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As a full service independent insurance agency, Private Client Insurance Services can provide you with multiple insurance carrier options and quotes for your yacht or boat insurance needs from the major A-rated Marine Insurance Companies. Our yacht insurance clients benefit from the most competitive premium quotes in the industry.

To get a marine insurance quote, please complete as much information as possible on the form below. This basic information will provide us with what we need to quickly complete the process for you.

Personal Insurance
Contact Information
First Name .........................................
Last Name .........................................
Middle Initial ......................................
Address .............................................
City, St, Zip .......................................
Phone ...............................................
Cell ..................................................
Email ................................................


Boat / Yacht Information
Make .................... Model ...................
Year ............ Length ............. Construction Type ............
Hull Identification # .....................
Purchase Price ....................... Insured Value .......................
Has this Boat / Yacht been surveyed? ........... Date .......................


Engine Information
Year ..... Make ...... Serial# ......
Horsepower ... Speed ... Fuel ... Type ...


Trailer Information
Year ............ Make ............ Value ...............


Operators Information
Names DOB
00/00/00		 Occupation Drivers License # Experience
(years)

Does any operator have any violations on their driving record? ............................
If yes, explain ..........................................
Navigational Limits ....................................
Lay-up Period ...........................................
Prior Boats / Yachts Owned .........................
Boating Courses ........................................
Any Boating Claims in the last 5 years? ........






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Request for Evidence of Property Insurance




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