BrokerCheck – check the background of this investment professional
Securities and advisory services offered through Commonwealth Financial Network®, Member www.FINRA.org/www.SIPC.org, a Registered Investment Adviser. Fixed insurance products and services offered through Pipes Insurance Service, LTD, MaPP Investment Service, LLC or CES Insurance Agency.

This communication is strictly intended for individuals residing in the states of AL, CA, GA, FL, MI, NC, SC, IL, PA, TX, WV and OH. No offers may be made or accepted from any resident outside these states due to various state regulations and registration requirements regarding investment products and services.

About Us

Since our founding in 1974, the word “service” has continued to be an integral part of our name and business.

Pipes Insurance Service is a customer-service driven insurance agency. It is our goal to provide the best possible experience to all of our clients. Whether it is finding a plan that best suits a customer’s needs, negotiating with companies to offer fair premiums, helping clients through the claims process, helping customers understand their coverage, or whatever the issue may be, our team is qualified and happy to serve. Pipes Insurance is an independent insurance agency, meaning we do not work for one insurance company. Rather, we offer a variety of products from a variety of different companies. Because of this, we are able to offer our clients a large selection of products from different carriers. Our insurance company partners are reliable, top-rated companies that carry products for all types of clients; from national corporations to newly-wed couples. This freedom to choose the products that we sell gives us flexibility so that we may find the best possible solutions for each customer’s specific circumstance.

Maintaining top-quality customer service is extremely important to us at Pipes Insurance Service. We strive to treat our clients respectfully and be available whenever we are needed. Our office hours are Monday through Friday from 9 am to 5 pm, but our professionals are available to contact at any time you need them. Our agents are ready to work with you to find the best solution to your insurance and financial needs. At Pipes Insurance Service, it is all about insuring your trust. Please give us a call or stop by. We would love to do business with you.

In the summer of 1974, Paul Pipes and his wife, Joyce, purchased a small independent insurance agency in New Philadelphia, Ohio, and began to build up a business founded upon strong ethics and values. The agency was named “Paul’s Insurance Service,” and Paul worked diligently alongside his wife and lone employee, Jan Groh, to build the company.

In 1984, Paul’s son, Scott, moved back to New Philadelphia after getting a bachelor’s degree in insurance from Bowling Green State University. Scott began doing business in the same building as his father; however, the operations were completely separate. Paul focused solely on property and casualty while Scott sold life and health insurance. All the while, the separate companies continued to grow.

In 1990, Scott bought into his parents’ agency, and the business began operating under the name “Pipes Insurance Service.” With news that Paul had a serious health condition, Scott purchased the remaining interest in the agency. Scott’s younger brother, Richard Pipes, a Kent State graduate, was working in the service industry for a national hotel organization at this time. Upon hearing of his father’s condition, Rick moved back to New Philadelphia to be with his family and begin working in the family business. In July 1993, Paul passed away.

Today, Pipes Insurance Service is owned by Scott and Rick Pipes. The company has nearly 20 employees, and operates out of four divisions: Personal Lines, Commercial Lines, Employee Benefits and Financial Services. The agency holds business with clients from multiple states, and continues to follow the same values that the company was founded upon.

MODEL CHRISTIAN ETHICS – Be honest, yet loving with your communication. Treat people with dignity and respect. Forgive. Healthy relationships are the foundation for living. Continually strive to reach perfection with both your intent and delivery. Give more than you receive.

BALANCE PERSONAL PRIORITIES – This job is not your #1 priority. Your spiritual welfare, family, and health are more important. This is not an excuse to do anything less than give 100% to your career. Set goals and be organized. If we are all able to do this, it will require everyone doing his or her share. You will have a difficult time getting to your family if you are always the one locking up, cleaning up, etc.

EXCEED CUSTOMER EXPECTATIONS – To exceed expectations, you must first know what they are, and then deliver more than what is expected. The customer is both our external clients and internal staff. Remember, your behavior affects our credibility with clients. Excellence today is tomorrow’s standard.

RESOLVE PINCHES – A natural outcome of communicating and working with people is misunderstanding. Resolve these immediately before they grow, fester and put a relationship at risk. If it is your pinch – initiate the resolution. If you are consistently having more pinches than everyone else, the problem is likely in the mirror. Give others the benefit of the doubt.

ENCOURAGE EACH OTHER DAILY – This is a mentally tough business. We solve problems for clients every day. Build up your teammates; acknowledge when they do something right. You have not earned the right to correct, coach or criticize if you have not recently encouraged.

