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Products
- Personal Lines
- Commercial Lines
About GMIA
Contact
Agents

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Global Marine Insurance Agency

Agent Quote

"*" indicates required fields

Boat & Contact Information

Boat Year*

Make*

Model*

Purchase Price / Insured Value*

Name*

First Last

Address*

Street Address City State ZIP Code

Email*

Phone*

Referring Dealership or Company

Name of Referring Dealership

Contact Information

Phone

Email

Owner / Beneficial Owner Information

Date of Birth

Month

Day

Year

Driver's License Number*

Marital Status*

Home Ownership*

Gender*

Mailing Address (if different)

Street Address City State ZIP Code

Vessel Information

Length of Vessel*

Length in feet

Hull ID

Number of Engines*

Requested Effective Date*

Month

Day

Year

Purchase Date*

Purchase date or financial loan closing date

Month

Day

Year

Maximum Speed (mph)

Horsepower Each Engine

Engine Type

Hull Material

Fuel Type*

Owner Experience & Loss History

Has the applicant previously owned other watercraft?*

Yes

No

Previous Watercraft Owned

Make(s)

Length(s)

Number of Years Owned

Previous Operating Experience

Has the applicant previously operated other watercraft?*

Including family, friends and rental boats.

Yes

No

Previous Watercraft Operated

Make

Length

Number of Years Operating

Claims & Loss History

Any boating claims/losses within last five years?*

Yes

No

Loss Details

Date of Loss

Month

Day

Year

Cause of Loss

Amount of Loss (USD)

Nature of Loss

Driving Violations

Any driving violations in past 5 years?*

Yes

No

Violation Details

Operator Name

First Last

Date of Violation

Month

Day

Year

Violation Description

Additional Experience, Claims or Violations

If the applicant has owned more than one boat or has had additional claims or driving violations in the past 5 years, provide details.

Additional Details

Mooring, Navigation & Vessel Use

If marina or storage facility, please include the name of the business.

Requested Navigation Territory

Types of Storage

Mooring Address

Street Address State

Vessel Use

Private Pleasure

Charter (6 pack)

Charter (Bare Boat)

Live-aboard

Loss Payee Information

Loss Payee

Address

Street Address City State ZIP Code

Trailer Information

Trailer Year

Trailer Make

Trailer Serial

Engine Information

Engine #1 Year

Engine #1 Make

Engine #1 Serial

Engine #2 Year

Engine #2 Make

Engine #2 Serial

Coverage Options

P&I Liability

Medical Payments

Uninsured Boater

Personal Effects

Towing Coverage

Trailer

Additional Information

Additional Comments

Any Relevant Files

Drop files here or

Accepted file types: pdf, jpg, jpeg, png, doc, docx, Max. file size: 50 MB, Max. files: 5.

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Locations:

Traverse City, Michigan
Seattle, Washington
Merced, California
Miami, Florida

Resources:

Boat Insurance Basics

Insurance Definitions

FAQs

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Regional Boating Guides

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Compensation Disclosure

When clicking on any of the Legal links, you’ll be redirected to Specialty Program Group, LLC’s website which is the holding company of Global Marine Insurance Agency.

Clear Marine Risk Solutions, a Division of Specialty Program Group LLC Doing business in California as SPG Insurance Solutions License No. 0L09546.