Please complete all the mandatory fields marked with an *
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Date Established:
Business Description (exact work being undertaken) if applicable:
Claims
Any claims suffered in the last 5 years Yes No
If yes please give suitable details:
Yes
No
Have you or any other person who will be in charge of the vessel ever been declared bankrupt Yes No
Details of Vessel
Was the vessel wholly built and fitted by professioanl boat builders Yes No
If yes, please give name of builders if known
Yes
No
Yes
No
Details of machinery
Inboard(s):-
Outboard(s):-
Maximum designed speed of:-
Details of Use
Will the vessel be used for private pleasure purposes only Yes No
If no please give details of intended use
Details of additional cover
What cover do you require against third party liability: £1,000,000 £1,500,000 £2,000,000 £2,500,000
Yes
No
Do you want to cover mast, spars, sails and rigging while racing Yes No
If yes please state replacement value and type of racing
Yes
No
Values
Present market value of:
Hull, machinery, equipment, gear£
Trailer and/or Trolley£
Dinghies and/or boats£
Outboard motors£
Personal effects£

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