DO THE RIGHT THING – Follow the guidelines, policies and rules. When problems arise, ask yourself, “What is the right thing to do?” This concept is both our vision and mission. The right thing always protects the customer, our employees and the company. Take action and report it. There is never an adequate reason to do the wrong thing.

BE A TEAM PLAYER – A team player recognizes the success of their team is the only way he or she will reach his or her potential. A team player uses their job description as a base guideline, not as a declaration of the only tasks they must accomplish on the job. For example, we cannot have the best facility if nobody contributes to housekeeping. A team player stays focused on the team’s success by giving his or her all. They accept losses, but will never let themselves become defeated. A team player values every other team member for his or her contributions. Be one another’s advocate and assume mutual accountability for success.

ERR ON THE SIDE OF ACTION – We have recruited great employees. We have excellent partners in the field. We have the leadership. Anything less than “number one” would be to sell our team, our company, ourselves and our family short. When you live on the mountaintop, everyone will observe and try to build higher. It is difficult to walk uphill every morning, but the view, prestige and honor of the mountaintop is experienced by few.

WALK THE TALK – “I’d rather see a sermon than hear one any day.” “I’d rather someone show me the way, rather than simply pointing toward it.” If you can’t live it, don’t teach it. If you can’t model it, don’t preach it. We must always be our own toughest critic. Reputation is easily lost, yet credibility is a continuous journey. Your behavior, follow-through and commitment affect our credibility. The old saying, “The chain is only as strong as its weakest link…” is true.

CREATE THE FUTURE – Trust your leaders and fellow team members. This trust is the lubricant of change. We must work to be given an opportunity to train our client’s employees, to sell to them, and to serve them. Being a member of this team is a privilege – while the invitation is open, the membership is earned. Be a continuous learner. To share in the profit, you must create a profile. Earn the respect of others through your professional skills, attitude and modeling of these principles.

  • PiPES Logo

    “Progressive Foam Technologies has been partnered with Pipes Insurance since 1994 to meet all of our insurance needs.  The last 21 years have brought dramatic growth to PFT and the Pipes team has been proactive in anticipating our changing requirements and supplying us with innovative solutions.  Pipes Insurance has our every confidence.”

     

    Patrick M. Culpepper
    President
    Progressive Foam Technologies, Inc.

     

    “I would highly recommend Pipes Insurance for all of your insurance needs both professionally and personally. Scott and his team have taken care of us for years with our business and casualty insurance and providing excellent options for our health insurance as well.”

     

    Chris Dyer
    Vice President
    H3D Tool Corp.

     

     

Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email or voicemail request Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Type of Policy:
Policy Number:
Your Name:
Contact Information:
Home Phone:
Work Phone:
E-Mail:
Best time to call:
 
Date of change:
Description of change:
 
Comments/other information:
It is our policy to make every effort to respond to this request within one business day.  Thank you. 
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

If you are interested in an insurance quote, please send us your name and contact information. Someone from our office will contact you to obtain the necessary information. Our Agency is dedicated to our customers and we do not sell or distribute your information to any third party.  Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
 
Name:
Email:
Daytime Phone:
Evening Phone:
Type of Insurance: Personal     Commercial   Other (Describe below)
Please provide a description/details about the type of quote you are looking for.
We will contact you ASAP to gather the information required to provide you with a quote.
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Policy Number:  
Your Name:  
E-mail:  
Daytime Phone#:  
Choose One:
 
Delete Vehicle: Year 
VIN
Make/Model
Reason:
Add Vehicle: Year
VIN
Make/Model
Owner:  
Primary Driver:  
Describe Use:
 
Coverage Requested:
Additional Coverage:
(Please use Other Comments area below for any desired coverage not listed here.)
Towing: 

Rental Reimbursement:  

Loan/Lease Gap:   
  Anti-lock Brakes: 
  Anti-Theft Alarm: 
  Airbags: 
 
Additional Interest, if any:
 
New Name:  
Street Address:  
City/State/Zip:  
 
Comments:
It is our policy to make every effort to respond to this request within one business day. Thank you.
Name:
Email:
Message:

Call us at: 330-339-6413 or 888-328-8958

Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Business/Commercial Insurance Quote Request

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Your name: No of employees:
Email: Annual sales:
Phone: Payroll:
Business name: No. of owners/officers:
Address: Street

City, State, Zip
Type of business:
Years in business:
Current Carrier:
Current Effective date:
Describe your business:
 
Property Coverage:
If property coverage is needed, please complete this section.  If property coverage is not needed, please skip to Liability section.
Building Limit: Contents Limit:
Construction Type: Year Built:
Square Footage: Roof Type:
 
