YACHT INSURANCE PROPOSAL FORM

Please complete the appropriate sections.

We require some personal details

Surname

First Names

Address 1

Address 2

Town          Post Code

County                      Email Address

Telephone Number

Age yrs.       Married   Single

Occupation

               

 

Name of Vessel            Port of Registry

Length of Vessel Mtrs                                                                            Flag

Beam of Vessel Mtrs

Year of Build                            Builder  

Type of Vessel: sailing yacht motor yacht motor sailing yacht speedboat

Material of Hull       Number of Masts

Number of Engines             Power of each engine hp

Max. Designed Speed Knts.

             Date of Purchase                Price Paid £

 

COVER REQUIRED in addition to Hull & Liability of up £1,000,000

      Legal Expenses     Racing Risks     

Total Amount to be Insured £   which includes:-                                                   

Total value of  Electronics £       Value of any Tenders £                             

Value of any Speedboats £

Third Party Indemnity required (if over £1m) £

Liability to Water Skiers       

Total NEW replacement value of masts, spars, sails, rigging £

Name of Present Insurer    Number of yrs NCD

 

Please indicate area of use UK       Mediterranean         Northern Europe

Date of commencement of cover    Number of Months in Commission

Port/Marina where based

Laid up    N/A     Ashore      Afloat       Mud Berth

At

Will this Craft be Used Solely for Private Pleasure Purposes  yes      no

If NOT please give Details:

OK we would also like to know something about your experience of handling small craft.

How many years experience with a) this type of craft  yrs        b) other craft  yrs.

Please list any maritime qualifications:-   

Will you always be in Charge of this Craft when on a Voyage   yes     no    

If not please give details of who will be in Command of this Craft:                                                                

Have you had any accidents/losses in the last five years      yes      no

If yes please give details:-   

                                                                 

                                          

Please check that all the information that you have given is to the best of your knowledge true and accurate. Then please submit the form for consideration

 

                                                                                            

                   Please NOTE that by submitting this Form we consider it to be electronically signed.                 

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