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Submitted URL: http://dunebuggyinsurance.com/
Effective URL: https://stratuminsurance.com/dune-buggy-insurance/
Submission: On September 20 via api from IN — Scanned from US
Effective URL: https://stratuminsurance.com/dune-buggy-insurance/
Submission: On September 20 via api from IN — Scanned from US
Form analysis 1 forms found in the DOM
POST /dune-buggy-insurance/
<form method="post" enctype="multipart/form-data" id="gform_8" action="/dune-buggy-insurance/" data-formid="8" novalidate="">
<div class="gform-body gform_body">
<ul id="gform_fields_8" class="gform_fields top_label form_sublabel_below description_below">
<li id="field_8_29" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_29">
<h2 class="gsection_title">Start Your Quote</h2>
</li>
<li id="field_8_41" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_41"><label
class="gfield_label gform-field-label" for="input_8_41">Tell us About your Ride<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_41" id="input_8_41" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="ATV (includes amphibious)">ATV (includes amphibious)</option>
<option value="Boat">Boat</option>
<option value="Can-Am Spyder">Can-Am Spyder</option>
<option value="Dune Buggy">Dune Buggy</option>
<option value="Electric Vehicle that is NOT an LSV">Electric Vehicle that is NOT an LSV</option>
<option value="Golf Cart">Golf Cart</option>
<option value="LSV - Low Speed Vehicle / NEV - Neighborhood Electric Vehicle">LSV - Low Speed Vehicle / NEV - Neighborhood Electric Vehicle</option>
<option value="Motorcycle">Motorcycle</option>
<option value="Oreion Motors Reeper or Hummer">Oreion Motors Reeper or Hummer</option>
<option value="Polaris Slingshot">Polaris Slingshot</option>
<option value="Scooter">Scooter</option>
<option value="Segway">Segway</option>
<option value="Snowmobile">Snowmobile</option>
<option value="Trike (2 wheel in back)">Trike (2 wheel in back)</option>
<option value="UTV / Side by Side">UTV / Side by Side</option>
</select></div>
</li>
<li id="field_8_40" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_40"><label
class="gfield_label gform-field-label" for="input_8_40">Is your vehicle Street Legal or Offroad?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_40" id="input_8_40" class="medium gfield_select" aria-required="true" aria-invalid="false">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="Street Legal - it has a license plate">Street Legal - it has a license plate</option>
<option value="Off Road - it does not have a license plate">Off Road - it does not have a license plate</option>
<option value="Off Road converted to Street Legal - it has a license plate">Off Road converted to Street Legal - it has a license plate</option>
</select></div>
</li>
<li id="field_8_1" class="gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_1"><label
class="gfield_label gform-field-label gfield_label_before_complex">Name<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row" id="input_8_1"> <span id="input_8_1_3_container"
class="name_first gform-grid-col gform-grid-col--size-auto"> <input type="text" name="input_1.3" id="input_8_1_3" value="" aria-required="true"> <label for="input_8_1_3" class="gform-field-label gform-field-label--type-sub ">First</label>
</span> <span id="input_8_1_6_container" class="name_last gform-grid-col gform-grid-col--size-auto"> <input type="text" name="input_1.6" id="input_8_1_6" value="" aria-required="true"> <label for="input_8_1_6"
class="gform-field-label gform-field-label--type-sub ">Last</label> </span></div>
</li>
<li id="field_8_4" class="gfield gfield--type-email gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_4"><label
class="gfield_label gform-field-label gfield_label_before_complex">Email<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container ginput_container_email gform-grid-row" id="input_8_4_container"> <span id="input_8_4_1_container" class="ginput_left gform-grid-col gform-grid-col--size-auto"> <input class="" type="email"
name="input_4" id="input_8_4" value="" aria-required="true" aria-invalid="false"> <label for="input_8_4" class="gform-field-label gform-field-label--type-sub ">Enter Email</label> </span> <span id="input_8_4_2_container"
class="ginput_right gform-grid-col gform-grid-col--size-auto"> <input class="" type="email" name="input_4_2" id="input_8_4_2" value="" aria-required="true" aria-invalid="false"> <label for="input_8_4_2"
class="gform-field-label gform-field-label--type-sub ">Confirm Email</label> </span>
<div class="gf_clear gf_clear_complex"></div>
</div>
</li>
<li id="field_8_2" class="gfield gfield--type-address gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_2"><label
class="gfield_label gform-field-label gfield_label_before_complex">Address where you keep your Motorcycle / ATV / UTV / Side By Side / Trike<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_complex ginput_container has_street has_street2 has_city has_state has_zip has_country ginput_container_address gform-grid-row" id="input_8_2"> <span class="ginput_full address_line_1 ginput_address_line_1 gform-grid-col"
id="input_8_2_1_container"> <input type="text" name="input_2.1" id="input_8_2_1" value="" aria-required="true"> <label for="input_8_2_1" id="input_8_2_1_label" class="gform-field-label gform-field-label--type-sub ">Street Address</label>
</span><span class="ginput_full address_line_2 ginput_address_line_2 gform-grid-col" id="input_8_2_2_container"> <input type="text" name="input_2.2" id="input_8_2_2" value="" aria-required="false"> <label for="input_8_2_2"
id="input_8_2_2_label" class="gform-field-label gform-field-label--type-sub ">Address Line 2</label> </span><span class="ginput_left address_city ginput_address_city gform-grid-col" id="input_8_2_3_container"> <input type="text"
name="input_2.3" id="input_8_2_3" value="" aria-required="true"> <label for="input_8_2_3" id="input_8_2_3_label" class="gform-field-label gform-field-label--type-sub ">City</label> </span><span
class="ginput_right address_state ginput_address_state gform-grid-col" id="input_8_2_4_container"> <select name="input_2.4" id="input_8_2_4" aria-required="true">
<option value="" selected="selected"></option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="American Samoa">American Samoa</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="U.S. Virgin Islands">U.S. Virgin Islands</option>
<option value="Vermont">Vermont</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Europe">Armed Forces Europe</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
</select> <label for="input_8_2_4" id="input_8_2_4_label" class="gform-field-label gform-field-label--type-sub ">State</label> </span><span class="ginput_left address_zip ginput_address_zip gform-grid-col" id="input_8_2_5_container">
<input type="text" name="input_2.5" id="input_8_2_5" value="" aria-required="true"> <label for="input_8_2_5" id="input_8_2_5_label" class="gform-field-label gform-field-label--type-sub ">ZIP Code</label> </span><input type="hidden"
class="gform_hidden" name="input_2.6" id="input_8_2_6" value="United States">
<div class="gf_clear gf_clear_complex"></div>
</div>
</li>
<li id="field_8_20" class="gfield gfield--type-radio gfield--type-choice gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_20"><label
class="gfield_label gform-field-label">Do you have a separate mailing address?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_8_20">
<li class="gchoice gchoice_8_20_0"> <input name="input_20" type="radio" value="No" id="choice_8_20_0"> <label for="choice_8_20_0" id="label_8_20_0" class="gform-field-label gform-field-label--type-inline">No</label></li>
