Heuston's Insurance Services

P.O. BOX 278

Tuckerton NJ,08087

Office: 609-812-1962

 "Free Quotes"  Low  Cost  Auto  Insurance

At Heuston's we offer Water Craft Insurance.

                                          

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Please provide the following complete information:

Name Date of Birth
Address Marital Status
City State Zip Yrs Boat Exp.
Work Phone Drivers Lic # 
Home Phone Any tickets or accidents:
FAX Ever convicted of DWI
E-mail

Boat, Trailer & Engine (s)

        Yr

Manufacturer

Model

Length in Feet

Value (current)
Boat   

Trailer

Manufacturer

Type (Outboard)

Horsepower

Age

Engine (s)

Safety Equipment: (check all that apply)                              Waters Navigated

VHF Ship to Shore Inland Lakes, Rivers & Streams
Atlantic Coast
Pacific Coast
Gulf of Mexico
GPS Depth Sounder
Loran Fume Detector
Alarm Halon System

Current Insurance Company (if none, state so)


Policy Expiration Date


# of claims in the last 3 years (if none, state so)

GIVE CLAIM DETAILS IN COMMENT SECTION

# of towing claims in 3 years


Insurance Coverage's   Include Motor value and Electrical Equipment
(if you don't have a policy currently, use the amount you paid for boat as the hull value, and discuss
your needs with the broker or agent)

Hull Uninsured Boaters Towing

Fishing Equipt

Medical Payments

Liability

Where is the boat stored in the winter?



Comments

Heuston's Insurance Services

P.O. BOX 278

Tuckerton NJ,08087

Tel: 609-812-1962

Fax: 609-812-1963

Email: tom@heustons.com

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 You will have peace of mind knowing your family and business are secure!