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Quote Type
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Name
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Today's Date
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Email Address
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Primary Residence
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Phone Number
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Prior Insurance Information
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Mailing Address
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You/Spouse had continuous Boat liability insurance for
past 6 months with no more than 30 day lapse in coverage
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Physical Address
(if different from
above)
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Prior Boat Insurance Limits
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Prior Boat Insurance Carrier
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Expiration date of current policy
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Social Security #
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Do you currently have another policy with Progressive or AIG?
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Driver Information
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Driver #1
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Driver #2
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Driver #3
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Driver #4
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Full Name
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Date of Birth
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Gender
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Marital Status
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Driver Status
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Relation
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License Status
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State Filing
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Violations
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License #
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License State
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Watercraft Information
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Watercraft #1
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Watercraft #2
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Watercraft #3
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Vehicle Type
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Year
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Make
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Model
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VIN #
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Hull Length
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Hull Material
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Number of Motors
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Propulsion Type
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Max Speed
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Total Horsepower
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Value of Watercraft
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Value of Trailer
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Watercraft Use
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Personal Effects
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On Water Towing
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Collision Deductible
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Comprehensive Deductible
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Roadside Assistance
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Coverages
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Bodily Injury/ Property Damage
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Uninsured Boater Coverage
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Medical Payments
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Additional Information about your Watercraft Quote
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