Bruce V. Schneider
Associates, Inc.

Four Nautical Flags that depict the letters AMIA which stand for All Marine Insurance Agency

All Marine
Insurance Agency

Commercial marina, boatyard

Commercial Marine

2 persons in rowing shell on water

Rowing & Paddling

several people riding in a boat less than 26 feet long

Boats Up To 26 Feet

A yacht over 26 feet traveling in the water

Yachts Over 26 Feet

A fast High Performance boat with several people in it, traveling at swift speed accross the water

High Performance

Call Us
631.698.3558

Fax Us
631.980.3700

All Marine Insurance Rowing & Paddling Club Quote Request Form (You May Use The TAB Key Between Fields)

General Information About Insured

Name of Club or Organization *

Address *

City *

State *

Zip *

Contact Name *

Title

Phone # *

Fax #

Email Type

Email *

Desired Effective Date *

Liability Section

What is the annual number of Participants/Members/Students that you have? *

Do you Run or Host Regattas or Festivals? *

If YES how many do you run/host per year

Do you participate in Regattas or Festivals run by others? *

If YES how many do you participate in?

Do you Rent or Borrow Boats for your use? *

If YES how many do you Rent/Borrow per year?

How long are they Rented/Borrowed for?

What is the approximate Total Hull value of the rented/borrowed boats?

Do you Rent your Boats out to anyone? *

If YES what are your Gross Receipts for Boat Rentals?

Do you Sell boats to anyone? *

If YES what are your Gross Receipts for Boat Sales?

Do you Rent Boat Storage or Rack Space to anyone? *

If YES what are your Gross Receipts for Storage?

Property Coverages

If Hull coverage is required what is the total Hull Value Limit needed?

If Other Equipment coverage is required what is the total Equipment Limit needed?

If Dock coverage is needed what is the total value of the Dock(s)?

For a Rented Building please indicate the Fire Damage Limit needed

If you have a Boathouse or other Property Coverage needs please describe them:

Supplemental Coverages

A Standard policy has $1M of Liability coverage. Please indicate total amount needed:

If Jones Act coverage is desired, how many paid coaches are on the water at any one time?

Please indicate if Hired and Non Owned Auto Coverage is needed

Loss History

In space provided please indicate your claims history for the past 7 years: If NONE please do not leave blank.

Please state NONE if appropriate *

Please upload any additional information relevant to your quote request

Additional Comments:

Call For A Quote Today 631.698.3558

BVSA Marine Insurance

PO Box 874, Middle Island, NY 11953

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