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TIDE CHART
 
Boat/Trailer Quote Form
Boat Owner's Name
Driver's Date of Birth
Driver's License #
Driver's Mailing Address
Mooring Zip
Home Phone #
Work Phone #
Cell Phone #
Best # to Call and Time
Email address
Watercraft Title
Watercraft Year, Make and Model
Watercraft Vin #
Hull Material
Hull Type
Bass
Cruise-Power
Houseboat
Multi-Power
Multihull-Sail
Personal Watercraft
Pontoon
Runabout
Sail
Trawler
Number of Motors
Liability Requirements
Total Horsepower
Engine
Single
Twin
Other
Diesel
Gas
Propulsion Type
Outboard
Inboard/Outboard
Inboard
Jet
Power
Non-power
Does the boat have an exposed engine?
yes
no
Boating Clubs
Maximum Speed
Rating Base *
Trailer Year, Make, Model and vin #
Original Owner
yes
no
Watercraft Use
Pleasure use exclusively
Racing/speed contest-sail only
Business/Commercial Use
Rented or leased to others
Live-aboard/primary residence
Multi-owner
yes
no
Idle assisted stearing device installed on this personal watercraft
yes
no
Violations
Prior Watercraft Insurer and Expiration Date
Boating Experience
Boating Safety Course
yes
no
Boat Location
Rack Storage
At Dock
On Trailer
On Mooring *
Marina Name or Boat Location (address)
Date of Inquiry
Other Information (additional drivers, mooring, etc.)
Area of Navigation
Summer, Winter, Spring Storage
Survey Available
Yes
No
 
 
*Definitions:
 
Rating Base:  
 
The definition of value of watercraft
(or rating base) depends on the type of physical damage coverage selected: 
 
For Total Loss Replacement/Purchase Price coverage, value of
watercraft = Purchase price, including tax and title fees. 
 
For Agreed Value coverage, value of
watercraft = Current market value, not including tax and title fees. 
For Cash Value coverage, value of watercraft = Current market value.
 
* Mooring:  Please include mooring address in Other Information Field.