Boat & Yacht Insurance Quote - Bertram Insurance Service

Fill out the form for a competitive quote on your boat, yacht or watercraft.

Personal Information

First Name*

Last Name*

Email Address*

Phone Number*

Address*

City*

State*

Zip Code*

Residence*

Applicant is titled owner*

If no, explain

Applicant's current employer & occupation*

Prior insurer*

Vessel Information

Year*

Make*

Model*

Type*

Length (feet)*

Approximate Value*

Purchase Date*

Hull Type*

Propulsion*

Hull Material*

Safety Equipment

Engine Information

Number of Engines*

Total Horsepower

Trailer Information

Has Trailer*

Year

Manufacturer

Model

Value

Tender Information

Has Tender*

Decription

Value

Navigation Limits & Usage

Describe Intended Navigation Limits*

Usage*

If Charter, how many per year?

# of Paid Crew

Operating Period*

Marina name & address *

Primary Operator Information

Name*

Date of birth*

Years of boating experience*

Years of boat ownership*

Driver's License Number*

License state*

Prior Vessels Operated

Year*

Length*

Manufacturer and model*

Dates operated*

Owned*

Year

Length

Manufacturer and model

Dates operated

Owned

Year

Length

Manufacturer and model

Dates operated

Owned

Licenses obtained or boating courses completed:

Describe ALL prior Marine Losses. If none, state "None" List and describe all motor vehicle violations/accidents in the past three years for this operator.

Loss Payee/Lienholder Information

Name & address

Additional Interest Information

Name & address

Explain interest

Eligibility Questions

Have the yacht or engine(s) been modified or altered from their stock condition?*YesNo

Is this yacht currently up for sale?*YesNo

During the past three years, have any operators had their driver's licenses suspended, revoked or refused?*YesNo

During the past three years, has any operator had any boat or automobile insurance canceled, been refused issuance or renewal, or received notice of such intent? If Yes, please explain below:*YesNo

Have the owner(s) or any operator(s) ever been convicted of a felony? If yes, explain below:*YesNo

Survey upload

Vessels over 10 years old must have an out of water survey that has been completed in the last 6 months.

Requested Insurance Limits

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Additional Information

Please provide any additional information or requests for your quote