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Online Boat Insurance Quote
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Your Name
(required)
Address (must be Maryland)
Email
(valid email required)
Website
Phone
Fax
Marital Status
Married
Single
Homeowner?
Yes
No
Boat Currently Insured? (If yes, list carrier, and # of years continuous. If none, type N/C)
Is This Boat Co-Owned?
Yes
No
Operator Information #1
Name
Birthdate
Sex
Male
Female
# Years with U.S. License
Number & Type of Accidents last 3 years:
1
2
3
4 or more
Number & Type of MINOR violations last 3 years:
1
2
3
4 or more
Number & Type of MAJOR violations last 3 years:
1
2
3
4 or more
# of years Boating Experience
Operator Information #2
Name
Birthdate
Sex
Male
Female
# Years with U.S. License
Number & Type of Accidents last 3 years:
1
2
3
4 or more
Number & Type of MINOR violations last 3 years:
1
2
3
4 or more
Number & Type of MAJOR violations last 3 years:
1
2
3
4 or more
# of Years Boating Experience:
Vessel and Underwriting Information
Year of boat:
Make & Model:
Boat Length
Hull Type:
Hull #(if available)
Max. Speed (in MPH)
Market Value: ($)
Engine Make:
Engine Type: (inboard, I/O, Jet)
Outboard Motor Serial # (if available)
Engine Horse Power
Fuel Type:
Trailer Coverage Needed?
Year/Make/Model of Trailer:
Trailer Value:
Address/Marina where boat is moored/stored:
Describe waters boat is taken on.
Describe boat general usage (ski, fish, etc.)
Vessel Coverages
Select Liability Limits
$15/30 BI / 10 PD
$25/50 BI / 15 PD
$50/100 BI / 25 PD
$250/500 BI / 100 PD
Hull Coverage:
$250 DED
$500 DED
$1000 DED
No Coverage
Uninsured Motorists Coverage?
Yes
No
Water Ski Medical Coverage?
Yes
No
Comments or Remarks (list additional drivers, special coverages, etc.)
Vehicle #2 Information(if none, leave blank)
Year of vehicle:
Make & Model:
Vehicle ID#(for rating accuracy):
Annual Mileage:
Used in Business? If yes, explain.
Vehicle #2 Coverages
Select Liability Limits---Limits must match vehicle #1
Select Comprehensive Deductible:
$100 DED
$250 DED
$500 DED
$1000 DED
No Coverage
Select Collisions Deductible
$100 DED
$250 DED
$500 DED
$1000 DED
No Coverage
Uninsured Motorists Coverage?
Yes
No
Rental Car & Towing Coverage?
Yes
No
Medical and/or PIP Coverage?
Yes
No
Coments or Remarks
if more than 2 vehicles or drivers, list additional vehicles' year, makes and models, driver's ages and driving records here:
Thank you for filling out this form COMPLETELY!
We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.
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Contact Information
Hours
9am-5pm, M-F
Address
696 Ritchie Highway
Severna Park, MD 21146
Phone:
410-544-3422
1-800-544-3164
info@moraninsurance.com
Fax:
410 544 6834