Liability Coverage:
Liability Limit:    
 
Business Auto Coverage:
If auto coverage needed, please complete this section.  If auto coverage is not needed, please skip to Comments section.
Liability Limit:
Any drivers under 25 or over 70?
Covered vehicles:
Veh Year Make/Model Gross Weight Radius Driven Comp Coverage Collision Coverage
1
2
3
4
5
Do any vehicles listed above have special equipment?  If yes, please describe below:
 
Comments:
Please include any additional information or comments here:
Protecting your privacy and identity is very important to us.
Social Security and drivers license numbers may be required to complete this quote. Please be sure you have provided an accurate contact number so that we can contact you personally for this information.
It is our policy to make every effort to respond to this request within one business day. Thank You.
Your Name:
Email:
Question:

Call us at: 330-339-6413 or 888-328-8958

Contact a Company

AultCare 1-800-344-8858
Anthem Please refer to the phone number on the back of your ID card or call our office at 330-339-6413
Medical Mutual 1-800-272-6967
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.

Name of your group:
Address of group:
Name and phone number of contact:
Nature of Business:
Federal Tax ID:
Number of full time employees(25+avg hrs/wk):
Type of Insurance you're interested in:
It is our policy to make every effort to respond to this request within one business day. Thank you.

Health

AultCare 1-800-344-8858
Medical Mutual 1-800-523-8558
Anthem 1-888-224-4902

LIFE

Grange Life 1-800-399-3797
Cincinnati Life 1-888-242-8811
Ohio National 1-800-366-6654
Mass Mutual 1-800-272-2216
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Policy Number:  
Your Name:  
E-mail:  
Daytime Phone#:  
Choose One:
 
Change Mortgagee or Other Interest: (If change involves more than one lender, please call.)
Loan number: Interest:
New Name:
Address:
City/State/Zip:
Comments:
 
Floater Coverage: (To add or increase floater coverage, please forward sales receipt or appraisal.)
Type of change: Floater type: Describe item(s) and change:
 
Check box to be contacted on any of these options:
 






 
Other changes or comments:
 
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.

Current Insurance:

Policy Holder:
Name:
Phone:Home Work Cell
Address:
Email: Fax:
DOB: Height: Weight:
Current Medications & Health Conditions:
Spouse:
Name:
DOB: Height: Weight:
Current Medications & Health Conditions:
Children:
DOB:
DOB:
DOB:
DOB:
DOB:
DOB:
Current Medications & Health Conditions:
Comments:
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Your Name:
Current Address:
Street
Prior Address:
(If less than 2yrs at current address)
Street
City, State & Zip
City, State & Zip
Phone:
Email:
 
Current coverage: Company:
 
 Expiration Date:
 Liability Limits:
 
Liability Limits and Coverages:
Please select the coverages and limits that are to apply to your vehicles.
Bodily Injury & Property Damage
Uninsured/Underinsured Motorists
Medical Payments
 
Your Vehicles:  
If you have more than four vehicles, please call our office for a quote.
Vehicle 1.
  Year
Make and model
VIN (if known):
  Vehicle type
Vehicle Use
 
* Racing/Commercial Unacceptable
  Comprehensive
Custom or modified
Turbocharged
Total CC's
  Collision
Options:
Vehicle 2.
  Year
Make and model
VIN (if known):
  Vehicle type
Vehicle Use
 
* Racing/Commercial Unacceptable
  Comprehensive
Custom or modified
Turbocharged
Total CC's
  Collision
Options:
Vehicle 3.
  Year
Make and model
VIN (if known):
  Vehicle type
Vehicle Use
 
* Racing/Commercial Unacceptable
  Comprehensive
Custom or modified
Turbocharged
Total CC's
  Collision
Options: 
Vehicle 4.
  Year
Make and model
VIN (if known):
  Vehicle type
Vehicle Use
 
* Racing/Commercial Unacceptable
  Comprehensive
Custom or modified
Turbocharged
Total CC's
  Collision
Options: 
 
Driver Information:   If there are more than four drivers, please call our office for a quote.
Driver 1: Driver 2:
Name:
DOB:
 Sex:
Name:
DOB:
 Sex:
Occupation:
Marital Status:
Occupation:
Marital Status:
Accidents or violations in the past 3 years:

Accidents or violations in the past 3 years:
Driver 3: Driver 4:
Name:
DOB:
 Sex:
Name:
DOB:
 Sex:
Occupation:
Marital Status:
Occupation:
Marital Status:
Accidents or violations in the past 3 years:

Accidents or violations in the past 3 years:
 
