Marine Insurance Quote

Name:

Address:

City:

Province:

Postal Code:

Phone number:

Email:

Desired Policy Effective Date (if known):

Is this vessel used for Private Pleasure use only?:

YesNo

Private Pleasure use means used strictly for your own personal use only, and does not permit any commercial activities or chartering.

Would this vessel ever be used for any water sports?:

YesNo

eg. waterskiing, wakeboarding, tubing, etc.

Would this vessel ever be raced?:

YesNo

Is this vessel used as a live-aboard?:

YesNo

Do you have a recent Marine Survey?:

YesNo

Upload Marine Survey (if available):

Liability Limit Requested:

Boat Type:

Hull Construction:

Amount of Insurance on Hull & Machinery:

Please include full current market value of the hull and attached machinery & electronics, including inboard motors, in Canadian dollars. Do NOT include value of outboard motors or auxiliary motor, trailer, dinghy, or other personal effects not permanently attached.

Boat Manufacturer:

Model (if applicable):

Year Built:

Overall Length:

length (feet)

Beam:

Any onboard appliances? (indicate all that apply):

Stove
Refrigerator
Ice Box
Propane Appliance
Heater
Other

Date of Purchase:

Today

mm/dd/yyyy

Purchase Price:

Canadian $

Main Motor Type:

Twin Engine:

YesNo

Year of Main Motor:

Manufacturer & Model of Main Motor:

Horsepower:

Serial number of Main Motor:

Amount of insurance (Main Outboard Motor only) - for inboard motors, indicate N/A:

Canadian $

Fuel:

Gas
Diesel
Other

Maximum Capable Operating Speed:

Is the HP within the maximum as specified by the Transport Canada compliance notice:

YesNo

Auxiliary Motor Type:

Year of Auxiliary Motor:

Manufacturer & Model of Auxiliary Motor:

Horsepower:

Serial number of Auxiliary Motor:

Amount of insurance (Auxiliary Outboard Motor Only):

Canadian $

Fuel:

Gas
Diesel
Other

Trailer:

YesNo

Make and model of trailer:

VIN of trailer:

Amount of insurance on trailer:

Canadian $

Tender/Dinghy:

YesNo

Year of Tender/Dinghy:

Length of Tender/Dinghy:

length (feet)

Serial Number of Tender/Dinghy:

Current Market Value of Tender/Dinghy:

Canadian $

Is Tender/Dinghy used as separate pleasurecraft?:

YesNoN/A

Is Tender/Dinghy used for waterskiing?:

YesNoN/A

Is Vessel moored?:

YesNo

Where is Vessel normally moored?:

Where is Vessel normally kept when not moored?:

For Vessels moored year-round, indicate N/A

Full Name of Primary Operator (PO):

Primary Operator Date of Birth:

Today

mm/dd/yyyy

How many years has PO been an owner of a vessel?:

What is the largest size of vessel owned by PO in the last 5 years?:

length (feet)

What is the largest size of vessel ever owned by PO?:

length (feet)

What is the largest size of vessel ever operated by PO?:

Boating Education (indicate all that apply):

Pleasure Craft Operators Card
Power Squadron Course / CYA
Masters or Captains Ticket
Pilot
Other

If there will be ANY other operators, we will require answers to all of the questions above for each additional operator.:

You can input additional operator information here.

Have you or any operator had any boat losses?:

YesNo

If yes, please provide complete details, including date of loss, cause, total amount of loss, and the name of the insurance company

Loss Details:

Have you or any operator ever had any suspensions, revocations, convictions, or criminal code charges related to driving OR boating?:

YesNo

Has any company ever cancelled or refused boat insurance?:

YesNo

Upload photos of vessel (if available):

Security code:

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Marine Insurance