Commercial Marine & Charters Quote

Insured Name(s)*

Email Address*

Phone Number*

Address*

Street Address Address Line 2 City Province Postal Code

Any marine losses/claims in the past 5 years?

If yes, details & amount

Education Courses:

SVOP / MED3 / RADIO OPERATORS / MARINE FIRST AID / TICKET

How many years of operating experience?

How many years have you owned vessels?

Operating Area:

Any Land Based Activities / Operations

Year

Length

Make

Hull Material (Fiberglass, Aluminum, Wood etc)

Vessel Use

Vessel Registered For Commercial Use:

Year

Make

HP

Inboard, Outboard or Inboard/Outboard

Do you have a current survey?

If no, do you have current photos?

Purchase date & price:

Auxiliary Outboard

If yes, is value included in purchase price?

Tender/Dinghy

If yes, is value included in purchase price?

Value of Tackle Gear and Downriggers

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Email

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