Boat Insurance Quote

Please complete this form as accurately as possible in order to ensure the best possible estimate. If you would rather speak to a sales representative, please call us at 416-728-6806.

Name Name First Last
Age
Phone Phone - ### - ### ####
Email
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Years as owner of a boat:
NO.OF YEARS AS OPERATOR/CREW
BOATING EDUCATION & COURSES

BOATING EDUCATION & COURSES None Yes
Insurance ever cancelled:

Insurance ever cancelled: None Yes
Driving Record:

Driving Record: Clear Other
Previous Insurer:

Name of Previous Insurer, Policy # and expiry date
Boating Losses (last 3 years):

Boating Losses (last 3 years): None Yes
If Yes, Provide details of loss
Vessel Year:
Make:
Model:
Engine:
Length:
H.P:
Max. Speed:
Market Value:
Trailer Value:
Other:
Liability
The completion of this form is for quote purpose and does not provide any insurance coverage. We may require more information in order to provide a quote. This quote request contains some information about coverage offered but it does not contain all.

The completion of this form is for quote purpose and does not provide any insurance coverage. We may require more information in order to provide a quote. This quote request contains some information about coverage offered but it does not contain all. I agree