BOAT QUOTE SHEET

DATE: ___________________

Referral / Source: _____________

Legal Name ___________________________________________________________________________________________________

Address ______________________________________________________________________________________________________
Phone ____________________ Work _____________________ Cell ____________________ E-Mail ____________________________

TYPE OF BOAT:

RUNABOUT

CABIN CRUISER

PONTOON

SAILBOAT

YEAR, LENGTH, & MANU. OF BOAT _________________________________________________________MODEL ___________

YEAR & MANU. OF MOTOR ____________________________________________________________________HP_____________
VALUE OF BOAT/MOTOR/TRAILER_____________________________________________________________________________
TYPE OF MOTOR:

INBOARD

OUTBOARD

INBOARD/OUTBOARD

VALUE OF BOAT, MOTOR, & TRAILER _________________________________________________________________________

DISCOUNTS:

BOAT EDUCATION____________ BOAT EXP IN YEARS___________ BOAT & AUTO___________

OPERATORS:
NAME

DL#

DOB

SSN

TICKETS OR ACC.

1. ___________________________________________________________________________________________________________
2. ___________________________________________________________________________________________________________

In order to write the policy you will need:

LIENHOLDER_________________________________________________________________________________________________
SERIAL #S
BOAT____________________________________ MOTOR____________________________ TRAILER_______________________
HULL CONSTRUCTION - F-W -M-OTHER-

HULL TYPE U-V-FLAT-OTHER

MAX SPEED_______

BOAT LOC. HOME OR MARINA, IF MARINA, NAME & ADD_______________________________________________________

PRIOR INS CO & POL #___________________________________________________NAME OF BOAT_______________________

IFS Score _________