May 19, 2012
Basil-Voges Insurance

Boat Quote

Your Information
Name *
Phone
Email *
Address
City
State *
Zip Code
Date of Birth
Drivers License # *
Licensed State *
Boat Information
Year, Make & Model
Hull Value or Purchase Price
Length of Vessel
Hull ID #
Hull Material *
Year, Make and HP of Engine
Fuel Type Gas  Diesel
List Safety Gear
Insurance Coverage Requested
Amount of Hull Insurance *
Hull Deductible ....of Hull Value 1%  2%
Watercraft Liability $300,000  $500,000  other
Medical Payments ($2,000 up to $5,000)
Navigation Area
Navigation Period 8 months  12 months
Mooring or Marina
Mooring or Marina Address
If vessel is used commercially, please describe operation.
Operator Information
Year and Length of Prior Vessels
Years of Boating Experience
Loss Experience Past Five Years
Miscellaneous Information
Currently Insured By
Is Vessel for Sale? Yes  No
Purchase Price of Vessel $
* = Required Field
Send