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No PWCs over 15 years of age accepted - No current Programs for Alaska or Hawaii Number of PWCs neeeding to be insured: 1 2 3 4 5 6 Number of Trailers neeeding to be insured: 0 1 2 3 4 5 6

	| Boater's Insurance Agency, Inc. || 809 Podva Road || Danville, CA 94526 || 800-344-7488 |
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