Marine Insurance

Are you a member of a boating association?

Member Number:

Your Boating Experience(Years)

Any Marine Insurance Claims made?

Last Claim Date:

Policy Required

Value

Will the boat be used for

Other

Total Sum Insured($)

3rd Party Cover Req.($)

Water Skiers Liability

Number of Passengers

Is food and drink served?

Bodily Injury Cover

Make

Model

Year Built

Length/HP/Construction

Make

Model

Year Built

Length/HP/Construction

Make

Model

Year Built

Length/HP/Construction

Make

Model

Year Built

Length/HP/Construction

Has the boat been surveyed

Last date of survey

Motor Type

Max. Speed of Boat(knots)

Fuel

Turbo Charged

Fire Extinguishers

Layup Postcode

Layup Months

Used for official and/or organised racing and/or speed trials

Details

Require Land Transit Cover

Postode where boat is stored

Moored Craft

Postcode of Mooring Location

Type of Berth

Type of Mooring

Other

Type of Rig

Number of Spreaders:

Type of Spreaders:

Mast Construction:

Date rig last checked

The boat is used for official and/or organised racing and/or speed trials

Details

Where can the boat be inspected

Has the boat been insured during the past 12 months

Have you advertised the boat for sale in the last 12 month?

Advertised Price

Has your boat been professionally designed

Has your boat been professionally built

Your Full Name

Daytime Phone Number

Your Email Address

Your Facsimile Number

Your Postal Address