Fraser Yacht Insurance Quote Request
Please complete the form with as much information as possible and submit. An Account Manager will be contacting you promptly to present a quotation or discuss your risk in more detail. For immediate assistance, please call us at
1-800-228-6779
.
*
Registered Owner
Beneficial Owner (if applicable)
Contact Person (if different than above)
Address
Address 2
City
State
Zip
*
Phone
Fax
*
Email
Date of Birth
Occupation
Vessel Manufacturer
Year Built
Length
Type (MY, Sail, Power)
Maximum Speed
Hull Material
Mast Material
Number of Engines
Make of Engines
Engine HP (Each)
Engine Fuel
Auto Extinguish System
Yes
No
Tender Description
Vessel Purchase Date
Vessel Purchase Price
Number of Years Boating Experience
Previous Boats Owned
Have you had any marine losses/claims?
Yes
No
If yes, explain below in Additional Comments Section.
Date Last Surveyed
Number of Paid Crew
Primary Moorage Location
Marina Name
Marina City
Hull Value/Limit
Desired Deductible
P&I / Liability Limit
Personal Effects Limit
Tender & Outboard Value
Navagation Area
Do you plan to charter?
Yes
No
Do you require war risks?
Yes
No
Additional Comments
Subscribe to our e-newsletter
Yes, please keep me informed
*
Indicates Response Required