home  |  about us |   privacy  |  locations  |  questions?



Boat & Personal Watercraft Insurance Quote

First & Last Name:  
Street Address:  
City, State & Zip:  
E-Mail Address:  
Telephone:  
Fax:  

Current Insurance Information
Insurance Company Name:  
Policy Exp. Date:  
Premium Amt:  
Term:  
How long with current?  

Boat Information
Boat Year:  
Length:  
Max Speed:  
# of motors:  
Manufacturer:  
Registration #:  
Purchase Price:  
Present Value:  
Hull construction:  
Total Horsepower:  
Engine:  
Trailer Year:  
Trailer Value:  
Trailer Make/Model:  
Storage Address:  

Protection & Indemnity Limits:  

Years Owning:  
Years Experience:  

Add any additional information that may assist us in your watercraft quote including coverages and/or coverage for yachts, personal watercraft or jet skis:
Note: By submitting this form you understand that no coverage is bound until you receive written notice. You also agree to release us from any liability if this information is accidentially viewed by unauthorized others. We will only use this information for insurance quoting purposes and not distribute to other parties.

Image Validation:
Please enter the characters
in the image to the right.
All letters are lowercase.
Image Validation
Characters:




Map to 1301 York Rd. #702, Lutherville , MD 21093  |   Tel: 410-339-7400  |  Email Us at kwhite@wetzelandlanzi.com
Copyright © 2008 Wetzel & Lanzi, Inc.  We are licensed in the following States: Maryland
home  |  personal  |  commercial  |  life/health  |   online quotes  |   our companies  |  support services   |  contact us   |  questions?  |  privacy  |  site map