<li class="gchoice gchoice_8_20_1"> <input name="input_20" type="radio" value="Yes - I have another mailing address" id="choice_8_20_1"> <label for="choice_8_20_1" id="label_8_20_1"
class="gform-field-label gform-field-label--type-inline">Yes - I have another mailing address</label></li>
<li class="gchoice gchoice_8_20_2"> <input name="input_20" type="radio" value="gf_other_choice" id="choice_8_20_2" onfocus="jQuery(this).next('input').focus();"> <input class="small" id="input_8_20_other" name="input_20_other" type="text"
value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }"></li>
</ul>
</div>
</li>
<li id="field_8_21" class="gfield gfield--type-textarea gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_21" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_21">Mailing Address - enter only your mailing address here</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_21" id="input_8_21" class="textarea medium" aria-invalid="false" rows="10" cols="50" disabled="disabled"></textarea></div>
</li>
<li id="field_8_7" class="gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-default-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible"
data-js-reload="field_8_7"><label class="gfield_label gform-field-label" for="input_8_7">When is your birthday?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_date"> <input name="input_7" id="input_8_7" type="text" value="" class="datepicker gform-datepicker mdy datepicker_with_icon gdatepicker_with_icon hasDatepicker initialized"
placeholder="mm/dd/yyyy" aria-describedby="input_8_7_date_format" aria-invalid="false" aria-required="true"><img class="ui-datepicker-trigger"
src="https://stratuminsurance.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg" alt="Select date" title="Select date"> <span id="input_8_7_date_format" class="screen-reader-text">MM slash DD slash YYYY</span></div>
<input type="hidden" id="gforms_calendar_icon_input_8_7" class="gform_hidden" value="https://stratuminsurance.com/wp-content/plugins/gravityforms/images/datepicker/datepicker.svg">
</li>
<li id="field_8_5" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_5"><label class="gfield_label gform-field-label"
for="input_8_5">Phone<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_5" id="input_8_5" type="text" value="" class="medium" aria-required="true" aria-invalid="false"></div>
</li>
<li id="field_8_19" class="gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_19"><label class="gfield_label gform-field-label"
for="input_8_19">Marital Status</label>
<div class="ginput_container ginput_container_select"><select name="input_19" id="input_8_19" class="medium gfield_select" aria-invalid="false" style="display: none;">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="Single">Single</option>
<option value="Married">Married</option>
<option value="Widowed">Widowed</option>
<option value="Divorced">Divorced</option>
<option value="Separated">Separated</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_8_19_chosen" style="width: 334px;"><a class="chosen-single">
<span>CHOOSE ONE</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
</li>
<li id="field_8_26" class="gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_hidden" data-js-reload="field_8_26">
<div class="admin-hidden-markup"><i class="gform-icon gform-icon--hidden"></i><span>Hidden</span></div><label class="gfield_label gform-field-label" for="input_8_26">What is your profession? ** Discount</label>
<div class="ginput_container ginput_container_text"><input name="input_26" id="input_8_26" type="text" value="" class="medium" aria-describedby="gfield_description_8_26" aria-invalid="false"></div>
<div class="gfield_description" id="gfield_description_8_26">Many professions can earn discounts. Tell us what you do and we will work to find you a discount.</div>
</li>
<li id="field_8_30" class="gfield gfield--type-number field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_30"><label class="gfield_label gform-field-label" for="input_8_30">How
many years of motorcycle or ATV/UTV experience do you have?</label>
<div class="ginput_container ginput_container_number"><input name="input_30" id="input_8_30" type="number" step="any" min="0" max="100" value="" class="small" aria-invalid="false" aria-describedby="gfield_instruction_8_30">
<div class="gfield_description instruction " id="gfield_instruction_8_30">Please enter a number from <strong>0</strong> to <strong>100</strong>.</div>
</div>
</li>
<li id="field_8_27" class="gfield gfield--type-select gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_27"><label class="gfield_label gform-field-label"
for="input_8_27">What is your highest level of Education ** DISCOUNT</label>
<div class="ginput_container ginput_container_select"><select name="input_27" id="input_8_27" class="medium gfield_select" aria-invalid="false">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="Junior High School">Junior High School</option>
<option value="High school - not completed">High school - not completed</option>
<option value="High School Graduate">High School Graduate</option>
<option value="Associate Degree">Associate Degree</option>
<option value="Bachelor's Degree">Bachelor's Degree</option>
<option value="Graduate of Professional Degree">Graduate of Professional Degree</option>
<option value="Some College">Some College</option>
<option value="Law Degree">Law Degree</option>
<option value="Medical Doctor">Medical Doctor</option>
<option value="Engineering Degree">Engineering Degree</option>
<option value="PhD or other Doctorat">PhD or other Doctorat</option>
<option value="Other">Other</option>
<option value="Prefer Not to Answer">Prefer Not to Answer</option>
</select></div>
</li>
<li id="field_8_25" class="gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_25" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_25">What is your spouse's name and birthdate?</label>
<div class="ginput_container ginput_container_text"><input name="input_25" id="input_8_25" type="text" value="" class="medium" aria-describedby="gfield_description_8_25" aria-invalid="false" disabled="disabled"></div>
<div class="gfield_description" id="gfield_description_8_25">If you are married, we need to INCLUDE or EXCLUDE your spouse on the quote. This means that his or her name must be listed on the policy. This does not mean that it affects the
price, but it is a requirement from most companies to list the spouse.</div>
</li>
<li id="field_8_16" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_16"><label
class="gfield_label gform-field-label gfield_label_before_complex">Driving Record</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_8_16">
<li class="gchoice gchoice_8_16_1"> <input class="gfield-choice-input" name="input_16.1" type="checkbox" value="Clean Record for the last 3 years" id="choice_8_16_1"> <label for="choice_8_16_1" id="label_8_16_1"
class="gform-field-label gform-field-label--type-inline">Clean Record for the last 3 years</label></li>
<li class="gchoice gchoice_8_16_2"> <input class="gfield-choice-input" name="input_16.2" type="checkbox" value="Ticket(s) in the last 3 years" id="choice_8_16_2"> <label for="choice_8_16_2" id="label_8_16_2"
class="gform-field-label gform-field-label--type-inline">Ticket(s) in the last 3 years</label></li>
<li class="gchoice gchoice_8_16_3"> <input class="gfield-choice-input" name="input_16.3" type="checkbox" value="Accidents(s) in the last 3 years" id="choice_8_16_3"> <label for="choice_8_16_3" id="label_8_16_3"
class="gform-field-label gform-field-label--type-inline">Accidents(s) in the last 3 years</label></li>
</ul>
</div>
</li>
