INLAND MARINE QUOTE FORM

Name

Occupation note "Director, MD , retired etc must be followed by trade like lawyer, computer consultant etc.

How did you hear about us?

Email Address Date of Birth

Experience/ qualifications of Using Water Craft

Number of years with this type of boat

Any no claims bonus?

Any claims?

Details of Claim amounts and Dates

Type of boat

Material of hull Age of boat Length

Maximum speed Type of mooring

Where is it laid up? Do you have a Boat Safety Certificate?

Inland Waterways Only? Confirm no commercial use

Total value to be insured