Charter Boat Insurance
Charter Boat Insurance Application
Directions: Please complete this form and click the SEND button. A representative of Olson, Inc. will follow up with you within 24 hours to confirm this application and answer any questions you may have. If you require immediate assistance, please contact Olson, Inc. at 410-923-7100.   
Policy To Be Insured In The Name(s) Of *
Address *
Telephone Number(s) *
Fax Number *
Are You A Captain? * Yes No
How Long Have You Held A License? *
Driver's License Information (number) (state) State
Date of Birth
Social Security Number
Total Crew (Including Captain) *
Year Of Vessel *
Length Of Vessel *
Name Of Vessel *
Hull ID Number*
Make Of Vessel *
Model Of Vessel *
Hull * Fiberglass Wood Steel
Propulsion * Gas Diesel
Engine Year *
Engine Make *
Engine Serial Number *
Engine Horse Power *
Usage * 6-Pack Over-6
Number of Passengers
(If Over Six)
Mooring Location *
Lay-Up Period From  To
Coverage Requested
Hull Limit * ($500 Minimum Deductible)
P&L Limit * ($500 Deductible)
$2,500 Fishing Equipment Coverage Floater  (Flat Charge w/ $250 Deductible
$2,500 Medical Payments  (Flat Charge)
$2,500 Uninsured Boaters  (Included)
$300 Commercial Towing Assistance  (Included)
Where Did You Purchase This Vessel
Purchase Price
Any Losses in Last Three Years Yes No          If Yes, Please Describe
Is Vessel Insured Now Yes No
Is There A Lein Holder On This Vessel? * Yes No
If Yes, Please Provide Name & Address
Date Of Last Survey * (Must Be Less Than 3 Years Old)
Navigation Warranty
Date *
Your Name *
Your Email *
Your Address * Street Address State Zip
Your Telephone *
* REQUIRED FIELDS
Olson, Inc.
882 Annapolis Road
PO Box 187
Gambrills, MD 21054
Telephone 410-923-7100