YACHT INSURANCE QUOTE and INFORMATION FORM


Kasra A.Ş.

Boat Owner's

Name

 :  

Surname

 :

E-mail

 :

Telephone

 : ( )

Fax

 : ( )
Mobile : ( )  
Number of Yachts :
Proposer's (If not same)

Name

 :  

Surname

 :

E-mail

 :
Hull Information
Hull Type :
Name of the Boat :
Registration Number :
Boat Type :
Year Of Manufacture :
Name Of The Manufacturer :
Length :
Width :
Use Of The Boat :
Model Of The Boat :
Maximum Speed :
Engine Information
Engine Manufacturer :
Number Of Engines :
Year Of Manufacture :
Power Of Engine (HP) :
Type Of Engine :
Type Of Fuel :
Lcation
Location City :
Mooring Location/Marina :
Navigation Area :
Laid Up Period (moths) :
Equipment Information
Radar Compass  
Depthfinder Loran  
EPIRB GPS  
Navigation Software VHF  
Is there a service boat? : Yes No
If Yes, # of service boats :
Name :
Registration Number :
Power :
Engine Make :
Speed :
If the boat is a charter boat, is it rented?
With the captain and crew
Bare Boat
Current Insurance
Current Company :
Expiration Date :
Coverage Requested
Hull (Actual Value) : (Inc. Engine & Equipment)
Liability:
Captain
Crew
Safety Equipment
Smoker Detector : Yes No
Fire Equipment : Automatic Manuel
Any claims in last 5 years
Other Notes Or Requests