Boat Quote Beagle

Boat Quote Beagle

TEL - (239) 529-6496
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Email
example@example.com
Marital Status
Occupation
Spouse's Name

First NameLast Name
Spouse's Date of Birth

MonthDayYear
Date
Phone Number

Area CodePhone Number
Residence
Primary Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Have long have you lived at address above?
In years
Is the Mooring Address the same?
Mooring Address

Marina Name

Street Address Line 2

CityState / Province

Postal / Zip Code
Hull ID?
Needed for firm quote
Hull Material?

Other
How will the vessel be stored?

Other
Do you currently have insurance?
If yes, please explain
Why are you shopping and who is your current insurer and expiration date
Year of vessel you are purchasing?
Length
Make
ex: Sea Ray, Hatteras, Boston Whaler
Model
ex: 320 Sundancer, 25 Center Console
Purchase price
Number of Engines
Make and Model of engines?
ex: Yamaha, Mercury, Caterpillar
Engine HP each?
ex: 200, 300, 1200
Fuel type?
Engine type?
Engine Serial Numbers?
Separate by a comma
Is the boat equipped with GPS monitored anti-theft device(i.e. GOST or SPOT)
Date of Last Survey?
Please attached

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Do you have a trailer you would like to insure?
Value of trailer?
Maximum speed?
Please give MPH
How many years of boat ownership?
What specific brand & size of boats have you owned (Include year and year's owned)?
ex: 2015 35' Boston Whaler from 2015 to 2021
How many years of boating experience?
What specific brand & size of boats have you Operated (Include year and year's operated)?
ex: 2015 35' Boston Whaler from 2015 to 2021
Have you taken any additional safety courses or do you have a Captain's license?

Other
P&I/ Uninsured Boater Liability Limits
Do you require coverage for the Bahamas?
Waters navigated?
Have you had any insurance claims in the past 5 years?
If you had a claim, please provide the year, amount, and cause.
ex: 2017, $12,000, Electronics Stolen
Have you had any driving violations in the past 5 years?
Any additional comments or questions?
Insurance companies use information from you and other sources, including your driving record, CLUE report, credit and claims histories. By submitting this form request you are authorizing us to take the information that you provide here and use it to obtain a quote.
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