[Breathe Watercraft Quote Form] – Breathe Insurance

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Watercraft Quote Form

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Your Information

Name
First Last
Email*
Phone
Watercraft Hull Information

Year*
Make*
Model*
Hull Number*
Registration Number
Watercraft Style*
Propulsion Type*
Inboard: The motor and drive train are inside the hull. Outboard: The motor is outside the hull. Inboard/Outdrive: The motor is inside the hull and the drive train is outside the hull. Sail: Equipped with sails but may have a motor. Waterjet: Jet powered boats. Manual: Canoe or kayak without a motor.
Outboard Year*
Outboard Make*
Outboard Model*
Outboard Value*
Outboard Serial Number*
Length (ft)*
Please enter a number less than or equal to 999.
Total Horsepower*
Please enter a number less than or equal to 999.
Hull Construction*
Hull ID Number*
Total Value Hull/Motor(s)*
Diesel Engine*
- Yes
- No
Purchase Date*
MM slash DD slash YYYY
Trailer Information

Do you want to insure your trailer?
Trailer Year*
Trailer Make*
Trailer Model*
Trailer Serial Number*
Trailer Value*
Underwriting Questions
Type of Storage*
Storage Location*
Street Address Address Line 2 City State ZIP Code
Is this watercraft rented or leased to others?*
- Yes
- No
Is this watercraft used for business purposes?*
- Yes
- No
Has this watercraft been previously salvaged?*
- Yes
- No
Is this watercraft used for permanent living quarters?*
- Yes
- No
Is this watercraft considered high performance?*
- Yes
- No
Is this watercraft used for water skiing?*
- Yes
- No
Is this watercraft homemade or a kit?*
- Yes
- No
Number of Motors*
Is the engine exposed (except outboard motors)?*
- Yes
- No
Is this watercraft owned by a Corporation?*
- Yes
- No
Do you have documents to Upload?

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Max. file size: 128 MB.
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