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Boat Insurance
Name:
Email Address:
Age:
Address:
City:
Province:
Postal Code:
Phone Number:
Policy Effective Date:
Liability Requested:
Boat Type:
Amount of insurance on boat:
Boat Manufacturer:
Year Built:
Overall Length:
Main Motor:
Construction:
Year of motor:
Type of motor:
Manufacturer:
Horsepower:
Maximum speed of motor:
Amount of insurance on Motor:
Twin Engine:
Yes     No
Trailer:
Yes     No
Year of trailer:
Make and model of trailer:
Amount of insurance on trailer:
Years operated:
Years owned:
Courses & Level Completed:
Loss Details:
Has any company ever cancelled or
refused insurance of this description?
Yes   No
 

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