<li id="field_8_17" class="gfield gfield--type-textarea gf_right_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_17" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_17">Are you able to tell us what tickets or accidents you have in the last 3 years? If you know the type of ticket and/or the date, it helps us to get a more
accurate quote.</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_17" id="input_8_17" class="textarea small" aria-invalid="false" rows="10" cols="50" disabled="disabled"></textarea></div>
</li>
<li id="field_8_9" class="gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_9"><label class="gfield_label gform-field-label" for="input_8_9">Do you
have a DUI?</label>
<div class="ginput_container ginput_container_select"><select name="input_9" id="input_8_9" class="medium gfield_select" aria-invalid="false" style="display: none;">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="No">No</option>
<option value="Yes - within the last 3 years">Yes - within the last 3 years</option>
<option value="Yes - within the last 5 years">Yes - within the last 5 years</option>
<option value="Yes - within the last 10 years">Yes - within the last 10 years</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_8_9_chosen" style="width: 334px;"><a class="chosen-single">
<span>CHOOSE ONE</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
</li>
<li id="field_8_10" class="gfield gfield--type-select gf_left_half field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_10"><label class="gfield_label gform-field-label"
for="input_8_10">Do you have insurance now on this vehicle / watercraft? **** DISCOUNT</label>
<div class="ginput_container ginput_container_select"><select name="input_10" id="input_8_10" class="medium gfield_select" aria-invalid="false" style="display: none;">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="Yes - it is active or in-force now">Yes - it is active or in-force now</option>
<option value="No - it lapsed 1-14 days ago">No - it lapsed 1-14 days ago</option>
<option value="No - it lapsed 15-29 days ago">No - it lapsed 15-29 days ago</option>
<option value="No - it lapsed more than 30 days ago">No - it lapsed more than 30 days ago</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_8_10_chosen" style="width: 334px;"><a class="chosen-single">
<span>CHOOSE ONE</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
</li>
<li id="field_8_11" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_11" data-conditional-logic="visible">
<h2 class="gsection_title">About Your Motorcycle / LSV / Golf Cart / ATV / UTV / Side By Side / Trike / Watercraft / Dune Buggy</h2>
</li>
<li id="field_8_12" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_12" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_12">Year<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_12" id="input_8_12" type="text" value="" class="small" aria-required="true" aria-invalid="false" data-conditional-logic="visible"></div>
</li>
<li id="field_8_31" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_31" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_31">Make<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_31" id="input_8_31" type="text" value="" class="medium" aria-required="true" aria-invalid="false" data-conditional-logic="visible"></div>
</li>
<li id="field_8_14" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_14" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_14">Model<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_14" id="input_8_14" type="text" value="" class="medium" aria-describedby="gfield_description_8_14" aria-required="true" aria-invalid="false"
data-conditional-logic="visible"></div>
<div class="gfield_description" id="gfield_description_8_14">Tell us as much as you can. Example: Artic Cat M8 LTD edition</div>
</li>
<li id="field_8_37" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_37" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_37">CCs (if you know the answer)</label>
<div class="ginput_container ginput_container_text"><input name="input_37" id="input_8_37" type="text" value="" class="small" aria-invalid="false" data-conditional-logic="visible"></div>
</li>
<li id="field_8_15" class="gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_15" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_15">VIN (not required, but very helpful to get a quote)</label>
<div class="ginput_container ginput_container_text"><input name="input_15" id="input_8_15" type="text" value="" class="medium" aria-describedby="gfield_description_8_15" aria-invalid="false" data-conditional-logic="visible"></div>
<div class="gfield_description" id="gfield_description_8_15">If you know your 17 digit VIN for a car (or other ID number for a golf cart/LSV), it helps us get an accurate quote. If you do not provide the VIN, then the quote is even more of an
estimate.</div>
</li>
<li id="field_8_39" class="gfield gfield--type-select field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_39" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_39">What kind of vehicle do you have?</label>
<div class="ginput_container ginput_container_select"><select name="input_39" id="input_8_39" class="medium gfield_select" aria-invalid="false" data-conditional-logic="visible" style="display: none;">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="Can Am Spyder">Can Am Spyder</option>
<option value="Dune Buggy / Rail - Street Legal (has license plates)">Dune Buggy / Rail - Street Legal (has license plates)</option>
<option value="Dune Buggy /Rail - Off Road (NO license plates)">Dune Buggy /Rail - Off Road (NO license plates)</option>
<option value="Motorcycle or Scooter - street legal">Motorcycle or Scooter - street legal</option>
<option value="Motorcycle or Scooter - off road">Motorcycle or Scooter - off road</option>
<option value="Trike-Style (2 wheels in the front)">Trike-Style (2 wheels in the front)</option>
<option value="Trike (2 wheels in the back)">Trike (2 wheels in the back)</option>
<option value="UTV or Side by Side">UTV or Side by Side</option>
<option value="ATV">ATV</option>
<option value="ATV - Amphibious">ATV - Amphibious</option>
<option value="Golf Cart - street legal">Golf Cart - street legal</option>
<option value="Golf Cart - off road, private roads, marina, gated community">Golf Cart - off road, private roads, marina, gated community</option>
<option value="Low Speed Vehicle - LSV">Low Speed Vehicle - LSV</option>
<option value="Neighborhood Electric Vehicle - NEV">Neighborhood Electric Vehicle - NEV</option>
<option value="Custom Vehicle (other than buggy)">Custom Vehicle (other than buggy)</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_8_39_chosen" style="width: 334px;"><a class="chosen-single">
<span>CHOOSE ONE</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
</li>
<li id="field_8_38" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_38" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_38">Is it street legal?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_38" id="input_8_38" class="medium gfield_select" aria-required="true" aria-invalid="false" data-conditional-logic="visible" style="display: none;">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="No - offroad only">No - offroad only</option>
<option value="Yes - it's registered and has a license plate">Yes - it's registered and has a license plate</option>
<option value="Yes - but I only use it on private roads/marina - no plates">Yes - but I only use it on private roads/marina - no plates</option>
</select>
<div class="chosen-container chosen-container-single" title="" id="input_8_38_chosen" style="width: 334px;"><a class="chosen-single">
<span>CHOOSE ONE</span>
