Marine/Property insurance specialists offer coverage from Class A rated carriers for boats and yachts of any size, charter boats, bluewater and brownwater hull and P&I, fishing boats, passenger vessels, as well as health insurance for captains and crew of vessels traveling internationally.

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Insurance Quote Form for
Boats, Yachts and Passenger Vessels Only

If you need a quote for another class of business, please call or fax Marine Underwriting, Inc.

For your personal marine insurance quotation, please fill out our form below.
Entry fields marked (Required) do require an input by you in order for this form to successfully submit.
Owners Information
Owner's Name (Required)

Address
 		Agency Name
Agency Phone
 		Agency Fax
City
 		State
 		Zip
Home Phone (Required)
Fax
 Owner DOB or Age
E-mail Address (Required)
Requested Effective Date
(mm/dd/yy)
 
Owners Experience
Courses Taken Member of:
Power Squadron Power Squadron Member
Coast Guard Auxiliary Coast Guard Auxiliary Member
   
Vessels Owned Owner or Captain Operated
# of years you have owned this vessel.

List other vessels owned
 (List year, length, manufacturer, model, and number of years owned)

Owner Operated or
Paid Captain Operated

If Captain Operated:
Captain's Name

Captain's Type of License

Total # of crew (including captain):

 
Boat Description
Year Length in feet Hull Material


Fiberglass
Aluminum 		Steel
Wood
Manufacturer / Model
 		Vessel Name
Type Vessel
Sportfish
Motoryacht
Megayacht 		Express Cruiser
Sedan Flybridge 		Sailboat
Trawler 		Liveaboard
Yes
No
Other
 		Date of Last Survey
 		In Water
Out of Water
 
Boat Equipment
Satellite Nav
Auto Fire System
Depth Finder
Security System
Fume Detector 		Generator
Compass
GPS
VHF Radio
Loran 		Single Side Band Radio
Radar
Chart Plotter
Weather Fax
Additional Items (Please list below)
Additional Equipment:
 
Engine(s)
# of
Engines
 		Year
 		Manufacturer / Model
 		Horsepower
Inboard Outboard Inboard / Outdrive Gas    Diesel
 
Watercraft Use
The insured vessel is used for:
Private pleasure use only
Private pleasure and charter
Charter only 		If charter, type is:
If other charter type:
# of Charters per Year:
Will the vessel used for racing?
Yes    No 		Max # of Passengers per Charter:
Will the vessel used for waterskiing?
Yes    No 		   
 
Mooring Location
Mooring / Storage Location (Address, City, State)
 		Lay-Up Period From:
 		To:
Navigation Limits Required
 
Tender ( inflatable dinghy, hard bottom dinghy, etc.)
Year
 		Length
 		Manufacturer / Model
Engine Type
 		Horsepower
 		   
Purchase Date
 		Price
 		Current Value
 		 
 
Trailer
Yes   No
Please Describe Below
 
Boat Coverage Information
Boat Purchase Price

 Date of Purchase

 Market Value of Hull
Liability Coverage

Towing

 Medical Payments

Deductible

 Personal Property

 Uninsured Boater

Equal to the Liability Coverage selected up to $2,000,000

 
Have you or this watercraft been involved in any accident, injury, or loss over the last five year?
Yes No    If yes; explain in detail below:
Thank you,

Please click on the "Send Application" button below.

For all your insurance needs, contact Marine Underwriting, Inc.

Mike Mercurio: (954) 427-1228 or (954) 592-0745
Licensed and E&O Insured

Home | Services | Get a Quote

Marine Underwriting, Inc.
5523 Lake Tern Ct. - Coconut Creek, Florida 33073, USA
Copyright © 2003 Marine Underwriting, Inc. - All rights reserved
Phone: (954) 427-1228 or (954) 592-0745    Fax: 954-698-6787
E-Mail: info@marineunderwriting.com