Watercraft/Jet Ski Quote Form (Ehlers)
Fill out the following form as completely as possible. Once you have completed the form, click the Submit button to send your information. Your request will be handled promptly.
Are you working with someone within our Agency? *
Personal Information
Marital Status *
Date of Birth *
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Watercraft Information
Highest Level of Education *
Year *
Hull Type *
Are you original owner of unit? *
Please describe engine/engines. *
Engine Type *
Is boat used inland or coastal? *
If you have trailer, please describe
Any tickets, accidents, claims in past 5 years for any operator
In the last 3 years has anyone in the household taken any type of boater safety course? *
Is there a lienholder? *
Provide address where boat is stored majority of time. *
Will boat be used in Texas only? *
Will boat be used in Texas only? *
Coverage Options
Liability Limits *
Uninsured/Underinsured Motorist *
Medical Payments to Others *
Comp Deductible *
Collision Deductible *
Towing & Emergency Road Service *
What valuation method do you desire? *
Payment Options *
Please provide any other information that may be useful *
How did you hear about us?
Important NoticeAny
submissions or payments made via this website do not constitute a
binding agreement to your policy or coverages. Changes and
payments to policies are not effective or binding until you, or any
party involved, receive official notice from either your insurance agent,
or your insurance company. If you have any questions, please feel free to
contact us. Per the terms of our
online privacy policy we will not resell your information to any third-party.
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