Boat

Boat

Watercraft Insurance Quote

Information

Name:
E-mail:
Address:
Home Phone:
Work Phone:

Watercraft Information

Power:	Inboard Outboard Inboard/Outboard Waterjet Sail Other:
Type of Hull:	Cabin Cruiser Open Cockpit Sailboat Houseboat Other:
Hull Material:	Fiberglass Metal Wood Fiberglass
Year:
Manufacturer / Model:
Length:	FT.
Maximum Speed:
Date Purchased:
Present Value:	$
Berth / Storage Location:
Waters Navigated:

Engine / Outboard Motor Information

Year:
Manufacturer / Model:
Horsepower:
Fuel Type:	Gasoline Diesel
Purchased Date :
Cost New:	$
Present Value:	$
Other:

Trailer Information

Year:
Manufacturer / Model:
Length:
Present Value

Coverage

Portable Accessories Limit:	$
Liability Limit: (or protection & indemnity)	$
Medical Payments Limit:	$
Skiers Liability	$
Other:	$
Deductibles: (NOTE: Higher deductibles reduce your premium)	$
Number of Licensed Operators: (in the household)
Comments (List claims in last 3 years)

Contact Bankhead Insurance Agency

Phone: (214)343-1333

Fax: (214)343-3875

Email: info@insurancedallas.com

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