Boat Insurance Quote

Your Name

Date of Birth

Your Address

Contact Number

Your Email

Do you have existing boat insurance

YesNo

If you have, could you tell us the insurance company name and your customer & policy no.

Have you had any boat related claims in the past 2 years

YesNo

Type of Boat

---Trailered PowerboatTrailered SailboatTrailered JetboatJet SkiSailing BoatCanoe/Kayak/DinghyWindsurferAmphibious CraftHovercraftOther

Will this boat be raced at anytime

YesNo

Make

Model

Boat Name

Year of Manufacture

Hull, Fixtures & Fittings Value $

Boats Gear $

Trailer Value

YesNo

Trailer Registration

How will the boat be stored when not in use

---Locked buildingSecured on the property where storedDrystackedMarinaOther

If your answer is 'other' to previous question, please tell us details

Is the boat on finance or lease

YesNo

If your answer is 'yes' to previous question, what's the company

Any other relevant information that may affect the insurance cover

Declaration: I/WE HEREBY DECLARE AND WARRANT that the answers given above are in every respect true and correct, and that I/We have not withheld any information within My/Our knowledge likely to affect the decision of the Company as to My/Our eligibility for insurance. This request and declaration shall be the basis of the quote request.

YesNo