Yacht & Motorboat Proposal

Please complete all fields.

First Name:

Last name:

Birthday

Phone

Work Phone

Occupation

Employer

Primary home address

Vessel particulars

Name of vessel

Length overall

Beam

Year built

Price Paid

Hull material

A professional kit?

Yes

Builder's name

Builder qualifications?

Amateur (see below)

Professional

Note: If amateur-built, or 5+ years old, Full Condition Survey and Valuation Report will be required. Vessels older than 25 years, and conversions, are not acceptable.

Engine details

Note: Serial number(s) must be provided before theft cover applies.

Outboard 1

Year & Make

Horsepower

Serial Number

Outboard 2

Year & Make

Horsepower

Serial Number

Outboard 3

Year & Make

Horsepower

Serial Number

Max speed of vessel with these engines

Has vessel ever been damaged?

Yes

If YES, please provide details

Is vessel fitted with auto or remote controlled fire extinguishers in engine and tank areas?

Yes

If YES, please state make and location

If NO, please provide details of other types of other types of extinguishers carried