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Boat Insurance

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Boat Insurance Quote Application

Name

City/Province

Phone Number

Policy Effective Date

Boat Type

Amount of insurance on boat

Year built

Main Motor

Year of motor

Maximum Speed of Motor

Twin engine?

Yes

No

Year of trailer

Amount of insurance on trailer

Courses & Level Completed:

Address

Postal Code

Email

Liability Limit Requested

$1,000,000

$2,000,000

3,000,000

4,000,000

Boat Manufacturer

Overall length

Construction

Horsepower

Amount of insurance on motor:

Trailer?

Yes

No

Make and model of trailer:

Years operated

Years owned

Loss Details:

Has any company ever cancelled or refused insurance of this description:

Thanks for submitting!

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ADDRESS

PO Box 179
3 South Water Street
Coboconk, ON
K0M 1K0

PHONE

Phone: 705-454-3387
Toll Free: 800-250-8844
Fax: 705-454-1998

EMAIL

info@bryantinsurance.ca

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