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Boat / Marine Quote
We follow the highest industry standards to safeguard the confidentiality of your personal information and secure the transmission of your information from your computer. Please fill out this form as completely as possible to ensure an accurate quote.

E-Mail:*Valid e-mail is required
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
City:*
State:*
Zip Code:*
Phone:*
Social Security Number: Not required, however we will be able to provide a more accurate quote
Current Carrier Information
Who is your current insurance carrier (not agency)?
Insurance Carrier Name:*
What is the expiration date of your current boat policy?
Expiration date:*mm/dd/yyyy
Years of Boating Experience?:*
Has the driver taken any safety courses?*
Yes
No
Safety Course Taken?*
Boat Information
Boat Info (Year, Make & Model):*
Serial # 1 / Hull ID:*
Registration #:
Hull Material:*
Type of Hull*
Length:*
Maximum Speed:*
Boat Use:*
Is trailer included in value of boat?:*
YES NO 
Motor Information: Year*
Make:*
Model:*
Horsepower:*
Inboard / Outboard / I/O:*
Gas / Diesel:
Serial #:
Trailer Information:
Year
Make:
Model:
Value:
Add a 2nd boat?*
Yes No 

Boat #2 (Year, Make & Model):
Serial # 2 / Hull ID:
Registration #:
Hull Material:
Length:
Maximun Speed:
Boat Use #2:
Is Trailer included in value off boat?
Motor Information: Year
Make:
Model:
Horsepower:
Inboard / Outboard / I/O:
Gas / Diesel:
Serial #:
Trailer Information: Year
Make:
Model:
Value:
Driver #1 Information
Driver Name:*
Date of Birth:*mm/dd/yyyy
Marital Status:*
Single Married Divorced Widowed 
Driver Social Security No: Not required, however we will be able to provide a more accurate quote
Residence Type:*
Own Home Rent Live With Parents 
Education:
Driver`s License No:*
List Boat Violations:*
List/Describe Any Accidents:*
Add a 2nd driver?*
Yes No 
Driver #2 Information
Driver Name:
Date of Birth:mm/dd/yyyy
Marital Status:
Single Married Divorced Widowed 
Driver Social Security No:
Residence Type:
Own Home Rent Live WIth Parents 
Education:
Driver`s License No:
Which car do you drive?
List Traffic Violations:
List/Describe Any Accidents:
Requested Coverage
Coverage is listed below as: per person/per accident/property damage.
Liability Coverage & Limits:*Person/Accident/Property
Unisured Coverage is listed below as: per person/per accident.
Uninsured/Underinsured Coverage:Person/Accident
Uninsured Property Damage:
Comprehensive/Other Than Collision
Deductible Boat #1:*
Deductible Boat #2:
Collision
Deductible Boat #1:
Deductible Boat #2:
Other
Towing Coverage:*
Yes No 
Comment or Questions:
In order to provide you with the most accurate quote possible, All in One Insurance Group will obtain your credit-based insurance score from a consumer reporting agency. If you decide to apply for a policy through an All in One Insurance Group Agent, we may obtain additional reports to verify the driving records of some or all persons to be covered under the policy, along with prior claims history reports of the named insureds, which may include information about other drivers in the household. Most automobile insurers use credit information, in conjunction with other factors, to calculate an insurance premium for new customers. Our use of this information will not have an effect on your credit history.
 

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