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Request a Quote - Boat

Please fill out this form as completely as possible to ensure an accurate quote. After reviewing the information an Account Manager will contact you. If you have questions please contact us.

Alaska USA Insurance Brokers protects your confidential information as outlined in our privacy statement, and the information you provide is sent to us over a secure encrypted connection.

Contact Information
Name: *
Mailing Address:
Street

City

State

Zip
Please provide an email address or phone number *
E-mail Address:
Daytime Phone:
Contact Method:  Please call me with quote premium.
 Please send quote via e-mail.
Instructions:
  1. Complete the form as thoroughly as possible
  2. Items marked with * are required
  3. The information you provide in this form will be used to prepare a quote for you
  4. Please allow 48 hours (weekdays) to be contacted
  5. For business quotes, you will be contacted within 72 hours

Contact us with questions.

Description of Property:
Motor type * Number of Engines *
Boat Type * Other Boat Type
Fuel * Maximum Speed *
Hull Material * Other Hull Material
Insured Watercraft:
Boat
Model Manufacturer Year
* * *
Serial Number Length TotalHP
* * *
Outboard Motor
Model Manufacturer Year
Serial Number TotalHP
Trailer
Manufacturer Serial Number Year
Coverages & Limits:
Boat (Including Auxiliary Equipment, please break down o/b information)
Outboard Motor 1 (ACV Coverage)
Outboard Motor 2 (ACV Coverage)
Boat Trailer
Personal Property($500 Automatic)
Commercial Towing($400 Automatic)
Boat Liability(ACV Coverage)
Medical Payments($1000 Automatic with Liability)
Uninsured Boater
Optional Coverages
Agreed Value Endorsement YesNo
Actual Cash ValueYesNo
Fishing EquipmentYesNo  Limit:  
Safety Equipment: Check all that apply:
GPS Yes No Automatic CO2 (Halon) Yes No
Ship to Shore Radio (VHF) Yes No Depth Sounder Yes No
Electronic Burglar Alarm Yes No Radar Yes No
Plotter Yes No EPIRB Yes No
Vapor Detector Alarm Yes No
Primary Operator Information:
Date of Birth *
Years of Boating Experience: *
Secondary Operator Information:
Date of Birth *
Years of Boating Experience: *
Waters to be Navigated:
Inland waters of the following states:
Coastal waters of the following states:
Is the boat chartered or used for anything other than private purposes? Yes No*
Previous Loss Information:
Please describe any losses or claims filed on your Boat Insurance in the last 3 years. Include the following information: date of loss, type of loss and amount of claim.
Additional Comments:
Please use the box below to enter any additional information you wish to include.