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10 Reasons to Call the Williams Agency!
1) All phone calls returned PROMPTLY!
2) Lowest Rates on most Florida policies!
3) Same Day Quotes and Insurance Coverage!
4) Auto, Homeowners Flood, and Boat Insurance Specialists!
5) A Wide Variety of Commercial Insurance too!
6) Huge Multi Policy Discounts when combining Insurance Plans.
7) 24/7 Claims Service!
8) Over 25 Years Combined Insurance Experience!
9) INSTANT Phone Quotes on Many Lines of Insurance.
10) Use Email? We LOVE Email! Tell Us What You Need!

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 Florida)
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)

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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.

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Contact Us Today at:
Williams Insurance Agency, LLC
PO Box 1316 | Niceville, FL 32588
Local Phone: 850-678-4333 | Fax Number: 850-678-0147

E-Mail us at: quotes@williamsinsuranceflorida.com