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Yacht Insurance Quote
We provide all types of marine insurance. We are only writing coverage on Yachts based in Florida.

If you would like to receive a quote for your yacht insurance, please fill out the entire form and submit.

This form is for vessels over 26'. If your boat is smaller, please use the Small Boat Quote form.
PART ONE - Personal Information  
Work Phone:    	
Home Phone:    	

Comments and Questions:

When was the boat purchased?:

What was the purchase price?:

Name of insurance company,
if currently insured:  

Have you had any prior boating losses or claims?
Yes  No
If "Yes", please explain:

Expiration date of insurance policy,
if currently insured:      

Boating Ownership Details: 
Please let us know the make, model and size
of the boats and yachts that you have owned.
Indicate the years that you owned them.

Birth Date of Principal Operator:
How Many Years Boating Experience?: 

Boating Experience Details: 
Please let us know the make, model and size
of the boats and yachts that you have experience
operating.  Indicate the years that you operated them.

Coast Guard or Power Squadron Course?:Yes  No

Has the Principal Operator been cited for
any traffic violations in the last 4 years?
Yes  No
If "Yes", please explain:

Your Boat or Yacht Information
Vessel Make:  	  	
Vessel Model:  	  	
Year Built:  	  	
Length (Feet): 	  	 
Engine Make:  	  	
# of Engines:  	  	
HorsePower (each):	
Is the boat on a trailer?  Yes  No
Auto/Halon or CO2 System?  Yes  No
Fume Detector?:	         Yes  No
CO Detector?:	         Yes  No

Check all that apply:
Loran             Radar
GPS/SAT           Compass
VHF               Life Raft
EPIRB             Depth Finder
Auto Pilot        Aux Generator
Theft/Fire Alarm  

Dinghy and Motor (If Applicable)
Do you have a dinghy?:   	       Yes  No
Value of Dinghy/Motor:   

Navigation Area: (Check all that apply)
Fresh Water       Salt Water
Bahamas           Other

Summer Mooring Location: 
Winter Mooring Location: 
Lay-Up Period: (If Any... Enter the Dates of Lay-up)

Total Value (Boat/Motors/Trailer):


Liability Limit 

Is the yacht a Liveaboard?  Yes  No
You may now:

American Marine Insurance Group 
P.O.Box 360875 
Melbourne, Florida  32936 
Phone:  321-254-3639 
Contact Form

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