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Local: 714.895.7050 | FAX: 714.780.1306

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We are proud to be
authorized agents for the
following quality insurance providers:

Empower High Performance Boat Insurance Quote Form

There are hundreds of insurance products out there, let Empower Marine Insurance Services do the shopping for you. We can give you multiple quotes and help you select just the right product for your needs. Please fill out the secure form below and hit the 'Submit' button. Empower will contact you shortly with quote information.

General Contact Info

First name
M.I
Last name
Address
City
State
Zip
Email
Phone
Alt. Phone
Fax

Date of Birth (DD/MM/YY)
Years of experience

Storage Address (if different than above)

Storage address
Storage city
Storage state
Storage zip

Tickets or Accidents in the past (5) Years?

If yes, please provide details

Prior boat(s) owned. Please provide year, make model and length

Lay-Up Period
Have you taken a Boating Safety Course?
Boat Usage

Describe Boat

Boat year
Boat length
Boat make
Boat model
Hull material

When did you purchase this boat? Example: 01/01/2000

Engine Information

Number of engines
Engine year
Engine make
Engine model
Engine hp
Fixed fire system
Supercharged

Coverage Requested

Deductible
Value of boat	$
Value of trailer	$
Limit liability

Additional Operators

Name
Age
Prior boats owned/operated?

Comments or other information

How did you hear about us?

888-606-2746
(888-60-MARINE)

Office Hours:
9AM to 5PM
Monday through Friday

Lic.#0C67306

Empower Marine Insurance 16585 Pacific Coast Hwy. PO Box 941 Sunset Beach, CA 90742 714.895.7050 FAX: 714.780.1306 Email