Passenger Craft / Ferry / Workboat Insurance Personal Information Name* Name of Vessel* Email* Address* Tel.No* Occupation Date of Birth Experience of Owner/Skipper* Qualifications of Owner/Skipper Vessel History Type / Class of Vessel Name of Vessel Builder Year Hull material Length Beam Gross registered tonnage Flag Last surveyed by independent surveyor Last surveyed by Marine Survey Office Expiry date of licence Current Insurance Information Name of Current Insurer/Previous Insurer No Claims Bonus (No. of Years) Current Premium Accidents / Claimsyesno If Yes outline details Engines & Equipment Engines Make & Model Year HP / KW Speed Fuel Other Information Area of Operation Mooring Type Mooring Location Months in Commission Exact use of vessel Number of passengers Crew Liability requiredyesno No. of Crew Purchase Price* Purchase Date* Total Sum Insured If there is any additional information you feel may be relevant Retention of Records As I am currently not a client of the firm, if I choose not to proceed with a product now, I agree that the firm may keep my records for up to 12 months. I ConsentI Do Not Consent
