for agents

Collector Proposal

Form for a Custom Quote

BLUEWATER INSURANCE

Personal Collector Proposal Form For Agents

We’re excited to help you with your collector clients policy. Please complete this form for our team to review and endorse your request. For immediate assistance please contact us toll free at 844.552.4210 or email servicecare@bluewater-ins.com

Order Number

AGENCY INFORMATION

Agency Name *

Agency Website

First Name (Agency Contact) *

Last Name (Agency Contact) *

Email Address (Agency Contact) *

Best Contact Number *

COLLECTOR CLIENT INFORMATION

First Name (Collector) *

Last Name (Collector) *

Email *

Phone *

Address *

City *

State *

Zip Code *

COLLECTION INFORMATION

What type of prized items does your client collect? *

Fine Art

Wine

Numismatic (coins)

Antiques

Artifacts

Guns, Knives & Accessories

Jewelry

Memorabilia

Musical Instruments

Other

What is the total value of your clients collection? *

(Min requirement is $15,000)

How many pieces are in the collection? *

If unknown, please indicate.

Please list the value of each collection type (if more than one). *

For example, Wine - $50,000, Jewelry - $25,000 etc. Please note, the accumulative values should equal the total collection value.

Are the pieces documented, graded, appraised or authenticated? *

Yes

Does your client maintain an inventory of the collection? *

Yes

Inventory list consist of, but not limited to item year, description, purchase date, purchase value, appraised value and/or provenance etc.

If yes, what is the process for inventory management? (Select all that apply) *

Word Doc

Excel Spreadsheet

Software

Photos

Bill-of-Sale

Receipts

Appraisals

Other

Does your client have any single pieces valued at $25,000 or more? *

Yes

Unknown

Is the collection stored in a safe? (If applicable) *

Yes

Premise Security Features (Select All That Apply) *

Central Alarm System

Video Surveillance

Deadbolt

24-hour Security Guard

Gated Community

Where does your client store their collection? *

Home Residence

Storage Facility

Both

Other

Multiple locations include secondary residence, business, museum, gallery etc.

Is the collection currently insured? *

Yes

Has your client filed a claim on their collection in the last 5 years? *

Yes

Help us understand your client's collection profile. For example - Number of years collecting, number of pieces in the collection, association or club affiliation etc.)

for agents

BLUEWATER INSURANCE

Personal Collector Proposal Form For Agents

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(844) 552-4210