LPI Marine Insurance Quote Request

LPI Marine Quote Request
Insurance Quote Request for All Boat Classes except: PWC (Personal Watercrafts like Jet Skis) and leased boats.

Please Note: This Application can be Saved while in progress by clicking on the Save button at the bottom of the Form. You will then be sent a link to the incomplete form so you can complete it at any time. There is no need to answer any questions which do not apply to you or your marine vehicle.
What date would you like your Vessel insured by?*

MonthDayYear
Date
What date would you like your insurance to expire on?*

MonthDayYear
Date
Do you have an LPI Broker?*

YesNo
If yes, what is the name of your Broker:
Full Name of Registered Owner:*
Phone Number:*
Please enter a valid phone number.
Email:*
example@example.com
If Owner is a Business or Corporation, Name of Entity:
If there is more than 1 Owner, how many Owners are there?
If there is more than 1 Owner, are the Owners Related?

YesNo
How is the Vessel kept during Boating Season?

In water tied to a DockOn land on Trailer when not in use.In water tied to floating Mooring Buoy or on Anchor or Raft MooredSuspended on Private Boat LiftOther
If Moored, is the Vessel checked on a Regular Basis?
Is the Vessel in Good Working Order?

YesNo
If not, describe the needed repairs:
Is the Vessel Chartered or Rented to Others?

YesNo
If yes, please describe Rental/Charter Activity:
Is this vessel used for Recreational Private Pleasure only?*

YesNo
If not, please describe Commercial Activity:
Brand/Year/Make/Manufacturer:*
Length of Vessel in Feet:*
What is the Hull Material?*

AluminumFiberglassWoodFG over WoodSteelOther
Propulsion Type:*

JetSailOutboardIn/Outboard/Stern DriveInboardOther
Current Market Value of Vessel and Main Motor(s):*
Is this boat currently insured?

YesNo
If yes, please Upload a Copy of your Current Policy here:

Cancelof
Has your marine insurance ever been cancelled, declined or refused?

NoYes
Should be Empty:

LPI Marine Quote Request