Pennsylvania auto, homeowners, and business insurance plans - free auto insurance quotes from BBIns-Online.com!
Insuring Pennsylvania Residents' Autos, Homes, Businesses and More, for Decades!
 
Discover What Others
Are Saying About B & B
Insurance Agency!

 
Pennsylvania auto insurance quote

FREE Auto Quote

FREE Homeowner Quote

FREE Motorcycle Quote

FREE Boat Insurance Quote

FREE Renters Quote

FREE Businessowners Quote

FREE Contractor Quote

FREE Life Insurance Quote

FREE Personal Umbrella Quote

24/7 Emergency Contacts

More About Our Agency

 
Download Our FREE Money-Saving Insurance Report Today!

8 Reasons You Should NOT Even Consider Doing Business With Another Insurance Agent or Direct Writer!
1) 12-Month GUARANTEE pricing.

2) FREE Bi-Monthly "Circle Of Safety" Exclusive V.I.P. Client Educational Information Newsletter.

3) "Spread The Word" Referral Rewards Program...We reward EVERYONE for referring others to us!

4) Talk and deal with REAL people who are LICENSED and advise you on how to get the most for your insurance dollar!!

5) 100% Exclusive satisfaction written TRIPLE Guarantee!

6) FREE New Client "Welcome Kit" and FREE Annual File Review Client Protection Checklist

7) FREE Client email safety "tip of the month" program.

8) A+ Rated, financially sound nationally recognized companies ONLY!


 
On-Line Boat & Jet Ski
Insurance Quote Form
One Simple Form - takes only 2-3 Minutes!
Your Personal Data

Your Name:
Street Address:
City:
State: (Must be Pennsylvania)
Zip Code:
E-Mail (REQUIRED):
E-Mail again for accuracy:
Phone:
Fax (optional):
 
Marital Status:
Single Married
Homeowner?
Yes No
 
Boat Currently Insured?
(If yes, list carrier, and # of years
continuous. If none, type N/C)
 
Is this Boat Co-owned?
(If yes, list all owners names)

OPERATOR INFORMATION #1
Name: Birthdate:
Sex (M/F): # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations, and approximate DATES of each in the fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

OPERATOR INFORMATION #2 (if none, leave blank)
Name: Birthdate:
Sex: # Years U.S.
 Licensing:
Be specific to tell if accidents are "at-fault" or "NOT-at-fault" - (carriers require proof on NOT-at-fault accidents); Also, be specific as to TYPE of violations in fields below:
Number & Type of Accidents last 3 years: Number & Type of MINOR violations last 3 years:
Number & Type of MAJOR violations last 3 years: Number of Years
Boating Experience:

VESSEL & UNDERWRITING INFORMATION
Year of Boat: Make & Model
(be specific):
 
Boat Length: Hull Type
(wood, Metal,
fiberglass, etc):
 
Max. Speed
(in MPH):		 Market Value: $
 
Engine Make: Engine Type:
(Inboard, I/O, Jet)
 
Engine Horse
Power:		 Fuel Type:
(Gas, Diesel, etc.)
 
Trailer Cov.
Needed?		 Yes No Yr./Make/Model
of Trailer:
 
Trailer Value: $ Where is boat
moored or stored?
 
Describe waters
boat taken on?		 Describe boat
general usage?
(fishing, ski, etc.)

VESSEL COVERAGES:
Limits of
Liability:		 $15/30 BI / 10 PD $25/50 BI / 15 PD
$50/100 BI / 25 PD $100/300 BI / 50 PD
$250/500 BI / 100 PD
 
Hull Coverage: NO Coverage $250 Deductible
$500 Deductible $1000 Deductible
 
Water Ski
Medical Coverage?		 Yes No   Uninsured
  Motorists Cov.?		 Yes No
 
Comments or Remarks:
(List additional drivers,
special coverages, etc. here)

Send my quotation via: E-Mail Fax
Regular Mail
Call me by Phone!

Thank you for filling out this form COMPLETELY!

We value your input as PRIVATE information. Every step has been taken to insure your privacy, security, and our intent is to release quote information only to you. We will not give your data to ANY other person or group for sales, marketing, or ANY other purposes. By checking the box below you agree to allow our agency to release this information via the method you have chosen, and to release us from any liability should this information be accidentally viewed by others. Our intention is to maintain your complete privacy.

Yes, I Agree. Please Send Me a Boat Quote NOW!

Click Button Below When Done

Please Click Only Once . . . May take up to 30 seconds!


Contact Us Today at:

Phone: (717) 520-9107
Fax: (717) 520-9308
1231 E. Chocolate Ave.
Hershey, PA 17033
E-Mail us: agent@bbins-online.com

 

     © 2009 Design by Insurance Web Sales - Our Privacy Notice