Boat Insurance Form

Name*
Address
Street Address Address Line 2 City Province Postal Code
Phone
Email*
Date
MM slash DD slash YYYY
Liability requested
Boat type
Amount of insurance on boat
Boat manufacturer
Year built
Overall length
Main Motor
Construction
Year of motor
Type of motor
Manufacturer
Horsepower
Maximum speed of motor
Amount of insurance on motor
Twin Engine
- Yes
- No
Trailer
- Yes
- No
Year of trailer
Make and model of trailer
Amount of insurance on trailer
Years Operated
Years Owned
Courses & Level Completed
Loss Details
Has any company ever cancelled or refused insurance of this description
- Yes
- No
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Radville Location
230 Main Street (Box 640)
Radville SK
S0C 2G0

Phone:( 306) 869-2243
Toll Free: (866) 313-2243
Fax: (306) 869-2859
Email: info@loewenagencies.com

Hours of Operation
Monday to Friday : 8:30 am-5:00 pm
Saturday: Closed
Sunday: Closed

Minton Location
30 Centre Street (Box 60)
Minton SK
S0C 1T0

Phone: (306) 969-2243
Fax: (306) 969-2244
Email: info@loewenagencies.com

Hours of Operation
Monday to Wednesday: 8:30 am-5:00 pm
Thursday to Sunday: Closed

Ceylon Location
512 1st Avenue West (Box 207)
Ceylon SK
S0C 0T0

Phone: (306) 454-2411
Fax: (306)454-2412
Email: info@loewenagencies.com

Hours of Operation
Monday to Friday: 8:30 am-5:00 pm
Saturday: Closed
Sunday: Closed

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