Boat Quote

Please fill out the fields below and send it off to receive your personal quote.
Note that Name, Phone number and E-mail address are mandatory fields.

Owner's Full Name
Postal Address
Which yacht club are you a member of?
Date of birth
Telephone
Occupation
Email address
Names of joint owners or mortgagees (if any)
Mortgage amount	€
Vessel Details
Name of vessel
Year built
Make
Model
Hull material		wood steel GRP other
Dimensions
Length
Extreme breadth
Draft in working trim
Date of last survey
Date purchased
Price paid	€
Number of crew on board/required to crew the vessel
Engine Details
Propeller		twin screw single screw
HP of each engine
Maker
Year built
Serial number
Maximum designed speed
Fuel used in main engine
Fuel used in aux. machinery
Fire Precautions
What fire extinguishers are kept on board?
Is petrol used or stored below deck?		yes no
Is the vessel fitted with bottled gas equipment?		yes no
If so, is all delivery tubing made of copper?		yes no (if no, give details: )
Experience
Years sailing
Length & make of previous boats owned		Length Make Length Make Length Make
ISA & ISA Affiliated Sailing Courses Taken and Qualifications Obtained
Insurance Record
Have you had any accidents or losses during the last 5 years?
		no yes (if yes, give details: )
Has any Insurer declined your proposal, refused renewal of your policy, loaded the premium or imposed special conditions?
		no yes (if yes, give details: )
Will the vessel be used for purposes other than private pleasure?
		no yes (if yes, give details: )
Will you allow others to use the vessel in your absence?
		no yes
		If yes, please give details of sailing experience and qualifications of additional users:
Will the vessel be used for waterskiing?
		no yes
Will the vessel be used for wakeboarding?
		no yes
Will the vessel be used for the pulling of rings, bananas or similar?
		no yes
Will the vessel be used for or in connection with parascending or similar?
		no yes
Do you require cover for racing risks? (i.e. damage to masts, spars, sails, standing and running rigging while racing?)
		no yes
		If yes, please state: age of masts, spars, sails, standing and running rigging:
full replacement cost of masts, sails, standing and running rigging:	€
Cruising range required
Mooring Details
Where is the vessel normally moored when in commission?
Which months of the year will the vessel be laid up?
		from to
Where will it be laid up?		ashore mud berth marina other
Cover Required
Sums to be insured: complete each of the following where applicable
Hull, machinery, equipment etc.	€
Dinghy and/or tender*	€
Outboard motor	€
Auxiliary motor	€
Electronic equipment	€
Special equipment	€	list/value all items over €300:
Personal effects	€	list/value all items over €300:
Other equipment	€	list/value all items over €300:
Total sum insured	€
* Dinghies and tenders must be permanently marked with the name of the insured vessel.
Limit of indemnity for any one accident required in respect of claims by Third Parties and Passengers: List and value all items over €300 for each of the following
		€1,500,000 other €