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Commercial Marine Quote

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Personal Information

Named Insured

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First Name

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Last Name

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Mailing Address

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Fax Number

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Website

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Company Information

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Type of Operation

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Physical Address

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How Long in Business

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# of Employees

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Current or Prior Insurance Carrier

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Policy Number

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Expiration Date

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Effective Date

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Prior Losses/Claims

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Gross Receipts

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Annual Payoff by Classification

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Do You Carry Workers Comp Insurance?

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Workers Comp Expiration Date

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Building Construction

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Security/Alarms

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Square Footage

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Year Built

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Tenant/Building Owner

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Building - Limit Requested

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Deductible for Building

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Contents - Limit Requested

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Floating Property/Docks - Limit Requested

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Deductible for Floating Property/Docks

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Loss of Income Floating Limit Requested

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Dock Construction

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Dock Year Built

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Inventory Limit

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In Transit Per Shipment Limit

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Inventory at Other Locations Limit

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Owned Vessels/Rental Boats

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Commercial General Liability Limit

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Marina Op Legal Liability Limit Requested: (non-owned vessels in your care, custody & control)

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Protection & Indemnity Limit Requested: (liability coverage on the water)

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Important Notice
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