of Motors*
Total HP*
Engine Year Make and Model*
Purchase Date: (mm/yyyy) * Purchase Price: $ *
Hull Construction:*

FiberglassAluminumOther
Engine Type:*

InboardStern Drive (I/O)OutboardOther
Fuel Type*

GasDieselOther
Top Speed (MPH)*
Trailer Coverage?*

YesNo
Navigation Requirements (Where do you use the boat?) *
Where is the vessel located when not in use (ie: residence, name of marina, private dock) *
Main Mooring Location (City & State)*
Main Mooring Zip Code*
Automatic Fire Extinguishing System in the engine compartment:*

YesNo
Gas Fume Detector in the engine compartment:*

YesNo
GPS Anti Theft*

YesNo
Is the vessel used as the primary residence:*

YesNo
Does Insured Live More Than 4 Hours From The Vessel:*

YesNo
Use of Vessel:*

PleasureCharterCommercialOther
# of months in lay up:
Lay up start date (month and day)
Years of Boating Experience:*
Boater Safety Class*
Year Make Model of boats you have owned (Up to 3- Very important for eligibility) *
Coverages Requested
Vessel Value:*
Trailer Value: (if needed)
Liability Limit:*

$100,000$300,000$500,000Other
Medical Payments:*

$5000$10,000$25,000
Personal Effects: Limit is based on the type of boat or you can select the limit desired.
Current Insurance Information

(Not required for new purchase)
Insurance Company: (Put NA if No Insurance) *
Premium:
Expiration Date:
Any Reported Boat Losses in Last 5 Years:*

YesNo
If yes please explain (date, amount paid, brief description)
Has any insurance coverage ever been Cancelled or Refused:*

YesNo
Notes to agent:
Accurate Insurance Mart

7815 N Dale Mabry Hwy #100

Tampa Fl 33614

813-374-0150

www.InsurancebyAIM.com
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Boat Insurance Quote Request