<div><b></b></div>
</a>
<div class="chosen-drop">
<div class="chosen-search">
<input class="chosen-search-input" type="text" autocomplete="off">
</div>
<ul class="chosen-results"></ul>
</div>
</div>
</div>
</li>
<li id="field_8_46" class="gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_46" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_46">To obtain a street legal dune buggy or sand rail quote, we need to quote at least one (or all) of the other vehicles registered in your household. We do not
quote stand-alone street legal buggies as of September 1, 2016. Please provide the year, make, and model of your other vehicles in the box below.<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_46" id="input_8_46" class="textarea medium" aria-describedby="gfield_description_8_46" aria-required="true" aria-invalid="false" rows="10" cols="50"
data-conditional-logic="visible" disabled="disabled"></textarea></div>
<div class="gfield_description" id="gfield_description_8_46">If you only provide the details of your street legal dune buggy, then we will not be able to send you a quote.</div>
</li>
<li id="field_8_22" class="gfield gfield--type-checkbox gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_22" data-conditional-logic="visible"><label
class="gfield_label gform-field-label gfield_label_before_complex">Discounts - Check all that Apply</label>
<div class="ginput_container ginput_container_checkbox">
<ul class="gfield_checkbox" id="input_8_22">
<li class="gchoice gchoice_8_22_1"> <input class="gfield-choice-input" name="input_22.1" type="checkbox" value="Motorcycle Endorsement on My License (M1 or other)" id="choice_8_22_1" data-conditional-logic="visible"> <label
for="choice_8_22_1" id="label_8_22_1" class="gform-field-label gform-field-label--type-inline">Motorcycle Endorsement on My License (M1 or other)</label></li>
<li class="gchoice gchoice_8_22_2"> <input class="gfield-choice-input" name="input_22.2" type="checkbox" value="Completed Safety Course in last 3 years (proof required)" id="choice_8_22_2" data-conditional-logic="visible"> <label
for="choice_8_22_2" id="label_8_22_2" class="gform-field-label gform-field-label--type-inline">Completed Safety Course in last 3 years (proof required)</label></li>
<li class="gchoice gchoice_8_22_3"> <input class="gfield-choice-input" name="input_22.3" type="checkbox" value="Member of HRCA, AMA or HOG" id="choice_8_22_3" data-conditional-logic="visible"> <label for="choice_8_22_3" id="label_8_22_3"
class="gform-field-label gform-field-label--type-inline">Member of HRCA, AMA or HOG</label></li>
<li class="gchoice gchoice_8_22_4"> <input class="gfield-choice-input" name="input_22.4" type="checkbox" value="Member of AARP" id="choice_8_22_4" data-conditional-logic="visible"> <label for="choice_8_22_4" id="label_8_22_4"
class="gform-field-label gform-field-label--type-inline">Member of AARP</label></li>
<li class="gchoice gchoice_8_22_5"> <input class="gfield-choice-input" name="input_22.5" type="checkbox" value="Member of USAA" id="choice_8_22_5" data-conditional-logic="visible"> <label for="choice_8_22_5" id="label_8_22_5"
class="gform-field-label gform-field-label--type-inline">Member of USAA</label></li>
<li class="gchoice gchoice_8_22_6"> <input class="gfield-choice-input" name="input_22.6" type="checkbox" value="Tracking Device (like loJack or teletrac)" id="choice_8_22_6" data-conditional-logic="visible"> <label for="choice_8_22_6"
id="label_8_22_6" class="gform-field-label gform-field-label--type-inline">Tracking Device (like loJack or teletrac)</label></li>
<li class="gchoice gchoice_8_22_7"> <input class="gfield-choice-input" name="input_22.7" type="checkbox" value="Active Military" id="choice_8_22_7" data-conditional-logic="visible"> <label for="choice_8_22_7" id="label_8_22_7"
class="gform-field-label gform-field-label--type-inline">Active Military</label></li>
<li class="gchoice gchoice_8_22_8"> <input class="gfield-choice-input" name="input_22.8" type="checkbox" value="Homeowner or Condo Owner" id="choice_8_22_8" data-conditional-logic="visible"> <label for="choice_8_22_8" id="label_8_22_8"
class="gform-field-label gform-field-label--type-inline">Homeowner or Condo Owner</label></li>
<li class="gchoice gchoice_8_22_9"> <input class="gfield-choice-input" name="input_22.9" type="checkbox" value="Mobile Home Owner" id="choice_8_22_9" data-conditional-logic="visible"> <label for="choice_8_22_9" id="label_8_22_9"
class="gform-field-label gform-field-label--type-inline">Mobile Home Owner</label></li>
<li class="gchoice gchoice_8_22_11"> <input class="gfield-choice-input" name="input_22.11" type="checkbox" value="Disabling Device - so you cannot start the vehicle" id="choice_8_22_11" data-conditional-logic="visible"> <label
for="choice_8_22_11" id="label_8_22_11" class="gform-field-label gform-field-label--type-inline">Disabling Device - so you cannot start the vehicle</label></li>
<li class="gchoice gchoice_8_22_12"> <input class="gfield-choice-input" name="input_22.12" type="checkbox" value="ABS - Anti Lock Brakes" id="choice_8_22_12" data-conditional-logic="visible"> <label for="choice_8_22_12" id="label_8_22_12"
class="gform-field-label gform-field-label--type-inline">ABS - Anti Lock Brakes</label></li>
<li class="gchoice gchoice_8_22_13"> <input class="gfield-choice-input" name="input_22.13" type="checkbox" value="Airbag" id="choice_8_22_13" data-conditional-logic="visible"> <label for="choice_8_22_13" id="label_8_22_13"
class="gform-field-label gform-field-label--type-inline">Airbag</label></li>
</ul>
</div>
</li>
<li id="field_8_23" class="gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_23" data-conditional-logic="visible"><label
class="gfield_label gform-field-label">Do you need to add any other riders? Remember, you must disclose all people of driving age in your household.</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_8_23">
<li class="gchoice gchoice_8_23_0"> <input name="input_23" type="radio" value="NO - no other people of driving age in my household" id="choice_8_23_0" data-conditional-logic="visible"> <label for="choice_8_23_0" id="label_8_23_0"
class="gform-field-label gform-field-label--type-inline">NO - no other people of driving age in my household</label></li>
<li class="gchoice gchoice_8_23_1"> <input name="input_23" type="radio" value="YES - I will add more drivers" id="choice_8_23_1" data-conditional-logic="visible"> <label for="choice_8_23_1" id="label_8_23_1"
class="gform-field-label gform-field-label--type-inline">YES - I will add more drivers</label></li>
<li class="gchoice gchoice_8_23_2"> <input name="input_23" type="radio" value="gf_other_choice" id="choice_8_23_2" onfocus="jQuery(this).next('input').focus();" data-conditional-logic="visible"> <input class="small" id="input_8_23_other"
name="input_23_other" type="text" value="Other" aria-label="Other" onfocus="jQuery(this).prev("input")[0].click(); if(jQuery(this).val() == "Other") { jQuery(this).val(""); }"
onblur="if(jQuery(this).val().replace(" ", "") == "") { jQuery(this).val("Other"); }" data-conditional-logic="visible"></li>
</ul>
</div>
</li>
<li id="field_8_24" class="gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_24" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_24">Please tell us the NAME, Birthdate, and relationship to you of others riders that you are adding.</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_24" id="input_8_24" class="textarea medium" aria-invalid="false" rows="10" cols="50" data-conditional-logic="visible" disabled="disabled"></textarea></div>
</li>
<li id="field_8_35" class="gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_35" data-conditional-logic="visible"><label
