Smithwick & Mariners Insurance, Inc.
Blackadar Marine Insurance
A Classic In The Field Of Marine Insurance
 
 
 
 

Boats & Yachts

Passenger Vessels | Commercial Marine | Professional Liability

 

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Use this form to submit a request for a no obligation price quote for your specific type of Marine Insurance.

To assure the timely and proper handling of your request, please indicate the type of vessel or insurance that would apply.

PLEASE CHECK WHICH TYPE APPLIES

 

Boats/Yachts - Minimum Value $25,000.00 Please

 

Passenger Vessels

 

Commercial Marine

 

Other

NOTE: A customer service representative will call you for an interview please let us know what will be a convenient time to reach you.....

Contact Information

First Name

Last Name

E-mail

Leave this field blank

Address

City                                         State   Zip-Code  

Day Phone

Home Phone

Fax No.

Cell Phone

As part of the underwriting process, some companies will utilize an insurance score based upon your credit history.  That insurance score may be used to underwrite and price your policy.  You have the right to be told the name and address of the reporting agencies that provide these reports.  You also have the right to review and correct your personal information.  This information may be disclosed as per our privacy policies to properly service your policy or to conduct business.

Would you like us to obtain quotes from all of our  companies including the ones that use credit history?

       
If you do not want us to utilize these companies, it may limit our options for quotations.
 

Vessel Information

Boat Mfg.

Model

Year Built

Length

No. of Engines

Horsepower Ea.

Boat Value Trailer Value Home Port
Engine Manufacturer
Top Speed (MPH)               
On Board Electronics
Auto Fire System Depth Finder UHF LORAN GPS
Liability Limit Requested             
Navigational Area
Lay Up Period: From (Month / Day) To (Month / Day)
Where and How is the Vessel Stored
List any Boating Courses Taken
Number of Years of Boat Ownership  
Make and Footage of Boats Owned Prior
 Have any Claims Been Filed in the Last Five Years? Yes No
If "Yes" was Answered to Prior Question Regarding Claims Please Explain

My Insurance Expires in:

This Vessel is for:

Please enter any comments, questions and/or additional descriptions.

Should we require additional information to complete your request, which form of communication would be most convenient?

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Formerly Blackadar Marine Insurance