Boat Quote

Our Policy is to Serve You

Details Required

Name of Insured(s)

Phone Number

Email Address

Date of Birth (Applicant)

Date of Birth (Co-Applicant)

Year

Construction Material

Make

Value

Model

Classification (fishing, cruiser, pontoon, etc.)

Length (ft.)

Registration No.

Year

Top Speed

Make

Horsepower

Inboard/Outboard

Value

VIN

No. of Engines

Habitational Policy With Rempel Insurance?

Yes

Used in Atlantic or Pacific Coastal Waters?

Yes

Normal area(s) of use

Location of mooring or storage

Please Provide 3 Year Insurance History Details

Additional Usual Operators?

Yes

If Yes, please state who and their boat insurance history

Comments / Questions