class="gfield_label gform-field-label">Do you need to add another Motorcycle / ATV / UTV / Side By Side / Trike / Dune Buggy?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_8_35">
<li class="gchoice gchoice_8_35_0"> <input name="input_35" type="radio" value="No" id="choice_8_35_0" data-conditional-logic="visible"> <label for="choice_8_35_0" id="label_8_35_0"
class="gform-field-label gform-field-label--type-inline">No</label></li>
<li class="gchoice gchoice_8_35_1"> <input name="input_35" type="radio" value="Yes" id="choice_8_35_1" data-conditional-logic="visible"> <label for="choice_8_35_1" id="label_8_35_1"
class="gform-field-label gform-field-label--type-inline">Yes</label></li>
</ul>
</div>
</li>
<li id="field_8_36" class="gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_36" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_36">Tell us the Year/Make/Model of your other Motorcycle / ATV / UTV / Side By Side / Trike</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_36" id="input_8_36" class="textarea medium" aria-describedby="gfield_description_8_36" aria-invalid="false" rows="10" cols="50" data-conditional-logic="visible"
disabled="disabled"></textarea></div>
<div class="gfield_description" id="gfield_description_8_36">If you have the VIN, please tell us here. If you are adding a second rider, please include a name and birthdate.</div>
</li>
<li id="field_8_33" class="gfield gfield--type-fileupload field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_33" data-conditional-logic="visible"><label
class="gfield_label gform-field-label" for="input_8_33">Do you want to send us a picture of your ride? You can include it here.</label>
<div class="ginput_container ginput_container_fileupload"><input type="hidden" name="MAX_FILE_SIZE" value="268435456" data-conditional-logic="visible"><input name="input_33" id="input_8_33" type="file" class="medium"
aria-describedby="gfield_upload_rules_8_33" onchange="javascript:gformValidateFileSize( this, 268435456 );" data-conditional-logic="visible"><span class="gfield_description gform_fileupload_rules" id="gfield_upload_rules_8_33">Accepted
file types: jpg, gif, png, pdf, Max. file size: 256 MB.</span>
<div class="gfield_description validation_message gfield_validation_message validation_message--hidden-on-empty" id="live_validation_message_8_33"></div>
</div>
</li>
<li id="field_8_47" class="gfield gfield--type-radio gfield--type-choice field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_47" data-conditional-logic="visible"><label
class="gfield_label gform-field-label">Do you authorize us to send you a text (SMS) about your quote or policy, if you purchase one?</label>
<div class="ginput_container ginput_container_radio">
<ul class="gfield_radio" id="input_8_47">
<li class="gchoice gchoice_8_47_0"> <input name="input_47" type="radio" value="Yes" checked="checked" id="choice_8_47_0" data-conditional-logic="visible"> <label for="choice_8_47_0" id="label_8_47_0"
class="gform-field-label gform-field-label--type-inline">Yes</label></li>
<li class="gchoice gchoice_8_47_1"> <input name="input_47" type="radio" value="No" id="choice_8_47_1" data-conditional-logic="visible"> <label for="choice_8_47_1" id="label_8_47_1"
class="gform-field-label gform-field-label--type-inline">No</label></li>
</ul>
</div>
</li>
<li id="field_8_48" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_48" data-conditional-logic="hidden" style="display: none;">
<h2 class="gsection_title">Watercraft Section</h2>
</li>
<li id="field_8_71" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_71" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_71">Are you the original owner of the watercraft?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_71" id="input_8_71" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="Yes">Yes</option>
<option value="No">No</option>
</select></div>
</li>
<li id="field_8_49" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_49" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_49">Year<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_49" id="input_8_49" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_51" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_51" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_51">Make<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_51" id="input_8_51" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_50" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_50" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_50">Model<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_50" id="input_8_50" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_53" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_53" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_53">Top Speed<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_53" id="input_8_53" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_55" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_55" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_55">Engine Size in total number of CCs<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_55" id="input_8_55" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_57" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_57" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_57">How many years of watercraft experience do you have?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_57" id="input_8_57" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_52" class="gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_52" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_52">Do you know the VIN or Hull ID?</label>
<div class="ginput_container ginput_container_text"><input name="input_52" id="input_8_52" type="text" value="" class="medium" aria-describedby="gfield_description_8_52" aria-invalid="false" disabled="disabled"></div>
<div class="gfield_description" id="gfield_description_8_52">The HIN consists of twelve characters, uninterrupted by slashes, hyphens, or spaces. HIN's are typically found on the boat registration and are embossed on the stern right quarter
of the boat.</div>
</li>
<li id="field_8_58" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_58" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_58">What is the hull material<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_58" id="input_8_58" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="Fiberglass">Fiberglass</option>
<option value="Aluminum">Aluminum</option>
<option value="Inflatable">Inflatable</option>
<option value="Roplene">Roplene</option>
<option value="Carbon fiber">Carbon fiber</option>
<option value="Rotomolded">Rotomolded</option>
<option value="Ferro cement">Ferro cement</option>
<option value="Steel">Steel</option>
<option value="Wood">Wood</option>
</select></div>
</li>
<li id="field_8_60" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_60" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_60">Engine Type<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_60" id="input_8_60" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="Outboard">Outboard</option>
<option value="Inboard/Outboard (Stern Drive)">Inboard/Outboard (Stern Drive)</option>
<option value="Inboard">Inboard</option>
<option value="Jet">Jet</option>
<option value="Carbon fiber">Carbon fiber</option>
<option value="Sailboat Powered">Sailboat Powered</option>
<option value="Sailboat Non-Powered">Sailboat Non-Powered</option>
</select></div>
</li>
<li id="field_8_63" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_63" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_63">Does the Boat/PWC have an exposed engine?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_63" id="input_8_63" class="medium gfield_select" aria-describedby="gfield_description_8_63" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="No">No</option>
