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Welcome To Cornerstone
Welcome To Cornerstone Insurance Agents

#4 Arcade Building, Pioneer's Way
P.O. Box F-41480, Freeport , Grand Bahama

(242) 602-6652
(242) 602-6653

©2024. CORNERSTONE INSURANCE AGENTS LTD.

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Boat Insurance Quote

At Cornerstone Insurance Agents Ltd., we make it easy for you to find the right insurance coverage that fits your needs. Whether you’re looking for auto, home, marine, business, or professional insurance, we’re here to help. Complete the form below and one of our expert agents will contact you with a tailored quote.

Private Motor insurance form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name: *

Gender:

Private Insurance Quote Questionnaire

D.O.B *

Occupation:

Type of Motor Policy: *

Comprehensive

Third Party

Total Loss Only

Driving History

How many years have you had your driver’s license? *

How many years have you had Motor Insurance in your name? *

Previous Insurance Details

Current/ Last Insurer: *

Policy Expiration Date: *

Any physical or medical disabilities which may affect driving?

Yes

No

OtherOther

If Yes, Choose All That Apply

Vision

Hearing

Seizures

Diabetes

Heart Condition

OtherOther

If Yes

Date of Accident:

Amount Paid:

Details:

Is policy to be joint held?

Yes

No

OtherOther

If Yes, Joint Policy Holder

Name of Joint Policy Holder:

Age

How long has Joint Policy Holder had a Driver’s License?

Has joint Policy Holder ever had Motor Insurance in their one name?

Yes

No

OtherOther

If so, how long?

Have Joint Policy holder had any Motor Claims under their own Insurance in the last 5 year?

Yes

No

OtherOther

If Yes

Date of Accident:

Amount Paid:

Details:

Vehicle Details

Vehicle Year: *

Vehicle Make: *

Vehicle Model: *

Engine Size: *

Text

Total number of seats:

Original Purchase Price:

Estimated Current Vehicle Value (If Comprehensive):

Date Purchased:

Vehicle Purchased New or Secondhand?

New

Secondhand

Are there any loans on the vehicle?

Yes

No

If Yes, Name of Bank:

If Yes, Which Branch:

Contact Us, If More Than One Vehicle Please

Will you have additional drivers? *

Policy Holder Only

Policy Holder & Spouse Only

Any Driver 25 years of age or older (Must have driver's license for over 2 years)

Authorized Driver (Open Driving)

Named Drivers Only (Maximum of 5 Persons)

If Named Drivers

Name

Name

First

First

Last

Last

Gender

Age:

How many years has this driver had his/her driver’s license?

Any Motor Claims in the last 5 years?

Yes

No

If Yes

Date of Accident:

Amount(s) Paid:

Details:

Contact Us, If More Than One Named Drivers Please

If you are human, leave this field blank.

Home insurance form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name (If Applicable):

Gender:

Commercial Property Insurance (Fire & Perils)

Policy Type

Home Insurance WITH Catastrophe (e.g. Hurricane)

Home Insurance WITHOUT Catastrophe (e.g. Hurricane)

House Number:

Street Name:

Subdivision:

City:

Island:

Is it within 200 ft. of Sea/ Canal/ Other Body of Water:

Yes

No

If yes, indicate proximity /distance:

Construction of Exterior Walls:

Concrete

Wooden

Steel

OtherOther

Construction of Roof:

Asphalt Shingles

Wood Shingles

Metal

Tiles

OtherOther

Use of Home:

Private Dwelling (Owner Occupied)

Dwelling Rented Out To Others

Description:

Condos/ Apartments/ Townhouses

Single Family Home

Air B&B

OtherOther

Number of Storeys:

Single

Two Storey

Split level

OtherOther

Age of building?

Details and value of any ongoing renovations?

Security features:

Alarm System

Burglar Bars

Security Cameras

Security Guards

OtherOther

Amount of Insurance required for Building (Sum Insured):

Amount of Insurance required for Contents (Sum Insured):

List additional items and coverage required:

Do you require Liability Insurance for more than $500,000? (standard policy limit)

Yes

No

If Yes, Amount required:

Have you had any claims or losses in last 5 years? (e.g. burglary, fire, hurricane)

Yes

No

If Yes, give details:

Any history of flooding?

Yes

No

If Yes, Give details on flooding:

Do you have a mortgage?

Yes

No

If Yes, Bank Name:

Do you have a current Appraisal Report?

Yes

No

If Yes, please give date of report:

Current Insurer:

Policy Expiration Date:

If you are human, leave this field blank.

