Full Name:            
Mailing Address:
City:
Florida
Zip Code:
Email Address: (Required) 
Home Phone:   Work Phone:   Ext.
How to Contact You:       Cell Phone:
Date of Birth:              (mm/dd/yyyy)
Gender:         Marital Status:
Current Insurance Company: 
Policy Expiration Date:          (mm/dd/yyyy)

Florida Boater Information:

  Boat       Year          Builder               Model            Vessel Type     Length
     1        
     2        

Boat Engine Information:
  Boat       Year       Engine Type       Manufacturer         # of Engines   Engine HP
    1            
    2            

Boat Trailer Information:
  Boat       Year          Builder               Model                Value
     1          
     2          

Mooring/Storage Location
  Boat
     1      
     2      

What types of safety equipment is on your vessel(s)?
(check as many boxes as desired)
  Boat
     1   VHF    Depth Finder    SAT NAV    Auto Halon
          EPIRB    SSB    GPS    Radar
          Loran    CO-2    Fume Detector    Other
     2   VHF    Depth Finder    SAT NAV    Auto Halon
          EPIRB    SSB    GPS    Radar
          Loran    CO-2    Fume Detector    Other

Value of waterskiing and/or fishing equipment:

Is boat used on any private lakes?
  Boat
     1      
     2      
Is boat used outside U.S. coastal waters?
  Boat
     1      
     2      

Is this a promotional/Memo boat?
  Boat
     1      
     2      

Is boat used for guide service or chartering?
  Boat
     1      
     2      

Is boat used for residence?
  Boat
     1      
     2      

Is boat used for waterskiing?
  Boat
     1      
     2      

Is your driving record accident & violation
free during the past 5 years?
 
If No, how many accidents?    How many violations? 

Boat Insurance Coverages Desired For?
(check as many boxes as desired)
Boat(s)    Motor(s)    Equipment    Trailer

Florida Boat Insurance Coverage Information:

                    Liability                  Uninsured
  Boat    Limits(x $1,000)      Boater(x $1,000)       Medical
     1                     
     2             SAME                       SAME                   SAME

                   Collision         Comprehensive
  Boat       Deductible           Deductible
     1             
     2             
List any boating safety education courses completed:


Any boating claims of losses to vessel(s) or
from liability in the past 5 years?

Description of losses:


Additional Information or Comments


Click on the "Submit Quote Information" button below to
send your Florida Boat insurance quote request.**


**Information received from this Florida Boat Insurance quote request form sent to FCI Insurance Agency will be for our use only and will not be sold, given to or distributed to any other parties. A quote will be based on the Florida boat insurance policy information provided and does not guarantee acceptance of the risk by us. The precise coverage afforded is subject to meeting underwriting guidelines, and the terms, conditions and exclusions of the policy as issued. By submitting this request you acknowledge that this is neither an offer to insure nor a guarantee of insurance. Completion of this form does not entitle you to a Florida Boat Insurance policy. We are licensed in Florida and will not provide boat insurance quotes for other states.


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FCI Insurance
Agency of Davie, FL
offers affordable and
experienced personal
insurance coverage
services throughout
Florida.
We are a Davie, FL insurance agency offering affordable Florida boat
insurance quotes to residents of the following cities and counties: Coral
Springs, Fort Lauderdale, Parkland, Coconut Creek, Margate, North
Lauderdale, Lighthouse Point, Hillsboro Beach, Deerfield Beach, Boca
Raton, The Hamptons, Highland Beach, Weston, Plantation, Playland Isles,
Melrose Park, Lauderhill, Sunrise, Tamarac, Wilton Manors, Oakland Park,
Lauderdale Lakes, Sea Ranch Lakes, Villages of Oriole, Pompano Beach,
Lauderdale-by-the-Sea, Boca West, Delray Beach, Boca Pointe, Boynton
Beach, Lantana, Rainbow Lakes, Atlantis, Lake Worth, Miami, South Palm
Beach, Palm Springs, Greenacres, Wellington, Haverhill, Palm Beach,
Golden Lakes, Riviera Beach, Glen Ridge, West Palm Beach, Lake Park,
Royal Palm Beach, Jupiter, Juno Beach, North Palm Beach, Loxahatchee,
Belle Glade, Palm Beach Shores, South Miami, Cutler Ridge, Princeton,
Perrine, Naranja, Homestead, Florida City, Leisure City, Richmond Heights,
Pinecrest, Howard, Coral Way Village, Westchester, Westwood Lakes,
Brownsville, Sweetwater, Key Biscayne, North Bay Village, Miami Beach,
Miami Springs, Virginia Gardens, Hialeah, El Portal, Miami Shores, Medley,
Indian Creek, Surfside, Bal Harbour, North Miami, Biscayne Park, Pinewood
Park, Opa Locka, Bunche Park, Hialeah Gardens, Palm Springs North,
Carol City, Norland, Ojus, Miami Lakes, Biscayne Gardens, Hallandale,
Sunny Isles Beach, Golden Beach, Aventura, Uleta, Miramar, Pembroke
Pines, North Miami Beach, Hallandale Beach, Ives Estates, Pembroke
Park, Coral Gables, Kendall, Dania Beach, Cooper City, West Miami,
Hollywood, Broward County, Palm Beach County, and Miami-Dade County,
FL. We can also offer affordable Florida boat insurance quotes throughout
the Sunshine state, including in Orlando, Tampa, St. Petersburg, Sarasota,
Tallahassee, Gainesville, and Jacksonville, FL.
We can provide affordable Florida Boat Insurance
coverage throughout the Broward County area!
Applicant Information:
Florida Boat
Insurance Terms
Your Florida Boat
Insurance Quotes Source
FCI Insurance Agency
& Auto Tag Service
8230 Griffin Road
Davie, Florida 33328
Broward County FL
(954) 434-6515
Fax: (954) 434-6524

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