<option value="Yes">Yes</option>
<option value="Third Choice">Third Choice</option>
</select></div>
<div class="gfield_description" id="gfield_description_8_63">A watercraft equipped with an engine that is not contained within an original equipment manufacturer designed cover and/or insulation.</div>
</li>
<li id="field_8_62" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_62" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_62">Would you like to insure your trailer? If so, please provide the market value of the trailer.</label>
<div class="ginput_container ginput_container_text"><input name="input_62" id="input_8_62" type="text" value="" class="medium" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_64" class="gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_64" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_64">Storage/Mooring ZIP code<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_text"><input name="input_64" id="input_8_64" type="text" value="" class="medium" aria-required="true" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_65" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_65" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_65">Does the watercraft have multiple owners?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_65" id="input_8_65" class="medium gfield_select" aria-describedby="gfield_description_8_65" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="No">No</option>
<option value="Yes">Yes</option>
<option value="Third Choice">Third Choice</option>
</select></div>
<div class="gfield_description" id="gfield_description_8_65">Multiple owners that do not live in the same household. More than two owners is not acceptable.</div>
</li>
<li id="field_8_69" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_69" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_69">Where is Boat/PWC kept during boating season?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_69" id="input_8_69" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="At my home - outside but on my property">At my home - outside but on my property</option>
<option value="At my home - in a garage">At my home - in a garage</option>
<option value="Away from home in a storage building">Away from home in a storage building</option>
<option value="Away from home in outdoors">Away from home in outdoors</option>
<option value="Away from home on a lift">Away from home on a lift</option>
<option value="Away from home in the water">Away from home in the water</option>
<option value="OTHER - please explain in the comments box below">OTHER - please explain in the comments box below</option>
</select></div>
</li>
<li id="field_8_67" class="gfield gfield--type-text field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_67" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_67">Total Horsepower (of all engines)</label>
<div class="ginput_container ginput_container_text"><input name="input_67" id="input_8_67" type="text" value="" class="medium" aria-invalid="false" disabled="disabled"></div>
</li>
<li id="field_8_68" class="gfield gfield--type-text field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_68" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_68">Engine/outdrive modified to enhance performance</label>
<div class="ginput_container ginput_container_text"><input name="input_68" id="input_8_68" type="text" value="" class="medium" aria-describedby="gfield_description_8_68" aria-invalid="false" disabled="disabled"></div>
<div class="gfield_description" id="gfield_description_8_68">Answer 'yes' if the watercraft has any engine or outdrive components installed to enhance performance beyond hull and/or engine manufacturer stock configurations (i.e. blowers,
performance outdrives, performance props, surface drive/mud motors, superchargers, etc.).</div>
</li>
<li id="field_8_70" class="gfield gfield--type-textarea field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible" data-js-reload="field_8_70" data-conditional-logic="hidden" style="display: none;"><label
class="gfield_label gform-field-label" for="input_8_70">Comments and Notes</label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_70" id="input_8_70" class="textarea medium" aria-describedby="gfield_description_8_70" maxlength="1000" aria-invalid="false" rows="10" cols="50"
disabled="disabled"></textarea>
<div class="charleft ginput_counter gfield_description" aria-live="polite">0 of 1000 max characters</div>
</div>
<div class="gfield_description" id="gfield_description_8_70">Provide additional information here</div>
</li>
<li id="field_8_42" class="gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_42" data-conditional-logic="hidden" style="display: none;">
<h2 class="gsection_title">FLORIDA SECTION</h2>
</li>
<li id="field_8_43" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_43" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_43">Is your vehicle registered in Florida?<span class="gfield_required"><span class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_43" id="input_8_43" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="YES">YES</option>
<option value="NO">NO</option>
</select></div>
</li>
<li id="field_8_45" class="gfield gfield--type-select gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_45" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_45">Do you have ANY other cars or Low Speed Vehicles registered in Florida at the same address?<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_select"><select name="input_45" id="input_8_45" class="medium gfield_select" aria-required="true" aria-invalid="false" disabled="disabled">
<option value="CHOOSE ONE">CHOOSE ONE</option>
<option value="YES">YES</option>
<option value="NO">NO</option>
</select></div>
</li>
<li id="field_8_44" class="gfield gfield--type-textarea gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible" data-js-reload="field_8_44" data-conditional-logic="hidden"
style="display: none;"><label class="gfield_label gform-field-label" for="input_8_44">If you keep you have your vehicle registered in Florida and you have ANY other cars registered in Florida, the insurance carrier requires that you write all
vehicles registered at your household in Florida with them. We will quote your other vehicles too. Please provide either the VIN or the year/make/model of your other vehicles.<span class="gfield_required"><span
class="gfield_required gfield_required_asterisk">*</span></span></label>
<div class="ginput_container ginput_container_textarea"><textarea name="input_44" id="input_8_44" class="textarea medium" aria-required="true" aria-invalid="false" rows="10" cols="50" disabled="disabled"></textarea></div>
</li>
</ul>
</div>
<div class="gform_footer top_label"> <input type="image"
src="data:image/svg+xml;base64,PHN2ZyB4bWxucz0iaHR0cDovL3d3dy53My5vcmcvMjAwMC9zdmciIHZpZXdCb3g9IjAgMCAyODggNTciIHdpZHRoPSIyODgiIGhlaWdodD0iNTciIGRhdGEtdT0iaHR0cHMlM0ElMkYlMkZzdHJhdHVtaW5zdXJhbmNlLmNvbSUyRndwLWNvbnRlbnQlMkZ1cGxvYWRzJTJGMjAxMyUyRjEyJTJGc3VibWl0LmdpZiIgZGF0YS13PSIyODgiIGRhdGEtaD0iNTciIGRhdGEtYmlwPSIiPjwvc3ZnPg=="
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* About Us
* A Modern Insurance Agency
* Discounts and Savings
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* Terms of Service and Privacy Policy
* Why Choose an Independent Insurance Agency
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* What is a Certificate of Insurance
* Who wants or needs a certificate of insurance?
