Boat Insurance

Luxury Yacht Insurance

INET Insurance
27594 Detroit Road
Westlake, Ohio 44145

Phone 1-440-808-0706

Phone toll free 1-800-797-INET
 ( 4638 )

Fax 1-440-871-5672

Ohio Yacht & Boat Insurance

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Please fill out the form below to the best of your ability. If you feel any of the information requested would not be needed feel free to leave the space blank and then click on submit or fax to:
INET Insurance at 440-871-5672.

Or for immediate assistance please call.

Phone toll free 1-800-797-4638

Phone               1-440-808-0706

USA Country Code is 011

OWNER INFORMATION
Name:
Address:
City:
State:
Zip:
Date of Birth:
Present Insurance Company:
Exp Date:
Premium:
Work Phone:
Home Phone:
Fax:
Email Address:
Occupation:
Years of Boating Experience:
Length and Make of Previous Boats Owned:
Courses & Membership:	USPS USCG ACBS Yacht Club
Motor Vehicle Driving Record, Past 5 Years:
BOAT INFORMATION
Vessel:	Year: Length: Make: Model:
Hull Material:	Fiberglass Wood Steel Aluminum
Max. Speed of Vessel:
Engines:	Number: HP (Each): Eng. Mfg.: GasDiesel IBOBIOJet Drives
Equipment:	VHF Depth Finder Loran GPS Radar Burglar Alarm Auto Fire Ext.
USE OF BOAT
Use:	Pleasure Charter
Mooring Location:	City: State: Name of Marina:
Navigation:	Atlantic Gulf Great Lakes Chesapeake Pacific Bahamas Caribbean Inland Waters - State of: Other - Explain:
Layup Dates From/To:	-
Losses:	Date, Type & Amount Paid:
COVERAGE REQUESTED
Coverages:	Hull & Equipment Value: Deductible: 1% 2%
P&I Liability:	$100,000 $300,000 $500,000 $1,000,000 $2,000,000
Paid Crew:	Yes No Number:
Trailer:
Dinghy/Tender:
Survey Available:	Yes NoSurvey Date
Vessel Purchase Date:
Purchase Price: