Quote Form

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First name

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Last name

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Date Of Birth

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Occupation

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Address

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Post Code

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Telephone number

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E-mail

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Sailing Qualifications

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Sailing Experience

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Vessel - Make & Model

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Vessel - Name

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Vessel - Length

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Vessel - Construction

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Vessel - Year Built

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Vessel - Year of Purchase

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Vessel - Purchase Price

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Vessel - Max Design Speed

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Cover Required

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Engine/s

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Engine - Make

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Engine Year Built

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Engine - Horsepower

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Engine - Type

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Mooring - Location

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Laid Up Location

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Mooring Type

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Mooring - Period In Commission

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Cruising Range

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Insured Value - Hull Engine and Fixed Equipment

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Insured Value - Outboard Motors

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Insured Value - Personal Possessions

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Insured Value - Trailer/Trolley

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Insured Value - Tender

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Total Insured Value

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Insurance Cover Required From

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Name Of Current Insurer

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Vessel Use

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Do you require water skiing and towing of toys ?

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Do you have a current survey for the vessel less than 5 years old ?

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How many years have you held marine insurance without any claims?

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Details of any claims/losses including dates, circumstances and cost

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