Tom Stanger Insurance
Boat / Watercraft Insurance Quote Form
First & Last Name:
Street Address:
City, State & Zip:
E-Mail Address:
Telephone:
Fax:
Current Insurance Information
Insurance Company Name:
Policy Exp. Date:
Premium Amt:
Term:
How long with current?
Boat Information
Boat Year:
Length:
Max Speed:
# of motors:
Manufacturer:
Registration #:
Purchase Price:
Present Value:
Hull construction:
Total Horsepower:
Engine:
Select..
Sail
Outboard
Inboard
In/Outdrive
Other
Trailer Year:
Trailer Value:
Trailer Make/Model:
Storage Address:
Protection & Indemnity Limits:
Select..
Less than $100,000
$100,000 - $300,000
$300,000 - $500,000
$500,000 - $1,000,000
Years Owning:
Years Experience:
Add any additional information that may assist us in your watercraft quote including coverages and/or coverage for yachts, personal watercraft or jet skis:
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