All Drivers:
If a Group Association Discount applies, please enter association name: 
 
Comments:
Please use the box below to enter any additional information you feel should be considered:
Protecting your privacy and identity is very important to us. 
Your Social Security and drivers license number may be required to complete this quote.   Please be sure you have provided an accurate contact number so that we can contact you personally for this information.
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.
Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Your Name:
Current Address:
Street
Prior Address:
(If less than 2yrs at current address)
Street
City, State & Zip
City, State & Zip
Phone:
Email:
 
Current coverage: Company:
 
 Expiration Date:
 Liability Limits:
 
Liability Limits and Coverages: Please select the coverages and limits that are to apply to your vehicles.
Bodily Injury
Property Damage
Medical Payments
Uninsured Motorists
UM Property Damage
Additional information:


 
Your Vehicles:   If you have more than four vehicles, please call our office for a quote.
Vehicle 1.  
  Year:
Make and model:
VIN (if known):
  Vehicle Use
 
  Miles to work/school
Optional Coverages:


  Comprehensive
  Collision
Vehicle 2.
  Year:
Make and model:
VIN (if known):
  Vehicle Use
 

Miles to work/school

Optional Coverages:


  Comprehensive
Collision
Vehicle 3.  
  Year:
Make and model:
VIN (if known):
  Vehicle Use  

Miles to work/school Optional Coverages:



  Comprehensive

Collision
Vehicle 4.
  Year:
Make and model:
VIN (if known):
  Vehicle Use
 
  Miles to work/school
Optional Coverages:


  Comprehensive
  Collision
 
Driver Information:   If there are more than four drivers, please call our office for a quote.
Driver 1: Driver 2:
Name:
DOB:
 Sex:
Name:
DOB:
 Sex:
Occupation:
Marital Status:
Occupation:
Marital Status:
Accidents or violations in the past 3 years:

Accidents or violations in the past 3 years:
Driver 3: Driver 4:
Name:
DOB:
 Sex:
Name:
DOB:
 Sex:
Occupation:
Marital Status:
Occupation:
Marital Status:
Accidents or violations in the past 3 years:


Accidents or violations in the past 3 years:
 
Household Members: (Non-Drivers)
Name:
D.O.B.
Relationship:
Insurance Carrier:
Policy Number:
 
Comments:
Please use the box below to enter any additional information you feel should be considered:

Protecting your privacy and identity is very important to us. 
Your Social Security and drivers license number may be required to complete this quote.   Please be sure you have provided an accurate contact number so that we can contact you personally for this information.
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Your Name:
Current Address:
Street
Prior Address:
(If less than 2yrs at current address)
Street
City, State & Zip
City, State & Zip
Phone:
Email:
 
Current coverage: Company:
 Expiration Date:
 Coverage Amount:
 
Type of policy desired:  
 
Amount of insurance desired:
Homeowners:  Condo/Renters: 
Current value of your home: Current value of your personal property:
Both Homeowners and Condo/Renters:  
Liability Limit:   
Medical Payments:  
Deductible:  
 
Property Information:
Construction Type:        Year built: 
In what County/Township are you located? 
Distance to the nearest fire hydrant: 
Number of Stories:
Ground floor sq ft:
Total sq ft:
Number of baths: Full   Half
Fireplace:
Central air:
Wood burner: 
Basement:
Percent finished:
Garage:
Porch: If yes, total square footage:
Swimming pool: 
Trampoline:
Pets:  

Home Updates:  Enter year updates were made. If year not known, enter "unknown":
Roof: Wiring: Plumbing: Heating:
 
Optional Property Coverages: Property Floaters - Indicate limits below:


Antiques: Furs:
Coins: Jewelry:
Computers: Stamps:
Fine Arts: Tools:
 
Other Floater Coverage:
Type Limit

Previous Loss Information
Please describe any losses or claims filed on your Homeowners Insurance in the last 3 years. Include the date, type of loss and the amount of the claim.

Additional Comments
Please use the box below to enter any additional information you wish to include:
Protecting your privacy and identity is very important to us. 
Your Social Security and drivers license number may be required to complete this quote.   Please be sure you have provided an accurate contact number so that we can contact you personally for this information.
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Your Name:
Current Address:
Street
Prior Address:
(If less than 2yrs at current address)
Street
City, State & Zip
City, State & Zip
Phone:
Email:
 
Plan Desired:
You: Your Spouse:
Term Life: Term Life:
Permanent Life:  Permanent Life: 
Amt. of coverage: Amt. of coverage:
 
Payment Type: 
Monthly or annual premium amount:
Maximum number of years for payment:
 
Options Desired:
Waiver of Premium if Disabled?
Accidental Death Benefit?
Spouse Term Rider?
Amount:
Children’s Life Rider?
Amount:
Return of Premium on Term Plan?
Terminal Illness Accelerated Benefit on Permanent Plan?
Long-Term Care Benefit on Permanent Plan?  
 
