Free Boat & Jet Ski Insurance Quote for New York from Quote NY.com

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On-Line Boat & Jet Ski Insurance Quote Form One Simple Form - takes only 2-3 Minutes! Your Personal Data
Your Name:
Street Address:
City:
State:	MUST be New York!
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):

Marital Status: Single Married	Homeowner? Yes No

Boat Currently Insured? (If yes, list carrier, and # of years continuous. If none, type N/C)

Is this Boat Co-owned? (If yes, list all owners names)

OPERATOR INFORMATION #1

Name: Birthdate:

Sex (M/F): # Years U.S.
Licensing:

Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations, and approximate DATES of each in the fields below:

Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:

Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

OPERATOR INFORMATION #2 (if none, leave blank)

Name: Birthdate:

Sex: # Years U.S.
Licensing:

Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:

Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:

Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

VESSEL & UNDERWRITING INFORMATION

Year of Boat: Make & Model
(be specific):

Boat Length: Hull Type
(wood, Metal,
fiberglass, etc):

Max. Speed
(in MPH): Market Value: $

Engine Make: Engine Type:
(Inboard, I/O, Jet)

Engine Horse
Power: Fuel Type:
(Gas, Diesel, etc.)

Trailer Cov.
Needed? Yes No Yr./Make/Model
of Trailer:

Trailer Value: $ Where is boat
moored or stored?

Describe waters
boat taken on? Describe boat
general usage?
(fishing, ski, etc.)

VESSEL COVERAGES:

Limits of
Liability: $15/30 BI / 10 PD $25/50 BI / 15 PD
$50/100 BI / 25 PD $100/300 BI / 50 PD
$250/500 BI / 100 PD

Hull Coverage: NO Coverage $250 Deductible
$500 Deductible $1000 Deductible

Water Ski
Medical Coverage? Yes No Uninsured
Motorists Cov.? Yes No

Comments or Remarks:
(List additional drivers,
special coverages, etc. here)

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Terms of Use/Privacy Notice/Copyright Info. Spirit Insurance Agency. Design © 2006 Insurance-Web-Sales Please report site-related technical problems to: quotes@spiritinsurance.net (This page last updated August 2006) Spirit Insurance Agency 1161 Deer Park Avenue N. Babylon, NY 11703 Phone: 631-595-1200 Fax: 631-595-1240