Commercial Application : www.BoatingInsurance.com

American Marine Underwriters : Where boaters go for insurance!

American Marine Underwriters also has specialty coverages for Marina and Boat Dealers, Boat Manufacturers, Marine Contractors, Yacht Clubs, Ship Yards, and Ocean Cargo and Marine Liabilities. If you are interested in commercial insurance, please take a moment to fill out the questions below and a licensed broker will get back to you at your convenience.

Commercial Information : Fields marked * are required
Last Name :*
First Name :*
Address :*
City :*
State :*
Zip Code :*
Home Phone :*
Work Phone :
Fax Number :
Email Address :*
Physical Location if Different Than Mailing Address:*
How Many Years in Business ? :*
List of All Names and/or Owners: *
Current Insurance Carrier and Premium:*
Expiration Date
Current Premium
Any Claims in the Last 3 Years ?	If YES, Complete Loss Report.*
Vessel Data :
Builder :*
Year :*
Length :*
Hull Material :*
Horsepower and Fuel Propulsion :*
Type of Vessel:*
Engine Year:*
Engine Manufacturer :*
Hull Value:*
Trailer Data :
Trailer :*
Year :*
Manufacturer:*
Model :*
Value :*
Coverages :
Mooring Address :*	Same as home address
Lay-up Period :*
Lienholder :*
Navigation Limits Required : *
Total # of Crew for Each Vessel :*
Please Give Details if Any Pre-Employment Program Carried Out By Applicant for Any New Crew:*
Protection and Indemnity Limit Requested :*
Hull Deductible Requested :*
Please Describe Any Additional Information the Company May Need in Order to Properly Evaluate the Risk:*
Please Include the Following Items With This Application: A. Copy of All Captains Licenses B. Most Recent Survey For Each Vessel
Loss Report (all fields required)
Vessel Involved :
Date of Claim :
Description Status :
Gross Claim Paid/Reserved :
Insured Signature: Broker Signature:	Date: Date: