Fishing Boat Insurance Enquiry Personal Information First Name* Surname* Email* Address Tel.No* Occupation Date of Birth Experience of Owner/Skipper Qualifications of Owner/Skipper Vessel History Vessel Name Type / Class of Vessel Builder Year Length Hull Material Beam Gross registered tonnage Registration No. 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 / Type of fishing 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
