Abbeygate Marine Insurance Quotation Request
Details of Proposer
Name Date of Birth  
 
Address


(city)
(province)
(postcode)
Telephone 
Nationality 
NIE/Passport 
Email 
Occupation 
  Where did you hear 
about us ? 
   
Insurance Details
Type of Craft   Year Built 
Where Registered  Vessel Make and Model 
Hull Material  Engine Make  
In/OutBoard  Year of Make  
HP  CC  
Max Speed 
(Unit)
Length of vessel  (M)
Sums Insured
Please select currency
Hull, Machinery, Gear, and Equipment
Outboard 1
Outboard 2
Tender/Life Raft
Trailer
Personal Effects
Special Equipment
TOTAL
Other Information
Use of Vessel
Cruising Range
(Cruising Range) - if 'other' please state where
Water Sking Risks
Towing Inflatable Toys
Racing Risks
Type of Mooring
(Mooring) - if 'other' please state where
Location of Mooring
Location When Ashore
Months in Commission
How long have you had a Marine Policy
Years Claim Free
Price Purchased
Does This Vessel Have A Current Survey?
How Many Years Experience With This Type Of Craft/Boat?
Please confirm what Qualifications you have for skippering the Vessel
Name of Last Insurer
What is your current Premium?
Charged With Any Convictions
Declined Insurance
Date Purchased And Price Paid   
Any Other Information

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