Boatowners Insurance Quote
For California residents only.
Click the SUBMIT button to receive your free quote. Remember should you wish to speak to a live person you can always phone us at 888-MY-INS-GUY/888-694-6748 (M-F 8:00 - 5:00).
Customer Information
Name
E-mail
Street address
City
County
State
Zip Code
Home Phone
Work Phone
FAX
Boat Description
Make of Boat
Year Built
Boat Length
Present Hull Value
Purchase Date:
Hull Type
-- select --
Fiberglass
Wood
Territory
-- select --
Inland Lakes
Pacific Ocean
Class
-- select --
Type of Boat...Type of Power
Runabout.......Outboard or none
Runabout.......Inboard
Runabout.......Inboard/Outboard
Runabout.......Jet Drive
Cabin Cruiser..Outboard
Cabin Cruiser..Inboard
Cabin Cruiser..Inboard/Outboard
Cabin Cruiser..Jet Drive
Canoe,Dinghie..All
Sailboat.......Any Type of Supplemental Power
Sailboat.......None
Catamaran......Any Type of Supplemental Power
Catamaran......None
Houseboat......Outboard or None
Houseboat......Inboard
Houseboat......Inboard/Outboard
Pontoon........Outboard
Personal Watercraft....0-300 CC's
Personal Watercraft..301-500 CC's
Personal Watercraft..501-700 CC's
Personal Watercraft..701 & over
Personal Watercraft..Jet Drive Boat(under 16')
Components Description
Component
Make
Year
Value
HP
Inboard or In/Outboard
Outboard 1
Outboard 2
Trailer
Additional Rating Information
Simultaneous Motor Use?
Yes
No
Diesel Engine?
Yes
No
Automatic Fire Extinguishing System?
Yes
No
Additional Boat Equipment $
Personal Effects Coverage $
Maximum Speed (MPH)
Operators Age
Operator Class
Primary OPR Years Exp........Under 21 OPR?
3 or More Years...................No
More than 1 but less than 3.......No
1 or Less.........................No
3 or More.........................Yes
More than 1 but less than 3.......Yes
1 or Less.........................Yes
Boating Education
Organization................Course
U.S.Coast Guard.............Boating, Sailing & Seamanship
U.S.Coast Guard Auxiliary...Boating Skills & Seamanship
U.S.Coast Guard Auxiliary...Advanced Boating Classes
U.S. Power Squadron.........Boating (outboard,inboard,sail)
U.S. Power Squadron.........Advanced Boating Classes
Captain's License
NASBLA......................Boating Safety
Requested Coverages
Liability Limits
Medical
Physical Damage Deductible
-- select --
$100,000
$250,000
$300,000
-- select --
$1,000
$2,000
$5,000
-- select --
$50
$100
$250
$500
$1,000
$2,500
Have you had any losses within the last three years?
Underwriting Information
Current Insurance
Expiration Date
Ever Filed for Bankruptcy?
Yes
No
Is your Credit Rating?
Excellent
Good
Fair
Poor
Reporting Method
How would you like to receive
your free Boat Insurance quote?
U.S.Postal
E-mail
Fax
Home Page
|
E-Mail
Gary Jones Insurance Agency
CA License #0E22842
insure@iinsureit.com
508 Main Street
310-615-0940 Phone
888-MY-INS-GUY
El Segundo, CA 90245
310-615-0994 Fax
888-694-6748
