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8014 State Line Rd, Ste 105
Leawood, KS 66208
(855) WesleyK (937-5395)
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Mon - Fri: 9:00 - 5:00
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Boat Quote Form
Boat Quote Form
Step 1 of 2
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Information About You
Quotes are provided by email. Please fill out your information below and you will receive your Quote via email within two business days.
Name
*
First
Last
Email
*
Phone
*
Address
*
Street Address
Address Line 2
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What is your date of birth?
*
Date Format: MM slash DD slash YYYY
What is your boating education level? (Advanced education requires a Captain's License.)
*
Select
Basic
Advanced
How many years of boating experience do you have?
*
Select
0
1 - 3
4 - 5
5 or more
General Insurance Information
Quotes are provided by email. Please fill out your information below and you will receive your Quote via email within two business days.
Do you have an auto or home policy with us? (If you have other insurance policies, you could qualify for a credit.)
*
Select
None
Auto
Home
Boat
More than one
Is this vessel a jet ski or wave-runner?
*
Yes
No
Is this vessel used for Private Pleasure Use only?
*
Yes
No
Is this vessel chartered to others?
*
Yes
No
Is this a houseboat in a salt water/coastal area?
*
Yes
No
Have there been any boating losses in the last 3 years?
*
Yes
No
Is the principal operator over 25 years old?
*
Yes
No
Does the vessel go faster than 75 mph?
*
Yes
No
Are there more than 2 motor vehicle incidents per operator and/or 3 per household?
*
Yes
No
Have you ever had insurance canceled, declined or non-renewed?
*
Yes
No
Does any operator have any criminal convictions (ex., Arson, Burglary, DUI) within the past 5 years?
*
Yes
No
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