* Quote by Industry
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Insurance
* Amphibious ATV Insurance
* ATV Insurance
* Ice House Insurance
* Scooter Insurance
* Trike Insurance
* UTV or Side by Side Insurance
* Renters Insurance
* Renters Insurance for Students
* Renters Insurance Quote
* Short Term Medical Insurance
* Small Business Services
Select Page
* About Us
* A Modern Insurance Agency
* Discounts and Savings
* Get to Know Us
* Going Green
* Newsletters
* Our Family Of Customers
* Personal Insurance Team
* Terms of Service and Privacy Policy
* Why Choose an Independent Insurance Agency
* Work with Us on Any Device
* Auto
* Auto Insurance for College Students
* Auto Insurance for Students
* Auto Insurance Quote
* Buying Auto Insurance Online with an Agent
* FR44 Insurance
* SR22 Insurance Filing
* Blog
* Boats
* Bonds
* California Lost Trust Deed or Note Bond
* How do buy a surety bond or become bonded?
* What is surety bond?
* Business
* Certificate of Insurance Home
* Certificates of Insurance for New Customers
* What is a Certificate of Insurance
* Who wants or needs a certificate of insurance?
* Quote by Industry
* Quote by Type of Insurance for Business
* Contractors Equipment
* Directors and Officers Insurance for Private Companies
* Employment Practices Liability Insurance (EPLI)
* General Liability Insurance and Business Owners Policies
* Home Business Insurance
* Inland Marine Insurance
* Professional Liability Insurance – Errors and Omissions
* Small Business Insurance Quotes
* The Small Business Team
* Understanding Small Business Insurance
* Customer Service
* Certificates of Insurance
* General Service Request
* Payments
* Quote Now
* Request an Auto ID Card
* Schedule a Call
* Dealer Services
* Email Us
* International
* Non Profits
* Non Profit Abuse and Molestation Insurance
* Non Profit Directors and Officers Insurance
* Non Profit General and Professional Liability
* Property
* Condo Insurance
* High-Net Worth Individuals and Families
* Home | Condo | Renters Quote
* Homeowners Insurance Learning Center
* Landlord Insurance
* Modular Home Insurance
* Power Sports – Motorcycle, LSV, Golf Cart, UTV, Dune Buggy, Scooter
Insurance
* Amphibious ATV Insurance
* ATV Insurance
* Ice House Insurance
* Scooter Insurance
* Trike Insurance
* UTV or Side by Side Insurance
* Renters Insurance
* Renters Insurance for Students
* Renters Insurance Quote
* Short Term Medical Insurance
* Small Business Services
DUNE BUGGY INSURANCE
POWER SPORTS INFO
Both street legal and offroad vehicles are eligible for quoting. In most cases,
we can help you save money by helping you with multiple policies. Here’s an
example: If we quote your auto insurance and dune buggy insurance together, you
can receive a discount. Example 2: If we package your motorcycle policy, auto
insurance, home policy, RV, and umbrella policy, you could see some serious
savings.
START YOUR QUOTE
POWERSPORTS OR LSV QUOTE REQUEST
* START YOUR QUOTE
* Tell us About your Ride*
CHOOSE ONEATV (includes amphibious)BoatCan-Am SpyderDune BuggyElectric
Vehicle that is NOT an LSVGolf CartLSV - Low Speed Vehicle / NEV -
Neighborhood Electric VehicleMotorcycleOreion Motors Reeper or HummerPolaris
SlingshotScooterSegwaySnowmobileTrike (2 wheel in back)UTV / Side by Side
* Is your vehicle Street Legal or Offroad?*
CHOOSE ONEStreet Legal - it has a license plateOff Road - it does not have a
license plateOff Road converted to Street Legal - it has a license plate
* Name*
First Last
* Email*
Enter Email Confirm Email
* Address where you keep your Motorcycle / ATV / UTV / Side By Side / Trike*
Street Address Address Line 2 City AlabamaAlaskaAmerican
SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of
ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew
HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern
Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth
CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin
IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces
AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code
* Do you have a separate mailing address?
* No
* Yes - I have another mailing address
*
* Mailing Address - enter only your mailing address here
* When is your birthday?*
MM slash DD slash YYYY
* Phone*
* Marital Status
CHOOSE ONESingleMarriedWidowedDivorcedSeparated
CHOOSE ONE
* Hidden
What is your profession? ** Discount
Many professions can earn discounts. Tell us what you do and we will work to
find you a discount.
* How many years of motorcycle or ATV/UTV experience do you have?
Please enter a number from 0 to 100.
* What is your highest level of Education ** DISCOUNT
CHOOSE ONEJunior High SchoolHigh school - not completedHigh School
GraduateAssociate DegreeBachelor's DegreeGraduate of Professional DegreeSome
CollegeLaw DegreeMedical DoctorEngineering DegreePhD or other
DoctoratOtherPrefer Not to Answer
* What is your spouse's name and birthdate?
