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| Vessel details |
| Country of Registration: |
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| Vessel name : |
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Navigational area |
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Where is vessel normally moored when in commission? |
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Where is vessel kept when not in commission? |
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| Vessel In commission all year (if no select months from right list) |
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Yes |
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No |
Commissioned months: |
From |
To |
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| Type of vessel |
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Other (please specifiy) |
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| Is the vessel used for racing |
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Yes |
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No |
Use of vessel: |
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| Other uses (if selected): |
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| Make |
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Model |
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| Flag |
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Length |
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| Max design speed |
(knots) |
Fuel type |
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| Draught |
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| Year built |
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Value (excluding masts and sails ) |
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| Materials |
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Value of masts and sails |
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| Other material |
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| Engines |
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Make &Model
(please specify for each engine) |
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| Engine type |
Inboard
|
Qty
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HP
(please specify for each engine) |
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| Outboard |
Qty |
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| Stern Drive |
Qty |
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| Surface Drive |
Qty |
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| Jet |
Qty |
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| Other |
Qty |
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| Year Built (please specify each engine) |
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Value (please specify each engine & currency) |
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| Nª of fire extinguishers |
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Manual |
|
Qty |
Fire Extinguisher Contents |
CO2 |
|
Qty |
| Foam |
|
Qty |
| Manual & Automatic |
|
Qty |
Water |
|
Qty |
| Other |
|
Qty |
Do you have a Marine Mortgage: |
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Yes |
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No |
If yes, outstanding amount: |
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| Date of last survey: |
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Nº of claim free years : |
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| |
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| Dinghy details |
| Number of Dinghies, Jet Skis and Tenders |
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| Make. Model, Length & Year Built (please specify for each Dinghy) |
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| Description of all engines |
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| Additional Dinghy information |
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| Water Skier's Liability |
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Yes |
|
No |
Number of Skiers |
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| Employer's Liability |
|
Yes |
|
No |
Number of Crew |
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| Maximum number of people on board including crew |
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| Please provide any additional information you deem necessary on the box to the right |
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