Dealer Application | Boater's Insurance Agency

Business Information

Name of insured

Street (mailing address)

Zip (5-digits)

City

State

How many years in business?

Select type of business

Current insurance carrier

Policy expiration date (mm/dd/yyy)

Contact person

Contact's email

Contact's phone

Contact's fax (optional)

Who is your mortgagee/landlord?

Mortgagee/landlord's address, city, state

If you have a Loss Payee, please name

Name and address of floorplan lender(s)

What is your floorplan limit per lender? ($)

Age/Construction/Protection

Street (location address)

Zip (5-digits)

City

State

How many miles are you from the fire department?

Is your local fire department paid or voluntary?

Are you the sole occupant? If no, please explain:

Building Details

Building #1

Year built

Type of construction

# of Stories

# Square Feet

Building Value/Limit ($)

Business Personal Property Limit ($)

Is there a centrally monitored burglar alarm? Yes No

Does the building have motion sensor lights? Yes No

Is the entire facility monitored by video cameras? Yes No

Is entire building sprinklered? Yes No

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Annual Sales For All Operations

Estimated new boat sales ($)

Estimated used boat sales ($)

Pro-shop/accessories sales ($)

Repair/service sales ($)

Storage sales ($)

Avg. inventory inside ($)

Avg. inventory outside ($)

Foreign sales ($)

Other sales/receipts ($)

Percent of sales from PWC (%)

Does the outside area has flood lights? Yes No

Is the outside area fenced-in? Yes No

Do boats stored on trailers have at minimum a ball and ring hitch lock? Yes No

Claim History

Have there been any losses or claims sustained in the last 5 years? Yes No

General Questions

Do you do any fiberglass repair? Yes No

Do store boats for others? Yes No

Do you offer dry rack storage? Yes No

Do you offer boat rentals? Yes No

Do you own a marina? Yes No

Do you have any fuel tanks onsite? Yes No

Is you dealership on a lake? Yes No

Do you loan boats to customers? Yes No

Do you sell any boats that are not manufactured in the U.S.? Yes No

Do you sell any watercraft capable of exceeding 50 mph? Yes No

Do you sell any custom, one-off design boats? Yes No

Do you sell any commercial watercraft? Yes No

Do you sponsor any charity/sporting events? Yes No

Do you want Business Interruption (BI) coverage? Yes No

Do you own any equipment or tools? Yes No

Are all demos performed by an employee of the dealership? Yes No

Average number of boat demos per month?

Average number of boat deliveries per month?

Are all deliveries by land? Yes No

Are any deliveries in excess of 50mi? Yes No

Are all deliveries handled by you/employee or a motor carrier with at least $100,000 in Motor cargo liability insurance? Yes No

How many NEW boats do you sell seach year?

How many USED boats do you sell seach year?

What is the highest value of any one boat? ($)

What brands of boats do you sell?

How many boat shows per year?

Max number of boats per show?

Total average value at one show? ($)

Are customers allowed in the repair/shop area? Yes No

Do you perform product testing after repairs? Yes No

Are there any guard dogs on the premises? Yes No

Assets to Insure

Are there any vehicles registered to the business that you need to insure? Yes No

Are there any boats registered to the business that you need to insure? Yes No