If you are married, we need to INCLUDE or EXCLUDE your spouse on the quote.
This means that his or her name must be listed on the policy. This does not
mean that it affects the price, but it is a requirement from most companies
to list the spouse.
* Driving Record
* Clean Record for the last 3 years
* Ticket(s) in the last 3 years
* Accidents(s) in the last 3 years
* Are you able to tell us what tickets or accidents you have in the last 3
years? If you know the type of ticket and/or the date, it helps us to get a
more accurate quote.
* Do you have a DUI?
CHOOSE ONENoYes - within the last 3 yearsYes - within the last 5 yearsYes -
within the last 10 years
CHOOSE ONE
* Do you have insurance now on this vehicle / watercraft? **** DISCOUNT
CHOOSE ONEYes - it is active or in-force nowNo - it lapsed 1-14 days agoNo -
it lapsed 15-29 days agoNo - it lapsed more than 30 days ago
CHOOSE ONE
* ABOUT YOUR MOTORCYCLE / LSV / GOLF CART / ATV / UTV / SIDE BY SIDE / TRIKE /
WATERCRAFT / DUNE BUGGY
* Year*
* Make*
* Model*
Tell us as much as you can. Example: Artic Cat M8 LTD edition
* CCs (if you know the answer)
* VIN (not required, but very helpful to get a quote)
If you know your 17 digit VIN for a car (or other ID number for a golf
cart/LSV), it helps us get an accurate quote. If you do not provide the VIN,
then the quote is even more of an estimate.
* What kind of vehicle do you have?
CHOOSE ONECan Am SpyderDune Buggy / Rail - Street Legal (has license
plates)Dune Buggy /Rail - Off Road (NO license plates)Motorcycle or Scooter -
street legalMotorcycle or Scooter - off roadTrike-Style (2 wheels in the
front)Trike (2 wheels in the back)UTV or Side by SideATVATV - AmphibiousGolf
Cart - street legalGolf Cart - off road, private roads, marina, gated
communityLow Speed Vehicle - LSVNeighborhood Electric Vehicle - NEVCustom
Vehicle (other than buggy)
CHOOSE ONE
* Is it street legal?*
CHOOSE ONENo - offroad onlyYes - it's registered and has a license plateYes -
but I only use it on private roads/marina - no plates
CHOOSE ONE
* To obtain a street legal dune buggy or sand rail quote, we need to quote at
least one (or all) of the other vehicles registered in your household. We do
not quote stand-alone street legal buggies as of September 1, 2016. Please
provide the year, make, and model of your other vehicles in the box below.*
If you only provide the details of your street legal dune buggy, then we will
not be able to send you a quote.
* Discounts - Check all that Apply
* Motorcycle Endorsement on My License (M1 or other)
* Completed Safety Course in last 3 years (proof required)
* Member of HRCA, AMA or HOG
* Member of AARP
* Member of USAA
* Tracking Device (like loJack or teletrac)
* Active Military
* Homeowner or Condo Owner
* Mobile Home Owner
* Disabling Device - so you cannot start the vehicle
* ABS - Anti Lock Brakes
* Airbag
* Do you need to add any other riders? Remember, you must disclose all people
of driving age in your household.
* NO - no other people of driving age in my household
* YES - I will add more drivers
*
* Please tell us the NAME, Birthdate, and relationship to you of others riders
that you are adding.
* Do you need to add another Motorcycle / ATV / UTV / Side By Side / Trike /
Dune Buggy?
* No
* Yes
* Tell us the Year/Make/Model of your other Motorcycle / ATV / UTV / Side By
Side / Trike
If you have the VIN, please tell us here. If you are adding a second rider,
please include a name and birthdate.
* Do you want to send us a picture of your ride? You can include it here.
Accepted file types: jpg, gif, png, pdf, Max. file size: 256 MB.
* Do you authorize us to send you a text (SMS) about your quote or policy, if
you purchase one?
* Yes
* No
* WATERCRAFT SECTION
* Are you the original owner of the watercraft?*
YesNo
* Year*
* Make*
* Model*
* Top Speed*
* Engine Size in total number of CCs*
* How many years of watercraft experience do you have?*
* Do you know the VIN or Hull ID?
The HIN consists of twelve characters, uninterrupted by slashes, hyphens, or
spaces. HIN's are typically found on the boat registration and are embossed
on the stern right quarter of the boat.
* What is the hull material*
FiberglassAluminumInflatableRopleneCarbon fiberRotomoldedFerro
cementSteelWood
* Engine Type*
OutboardInboard/Outboard (Stern Drive)InboardJetCarbon fiberSailboat
PoweredSailboat Non-Powered
* Does the Boat/PWC have an exposed engine?*
NoYesThird Choice
A watercraft equipped with an engine that is not contained within an original
equipment manufacturer designed cover and/or insulation.
* Would you like to insure your trailer? If so, please provide the market value
of the trailer.
* Storage/Mooring ZIP code*
* Does the watercraft have multiple owners?*
NoYesThird Choice
Multiple owners that do not live in the same household. More than two owners
is not acceptable.
* Where is Boat/PWC kept during boating season?*
At my home - outside but on my propertyAt my home - in a garageAway from home
in a storage buildingAway from home in outdoorsAway from home on a liftAway
from home in the waterOTHER - please explain in the comments box below
* Total Horsepower (of all engines)
* Engine/outdrive modified to enhance performance
Answer 'yes' if the watercraft has any engine or outdrive components
installed to enhance performance beyond hull and/or engine manufacturer stock
configurations (i.e. blowers, performance outdrives, performance props,
surface drive/mud motors, superchargers, etc.).
* Comments and Notes
0 of 1000 max characters
Provide additional information here
* FLORIDA SECTION
* Is your vehicle registered in Florida?*
CHOOSE ONEYESNO
* Do you have ANY other cars or Low Speed Vehicles registered in Florida at the
same address?*
CHOOSE ONEYESNO
* If you keep you have your vehicle registered in Florida and you have ANY
other cars registered in Florida, the insurance carrier requires that you
write all vehicles registered at your household in Florida with them. We will
quote your other vehicles too. Please provide either the VIN or the
year/make/model of your other vehicles.*
Δ
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