Date of Last Survey (if applicable): Boats / years, etc.): Owner’s Experience with ATV’s (5 years, 10 Type of (Pleasure, Power Squadron, USCGA, Other Education): Owner’s Experience Waters Navigated (Watercraft); (Inland, Atlantic, Pacific, Great Lakes, etc.): Terrain Navigated (ATV); (Hills, , Dunes, Rock, etc.): Storage (Summer) Location: Dry Wet Storage (Winter) Location: Dry Wet OTHER QUESTIONS (If Applicable) (Check Box Below (“x”) for Yes): Is The Boat Chartered To Others?: How Often?: Where To?: Duration: Purpose: Is The Boat Used Commercially or For Business Purposes?: Is The Boat Used for Racing?: How often?: Duration of Race: Is The Boat Used for Waterskiing?: How Often?: Does The Applicant Employ a Paid Crew?: How Many Full-Time: How Many Part-Time: Any Sleeping Facilities?: (Provide Number Of Beds): Any Existing Damage to The Boat?: Is The Boat Used as a Primary Residence?: Any Additional Owners Not Listed as The Named Insured?: EQUIPMENT (If Applicable) (Check for Yes): Box Below (“x”) Bilge Pump: Cooking Stove: Fume Detector: CO2 / Chemical Systems: Fire Extinguishers: How Many: Depth Sounder: Fish Finder: Radar: Radio Direction Finder: Ship-to-Shore Radio: Anti-Theft Devices: What Type: Heater: Air Conditioning: Refrigerator: TENDER / LIFE BOAT (If Applicable): VIN/Serial#: Year: Make: Model: Length: Continued on the next page… TRAILER (If Applicable): VIN/Serial#: Year: Make: Model: Length:
Date of Last Survey (if applicable): Owner’s Experience with Boats / ATV’s (5 years, 10 years, etc.): Type of Owner’s Experience (Pleasure, Power Squadron, USCGA, Other Education): Waters Navigated (Watercraft); (Inland, Atlantic, Pacific, Great Lakes, etc.): Terrain Navigated (ATV); (Hills, , Dunes, Rock, etc.): Storage (Summer) Location: Dry Wet Storage (Winter) Location: Dry Wet OTHER QUESTIONS (If Applicable) (Check Box Below (“x”) for Yes): Is The Boat Chartered To Others?: How Often?: Where To?: Duration: Purpose: Is The Boat Used Commercially or For Business Purposes?: Is The Boat Used for Racing?: How often?: Duration of Race: Is The Boat Used for Waterskiing?: How Often?: Does The Applicant Employ a Paid Crew?: How Many Full-Time: How Many Part-Time: Any Sleeping Facilities?: (Provide Number Of Beds): Any Existing Damage to The Boat?: Is The Boat Used as a Primary Residence?: Any Additional Owners Not Listed as The Named Insured?: EQUIPMENT (If Applicable) (Check Box Below (“x”) for Yes): Bilge Pump: Cooking Stove: Fume Detector: CO2 / Chemical Systems: Fire Extinguishers: How Many: Depth Sounder: Fish Finder: Radar: Radio Direction Finder: Ship-to-Shore Radio: Anti-Theft Devices: What Type: Heater: Air Conditioning: Refrigerator: TENDER / LIFE BOAT (If Applicable): VIN/Serial#: Year: Make: Model: Length: Continued on the next page… TRAILER (If Applicable): VIN/Serial#: Year: Make: Model: Length:
Watercraft-Insurance-Questionnaire.docx