Yacht Additional Information Questionnaire

Additional Vessel Information

Is there a lienholder on the vessel?

Please provide information

Is the vessel ever operated single-handed?

Is the vessel used for water skiing or diving?

Is the vessel chartered out?

How many passengers per trip?

Estimated number of trips per year

Details of the Charter operation

Additional Equipment Information

Are there fire extinguishers present on the vessel?

Yes
No

Are there anti-theft devices present on the vessel?

Yes
No

Is there a GPS tracker present on the vessel?

Yes
No

Is there a depth sounder present on the vessel?

Yes
No

Is there a sonar system present on the vessel?

Yes
No

What is the number of bilge pumps on the vessel?

Declaration

I declare that the information provided in connection with this proposal, whether in my own hand or not, is true and I have not withheld any material facts*. I understand that non-disclosure or misrepresentation of a material fact* may entitle underwriters to void the insurance.

*A material fact is one likely to influence acceptance or assessment of this proposal by underwriters; if you are in any doubt as to whether a fact is material or not you must disclose it.

Signature*

Name*

First Last

Date*

Email*

Phone

This field is for validation purposes and should be left unchanged.

Additional Vessel Information

Additional Equipment Information

Declaration

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