Vincent F. Gauci - VFG Associates,LLC

VFG Associates, LLC

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Call 734-855-4930
or 800-859-4453
Fax 734-855-4933
29432 Joy Road, Livonia, MI 4815

Request Form

Watercraft 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.

Please Select your preferred agent.
Agent:
Effective Date:
Your Name:
Your Mailing Address:
Street

City, State & Zip
    
E-mail Address:
Daytime Phone #:
Choose One: Please call me with quote premium.
Please send quote via e-mail.
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

Outboard Motor: Year Manufacturer Model  Serial Number TotalHP  
   
Trailer:
Year  Manufacturer     Serial Number    
       
Is the boat chartered or used for other than private pleasure purposes?    Yes     No
Coverage:   Limits: Coverage:   Limits:
Boat (Incl. auxiliary equipment) Boat Liability
Outboard Motor 1.  (ACV Coverage) Medical Payments  ($1000 Automatic)
Outboard Motor 2.  (ACV Coverage) Uninsured Boater
Boat Trailer     
Personal Property  ($500 Automatic) Optional Coverages:
Agreed Value Endorsement
Actual Cash Value
Fishing Equipment - Limit:  
Commercial Towing  ($400 Automatic)
   
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.


If you have not received a response from us within one business day, please contact us again. Thank you.

Securities Offered Through KCD Financial,Inc. Member FINRA & SIPC, 3313 S. Packerland Drive, Suite E, DePere, WI 54115