Quick Quote

Step 1 of 9

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1. High-Performance application
Who’s applying?*
Agency Name*
Producer Name*
Your Name*
Relationship to insured*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Phone*
How did you hear about us?*

2. Named Insured Information
Name*
First Last
Date of Birth*
Phone*
Address*
Street Address City State / Province / Region ZIP / Postal Code Country
Email*
Requested Effective Date*

3. Vessel Information
Vessel Type*
Vessel Make*
Vessel Model*
Vessel Year*
Vessel Length*
Hull Material*
Other , Describe
Hull ID
Purchase Date*
Purchase Price*
Current Value*
Has there been a survey?
- Yes
- No
Date of Most Recent Survey*
Survey
Upload a photo
Is there a trailer or Tender?
Trailer or Tender Value?

4. Engine Information
# of Engines*
Engine Type*
Engine Make*
Engine Year*
Horsepower (Total)*
Top Speed*
Propulsion Type*
Supercharged*
Has the engine been modified?*
- Yes
- No
Please explain:*

5. Usage
Areas(s) of Navigation*
Mooring Location Name:*
Mooring Location Address*
Mooring Type*
Off-Season Storage
Please Explain
Is the boat laid up?*
From*
To*
Lay up type*
Is this boat your primary residence?*
Commercial use?*
Briefly describe the commercial use*
Number of Paid Crew
Did you take any Safety Courses ?
Safety Courses' name and date:

6. Policy Information
Limit of Liability*
Current Insurance Carrier*
Any past insurance losses/claims?*
Date Of Loss*
Amount Of Loss*
Describe Loss*

7. Owner / Operator Experience
Primary Operator*
First Last
Date of Birth*
Resident Status*
Martial Status*
Occupation*
Driver's License Number / State*
Minor Convictions:
Major Convictions/DUI
Upload MVR
Drop files here or
Years of Boating Experience*
Experience 1.*
. . . .
Experience 2.
. . . .
Experience 3.
. . . .
Total Number of Registered Owners / LLC Members:*
Additional Owner / Operator Experience

8. Additional Insured or Loss Payee
Interest
Organization name
Name
Address
Street Address City State / Province / Region ZIP / Postal Code Country

9. Additional Information
Comments:
Additional Documents
Drop files here or
Email
This field is for validation purposes and should be left unchanged.