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REQUEST A QUOTE (BOAT)

Request a quote by completing the information below or click here to call us directly.

 

General Information

*First, Last Name:
*Street Address:
*City:
State: MI
*Zip Code:
*Day Phone:
Evening Phone:
Fax:
*E-Mail:
SSN:
Marital Status: Single Married
Do you have a checking account? Yes No

Check this box to grant our agency permission to secure your credit and/or claim history, for insurance purposes only, under the Fair Credit Reporting Act.
Boat

List operator first name, DOB, whether operator has completed Coast Guard Auxiliary/Power Squadron course
*Operator1:

 

No     Yes  
Operator2:

 

No     Yes  
Operator3:

 

No     Yes  
Boat currently insured? No     Yes  
Current Policy Expiration:
*Current/Desired Policy Deductible:
*Boat Type:
*Use:
*Vessel Storage Location:
*Waters Navigated:
*Used for racing?

Hull
*Make/Model:
*Type:
*Length:
*Estimated Market Value:
*Year Built:
*Max Speed in MPH:
Personal Effects:
Misc. Boating Equipment:

Engine(s)

*Engine1 Make:
*Year:
*Type:
*Fuel Type:
*Est. Value (O/B Only):
*Horse Power:

Engine2 Make:
Year:
Type:
Fuel Type:
Est. Value (O/B Only):
Horse Power:
Trailer? No     Yes  
If yes, Make and Value:

Liability:
Medical Payments:
Water Ski Medical Needed? No     Yes  
Any listed operator involved in boating accident within past 5 yrs; boat and/or equipment suffered damage within past 5 yrs; or any listed operator involved in auto accident or received moving traffic citation in last 3 years? No     Yes

Final Step
If you have completed all required fields, please enter your comments below (if any) and press the Submit Request button.  If you'd like to review your information one more time, click here to return to the top.

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