Applicant Information:
Applicant:
Spouse:
Date of Birth: Date of Birth:
Height: Height:
Weight: Weight:
Tobacco: Tobacco:
Children:  
#1 Birthdate: #4 Birthdate:
#2 Birthdate: #5 Birthdate:
#3 Birthdate: #6 Birthdate:
 
Present or past treatment or conditions:
Heart disease, cancer or diabetes:
Family history of cardiovascular disease before the age of 60:
Present or past treatment for blood pressure, cholesterol, hypertension, depression:
Sky diving/hang gliding/scuba diving/hazardous occupation:
Current medical condition/medications:  (Please list below)
Current Medications & Dosage (Mg./Day):
 
Additional Questions/Comments
Please use the box below to enter any additional information you wish to include:
Protecting your privacy and identity is very important to us. 
Your Social Security number is required to complete this quote.  We will contact you personally at the number you have provided for this information.
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Policy Number:  
Your Name:
E-mail:
 
For Which Vehicle(s)?:
(Please call, if ID cards are needed for more than 3 vehicles.)
Car #1:
Car #2:
Car #3:
 
How should the ID cards be delivered?
  Email ID cards to me at the address shown above
  Fax ID cards to:
  I will pick up the ID cards at your office
  Mail ID cards to: Street

City, State, Zip
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Your Name:
E-mail:
Telephone Number:
Policy Number:
Named Insured:
 
Certificate Information:
Name of Certificate Holder:
Address of Certificate Holder: Street

City, State, Zip
Project Name/Description:
Special language requirements:
(Requires agency review)
 
How should this certificate be handled?
In consideration of the environment, our preferred method of delivery is E-mail.  If this is not an option, please provide a fax number or mailing address:
Email certificate to:
Please fax the certificate to:
Fax No: Attn:
I will pick up the certificate at your office.
Please mail to the certificate holder at the address indicated above.
Please mail the certificate to: Name: 
  Address:
It is our policy to make every effort to respond to this request within one business day. Thank you.
Coverage via this online request is NOT bound until you have received an acknowledgement from our office.

Please click on the link below to achnowledge that you have read and understand the above statement.

Please note: We cannot bind coverage from an email request. Coverage is bound after you receive a written email or telephone confirmation from an agency staff member.
Effective Date:
Your Name:
Current Address:
Street
Prior Address:
(If less than 2yrs at current address)
Street
City, State & Zip
City, State & Zip
Phone:
Email:
 
Description of Property:
     
Motor type:
Number of Engines:
Boat Type:
Other Boat Type
Fuel:
Maximum Speed:
Hull Material:
Other Hull Material:
 
Insured Watercraft:
Boat:  Year Manufacturer Model  Serial Number TotalHP Length

O/B Motor: Year Manufacturer Model  Serial Number TotalHP  
   
Trailer:
Year  Manufacturer     Serial Number    
       
Is the boat chartered or used for other than private pleasure purposes?   
 
Coverage:   Limits: Optional Coverages:
Boat (incl. aux equip) Agreed Value Endorsement
Actual Cash Value
Fishing Equipment Limit:  
O/B Motor 1.  (ACV Coverage)
O/B Motor 2.  (ACV Coverage)
Boat Trailer 
Pers. Property  ($500 Automatic)
Towing  ($400 Automatic)
Boat Liability
Medical Payments  ($1000 Automatic)
Uninsured Boater
 
Safety Equipment:
GPS
Automatic CO2 (Halon)
Ship to Shore Radio (VHF)
Depth Sounder
Electronic Burglar Alarm
Radar
Plotter
EPIRB
Vapor Detector Alarm
 
Operator Information:
Date of Birth:
Years of boating experience:
Waters to be Navigated:
 
Inland waters of the following states:
Coastal waters of the following states:

Previous Loss Information
Please describe any losses or claims filed on your Boat Insurance in the last 3 years. Include the date and type of the loss, as well as the amount of the claim.
 
Additional Comments
Please use the box below to enter any additional information you wish to include:
Protecting your privacy and identity is very important to us. 
Your Social Security and drivers license number may be required to complete this quote.   Please be sure you have provided an accurate contact number so that we can contact you personally for this information.
It is our policy to make every effort to respond to this request within one business day. Thank you.