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Details of Proposer

Name
Address
Telephone

Date of Birth   Email Address Nationality NIF / Passport Occupation
Where did you hear about us * Please Select *GoogleExisting ClientRecommendationLink from another siteIntroducer4Business MagazineEuro Weekly NewsBingCyprus Local DirectoriesCyprus MailDaxi MagazineFacebookInstagramLinkedInMailshot Paphos PostPocket Diary (Cyprus)Portugal NewsRadioRock FMTwitterWe love CyprusOther

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Insurance Details

Type of Craft *Please Select* Jet Ski Sailing Yacht Motor Cruiser Open Day Sailing Boat Sportcruiser Skiboat RIB Runabout Where Registered Spain Portugal Cyprus Greece Italy Malta UK Hull Material *Please Select* GRP Wood Steel Aluminium Other In/OutBoard Inboard Outboard HP Max Speed
Knots MPH

Year Built Vessel Make and Model Engine Make Year of Make CC Length of vessel (m)

 

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Sums Insured

Please select currency

Euros GBP CYP Dollars

Hull, Machinery, Gear, and Equipment

Outboard 1

Outboard 2

Tender/Life Raft

Trailer

Personal Effects

Special Equipment

TOTAL

 

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Other Information

Use of Vessel

*Please Select* Private Pleasure Skipper / Owner Charter Houseboat Residential Other

Cruising Range

*Please Select* Portugese Waters Spanish Waters Med Waters not east of 5 degrees Other

(Cruising Range) - if 'other' please state where

Water Sking Risks

Yes No

Towing Inflatable Toys

Yes No

Racing Risks

Yes No

Type of Mooring

*Please Select* Canal Bank Ashore Marina Harbour Swinging Other

(Mooring) - if 'other' please state where

Location of Mooring

Location When Ashore

Months in Commission

How long have you had a Marine Policy

4 or More Years Nil 1 Years 2 Years 3 Years

Years Claim Free

4 or More Years Nil 1 Years 2 Years 3 Years

Price Purchased

Does This Vessel Have A Current Survey?

How Many Years Experience With This Type Of Craft/Boat?

4 or More Years Nil 1 Years 2 Years 3 Years

Please confirm what Qualifications you have for skippering the Vessel

Name of Last Insurer

What is your current Premium?

Charged With Any Convictions

Yes No

Declined Insurance

Yes No

Date Purchased And Price Paid

Any Other Information