Boat Insurance Quote Request | Fish & Associates Insurance

Your Name *

Your Mailing Address *

Street

City *

State *

Zip *

E-mail Address *

Daytime Phone Number *

Your Watercraft:

If you have more than one watercraft, please call our office for a quote.

Year *

Manufacturer & Model *

Serial # (if known) *

Length *

Total Horsepower *

Value *

Power: *

Max Speed (mph) *

Hull Type: *

Hull Material: *

Water Navigated: *

Number of Outboard Motors: *

Outboard Motor 1

Year *

Horsepower *

Manufacturer *

Serial # (if known) *

Value *

Outboard Motor 2

Year *

Horsepower *

Manufacturer *

Serial # (if known) *

Value *

Outboard Motor 3

Year *

Horsepower *

Manufacturer *

Serial # (if known) *

Value *

Boat Operator

Number of Boat Operators:

Operator 1

Name

DOB

Marital Status

Boater licensed for 2 or more years?

Yes

No

Completed a safety course in the past 3 years?

Yes

No

Operator 2

Name

DOB

Marital Status

Boater licensed for 2 or more years?

Yes

No

Completed a safety course in the past 3 years?

Yes

No

Operator 3

Name

DOB

Marital Status

Boater licensed for 2 or more years?

Yes

No

Completed a safety course in the past 3 years?

Yes

No

Operator 4

Name

DOB

Marital Status

Boater licensed for 2 or more years?

Yes

No

Completed a safety course in the past 3 years?

Yes

No

Trailer

Year *

Manufacturer *

Serial # (if known) *

Value *

Coverages

Deductible: *

Liability: *

Medical Expense (others): *

Medical Expenses (insured): *

Un-insured Coverage: *

Completed a U.S. Power Squadron or U.S. Coast Guard Auxiliary course? *

Yes

No

Additional Comments

Please use the box below to enter any additional information you feel should be considered:

Protecting your privacy and identity is very important to us.

Your Social Security and drivers license numbers may be required to complete this quote. We will contact you personally for this information.

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