Boat / Yacht Insurance

Boat / Yacht Insurance
Welcome! Please fill out this form to the best of your ability so we can provide an accurate free insurance quote. Your responses are completely confidential and will only be saved if you choose to become a client of Olive Branch Ventures.
Feel free to upload any existing ACORD forms or other documents you believe may be relevant.

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Contact Information
Full Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address (Where boat is kept or owner's home)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Driver's License # and State
Occupation / Business Type
Mailing Address (if different)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Vessel Information
Boat Type:

SailboatPowerboatFishingYachtPersonal WatercraftCommercial CharterOther
Year / Make / Model:
Length (Feet) & Beam Width (Feet):
Hull Identification Number (HIN):
Hull Material:

FiberglassAluminumWoodSteelOther
Engine Type:

InboardOutboardInboard/OutboardOther
Engine Make / HP & Number of Engines :
Maximum Speed (MPH/Knots):
Purchase Date & Price
Any modifications or custom equipment (if yes, describe)?
If trailer is included, please provide the following: Year / Make / Model / Value.
Fuel Type:

GasDieselElectricOther
Usage Information
Primary Use:

PleasureLive-AboardFishingCharterCommercial WorkRacingOther
Typical Operating Waters:

InlandCoastalGreat LakesOceanOther
Navigation Area & Average Hours Used Per Year:
Storage Location:

MarinaPrivate DockDry StorageTrailerMooringOther
Is the marine stored at this location all year long or on specific months (mentions the months) ?
Boating Experience (Years Operating):
Security Measures:

AlarmGPS TrackingLock SystemCCTVOther
Have you completed any Boating Safety courses (if yes, which course and year)?
Coverage Options
Hull Coverage Type:

Agreed ValueActual Cash Value
Hull Coverage Amount:
Dollar value
Deductible:

$250$500$1,000$2,500
Liability Coverage Limit:

$100K$300K$500K$1MOther
Click All The Coverages You Need:

Medical PaymentsUninsured BoaterPersonal EffectTowing & AssistanceTrailerFishing EquipmentWatersportsPollution LiabilityCrew CoverageOther
History
Any losses, claims, or accidents in the past 5 years? Please provide when and price of claim.
Any prior insurance for this or other boats?
Any conventions or violations?
Is boat used for racing or charter for hire?

YesNo
Additional Space:
Use the space to provide any information you feel is necessary.
Should be Empty:

Boat / Yacht Insurance

Contact Information

Vessel Information

Usage Information

Coverage Options

History