Boat Insurance form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name (If Applicable):

Gender:

Marine Insurance Quote Questionnaire

Boat Year:

Boat Make:

Boat Model:

Length of Boat:

Width of Boat:

Material of Boat:

Wood

Fiberglass

Steel

OtherOther

Boat Type:

Cabin Cruiser

Catamaran

Open Vessel

Sport Fisherman Vessel

OtherOther

Engine Year:

Engine Make:

Engine Model:

Engine Horsepower:

Motor:

Fuel:

Gasoline

Diesel

OtherOther

Use of Vessel:

Pleasure

Commercial

OtherOther

Maximum design speed of boat

If commercial:

Excursion

Fishing

Mailboat

Ferry

Tug/Barge

OtherOther

Total Value of the vessel and equipment:

Total value of trailer (if any):

Total value of dinghy (if any):

Maximum number of passengers to be carried:

Number of crew:

Age of captain:

Years of experience of the captain:

Navigating limits:

Bahamian Waters

OtherOther

Types of watersports you engage in?

Amount of liability required:

$100,000

$250,000

$500,000

OtherOther

Do you have any past claims within the last 5 years?

Yes

No

If Yes, Give Details

Date of last condition & valuation survey:

If you are human, leave this field blank.

Business insurance form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name: *

Gender:

Coverage Required: *

Commercial Property Insurance (Fire & Perils)

Burglary

Money

Business Interruption

Fidelity Guarantee

Glass

Computer

Public Liability

Employers Liability

Street Name:

City:

Island:

Construction of Exterior Walls:

Concrete

Wooden

Steel

OtherOther

Construction of Roof:

Asphalt Shingles

Wood Shingles

Metal

Tiles

OtherOther

Type of Business Activities:

Length of time in business:

Have you had any claims within the past 5 years?

Yes

No

What security features do you have in place?

Burglar bars

Security guards

Alarm systems

Security Cameras

OtherOther

Commercial Property Insurance (Fire & Perils)

Coverage Options:

Fire & Perils including catastrophe (Hurricane)

Fire & Perils excluding catastrophe (Hurricane)

Provide quote for both options

OtherOther

Values to be insured:

Buildings/Leasehold improvement

Stock / Inventory

Contents (furnishing, fixtures, fittings)

OtherOther

Value of Buildings/leasehold improvements:

Contents (furnishing, fixtures, fittings):

Select any additional policies of interest. We will contact you for further details:

Goods In Transit

Marine Cargo

Business Travel

Group Personal Accident

If you are human, leave this field blank.

Professional Liability form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name (If Applicable):

Gender:

Type of business:

Where is business conducted:

Store Front

Office

Work done at your clients premises

OtherOther

Location (whether it be office store front or away from premises at other locations):

Subdivision:

Number of premises:

Annual Revenue:

Number of Employees:

Annual wage-roll:

Amount of Liability Coverage required:

$100,000

$250,000

$500,000

$1 Million

OtherOther

Quote(s) Request for:

Public Liability

Employers Liability

Professional Indemnity

If Public Liability

Premises liability required only:

Yes

No

Products liability:

Yes

No

Do you have any past claims within the last 5 years?

Yes

No

If Employers Liability

Do you have any past claims within the last 5 years?

Yes

No

Limit of liability required:

$100,000

$250,000

$500,000

$1 Million

OtherOther

If Professional Indemnity

Please choose nearest occupation category and we will contact you for further details: Please choose nearest occupation category and we will contact you for further details:

If Other (Describe Activities):

Limit of liability required:

$100,000

$250,000

$500,000

$1 Million

OtherOther

Do you have any past claims within the last 5 years?

Yes

No

If you are human, leave this field blank.

Contractors insurance form

Name *

Name

First

First

Last

Last

Phone *

Email *

Company Name:

Gender:

Construction Insurance Quote Questionnaire

Status:

Street Name:

City:

Island:

Date construction commenced:

Distance from the sea? (Est. Miles)

Type of Project (e.g. Home, condominium, other):

Type of Construction:

New Construction

Existing Property

Renovation

OtherOther

How long will it take for the work to be completed? *

3 Months

6 Months

9 Months

12 Months

OtherOther

Construction of Exterior Walls:

Concrete

Wooden

Steel

OtherOther

Construction of Roof:

Asphalt Shingles

Wood Shingles

Metal

Tiles

OtherOther

Desired Sum Insured (value of construction contract):

Value of existing structure (if any):

Tools & Equipment Cover:

Yes

No

Does project involve working from heights above 30 ft?

Yes

No

At what Stage of construction is project at? (Example on roof or on Windows and doors installed etc.)

Amount of Public Liability required?

$250,000

$500,000

$1 Million

OtherOther

Amount of Employers Liability required?

$250,000

$500,000

$1 Million

OtherOther

Bond Required?

Yes

No

If Yes, Give Details:

If you are human, leave this field blank.

Don't Hesitate to Contact

Get a Free Insurance Quote

Life Insurance

Home Insurance

Car Insurance

Business Insurance

Health Insurance

Wedding Insurance

Need help with something else?

No matter where you live or what you drive, we find the policies that are right for you.

Professional Team

Meet Our Expert Agents

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Harry Kane

Officer

John Doe

Officer

Sarah Albert

Officer

Experience peace of mind with Cornerstone Insurance Agents Ltd.

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#4 Arcade Building Pioneer's Way
Freeport, Grand Bahama,
(242) 602-6652 /3
info@cornerstonebahamas.com

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