Welcome
We Care
Services
   Home
   Auto
   Life
   Marine
   Business
Hammock Clients
Companies and Claims
Get A Quote
About The Owner
Contact Us
Directions
FAQ

Kopec Flagler County Chamber
 
 

Flagler County’s Preferred Insurance Agency


Get A Quote

Home  |  Auto  |  Life  |  Marine  |  Business

Marine Insurance Quote

Name:
Email:
Work Phone:
Home Phone:
Cell Phone:
Address:
How Did You Hear
About Us?:
Referral (please specify)
Internet (please specify)
Community First Yellow Pages (employee group photo on
      cover, glossy pages)
Flagler Chamber of Commerce Phonebook (scenic
      beach/dolphin photo cover)
Yellow Book Phonebook- Flagler County Directory &
      Shopping Guide (yellow cover)
AT&T (Bellsouth) Phonebook
Other (please specify)

Driver 1
Name:
DOB:
Driver's License #:
Tickets or violations in the last five years:

Driver 2
Name:
DOB:
Driver's License:
Tickets or violations in the last five years:

Type of Vessel:
(center console, fish, sport, cruiser, etc.)
Year of Vessel:
Manufacturer:
Model:
Hull #:
Hull Length:
Hull Value:
Agreed Value   Cash Value   Replacement Cost
Engine Manufacturer:
Serial Number(s):
Outboard/Inboard: Outboard   Inboard
Engine Size (hp):
Engine Value (each):
Top Speed (mph):
Moored Location:
Locations(s) of Use:
Special Equipment/Value:
Trailer Make/Model/Serial:
Boating Safety Courses? Yes   No
Hurricane Preparedness Plan:
Lien Holder:
Prior/Current Carrier:
Current premium amount per month:
Current policy expiration date:

Don't forget to have our office review your entire insurance portfolio
including auto, home, marine, life, and business insurance.

 
    Flagler Chamber Logo

Welcome  |   We Care  |   Services  |   Home  |   Auto  |   Life  |   Marine  |   Business  |   Companies and Claims
Hammock Clients  |   Get A Quote  |   About The Owner  |   Contact Us  |   Directions  |   FAQ


Contact Kopec Insurance Ocean Hammock Insurance