GUERNSEY MARINE INSURANCE QUOTE FORM
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Craft Details
Type of craft	Motor Yacht Speed Boat or RIB Sailing Yacht Dinghy
Make/Model/Type/Class
Name of craft
Year craft built
Year of last survey
Year of purchase
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 2
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Craft Details continued
Length	feet metres
Hull Material	GRP (fibreglass) Wood Steel Aluminium Ferro Cement Other
Total sum insured (£)
Purchase price (£)
Claim-free years	1 Year 2 Years 3 Years 4 Years 5 Years 6 Years 7 Years 8 Years 9 Years 10 Years Over 10 Years
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 3
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Craft Details continued
Details of claims in past 5 years
Cruising range	Please select... Channel Island Waters CI Waters, French coast from Cherbourg to Brest CI Waters, French coast from Brest to River Elbe Other, please specify...
Age of main user
Occupation of main user
Marine experience/qualifications
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 4
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Craft Details continued
Fuel type	Petrol Diesel n/a
Horse Power
Max design speed	Less than 17 knots 18-30 knots 31-40 knots 41-50 knots
Fire extinguishers in engine compart	Yes    No
Mooring location
Type of mooring	Marina pontoon berth Swinging mooring Pile moorings Alongside non-marina Ashore Ashore in locked building Other
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 5
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Craft Details continued
Is the craft laid up in winter?	Yes    No
In commission period
Liability for water-skiers	Yes    No
Use	Private Charter Commercial Fishing Racing
Navigation/Electronic equipment sum insured (£)
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 6
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Title	Mr Mrs Miss Ms Dr *
First Name	*
Surname	*
Date of Birth	dd 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 mm 01 02 03 04 05 06 07 08 09 10 11 12 yyyy 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982 1981 1980 1979 1978 1977 1976 1975 1974 1973 1972 1971 1970 1969 1968 1967 1966 1965 1964 1963 1962 1961 1960 1959 1958 1957 1956 1955 1954 1953 1952 1951 1950 1949 1948 1947 1946 1945 1944 1943 1942 1941 1940 1939 1938 1937 1936 1935 1934 1933 1932 1931 1930 1929 1928 1927 1926 1925 1924 1923 1922 1921 1920 *
Home Telephone	*
Work Telephone
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GUERNSEY MARINE INSURANCE QUOTE FORM PART 7
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Mobile Telephone
Email Address	*
House Name/No	*
Street Address	*
Town/City	*
Postcode	*
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