Proposer Details

Your Name & Surname(required)

ID Number (required)

Date of Birth (required)

Occupation

Contact Number

Your Email (required)

Boating Experience

Loss/Claims Experience past 5 years with any boat owned/used

Vessel Details

Name

Make/Type of Craft

Year of Build

If Sailing age of Sails/Spars/Masts/Standing & Running Rigging

Length

Beam

Construction

Make/Model of Engine

Engine Age

HorsePower

Fuel used
PetrolDiesel

Maximum Designed Speed (in Knots)

Automatic/Remote Controlled Fire Extinguishing Appliances fitted in:-

Engine Room
YesNo

Tank Space
YesNo

Galley
YesNo

Location of Mooring

Months in Use

Cruising Range

Laid up Location

Use of Craft
 Private & Pleasure Skipper Charter Bareboat Charter Private Racing

Additional Details

Value to be insured (current market value)

Total Sum to be Insured:

Hull & Machinery (Inboard)

Special Equipment

Tender/dinghy

Outboard Motor

Auxiliary Outboard Motor

Road Trailer

Personal Effects

Do you have a current motor insurance policy insured with us?
YesNo

If yes, please state Reg. No.

Are you entitled to No Claim Bonus on Marine Craft? (proof documentation will have to be provided)
YesNo

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