Commercial Fishing Vessel Insurance Form

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If you wish for a no obligation quote on your fishing vessel insurance, please fill in the form below.
If you want a quote for any other type of vessel, this is not the right form, you must click here

We will make no part of this information public.
We will not sell, lend or reproduce it in any way to unauthorised persons
We will make a proportion of this information known to Maritime Underwriters

The insurance quoted can be payable in quarterly instalment,
an advantage over yearly payments for those who prefer it.

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Please provide the following contact information:                   

Name                        
Title                          
Business address      
Address (cont.)         
City                          
State/Province        
Zip/Postal code      
Country                  
Phone                     
FAX                        
E-mail                    
Type of fishing engaged in 
Number of crew        
Hull insurance ( Amount Requested )
    D/A        Form 
P & I Insurance (Amount Requested ) 
    D/A         Form 
 
Cost of vessel when purchased            
Name of mortgagee ( If applicable )  
Name of vessel                                    
Year Built  
Where was the vessel built   
Type of fishing                        
Length         Beam        Draft  
Make of main engine   
Fuel   
Vessels home port   
Date of last overhaul     
Date engine installed   
Number of hours on engine as of this date   
Year and model of engine   
Number of vessels owned / operated by this applicant   
Names of other vessels owned / operated by this applicant
Are all US Government standards complied with ?
 
List all losses for the last five (5) years for this vessel and any other vessels owned/operated by applicant.Include total losses and vessels not currently owned/operated by applicant.

     
Please copy the combination of letters and numbers exactly as seen above into the box below.

  

I want a quote and undertake that this is an honest representation of the facts.

By pressing the submit button I agree that I am not bound or obligated in any way to complete the insurance process or insurers to accept risk.

However it is agreed that the answers and information I have given are true and shall constitute warranties should a policy be issued.

Wait for a few minutes once the submit button has been pressed  (only once please)

If we need any further information, we will get back to you.

Thank you

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Last revised: April 04, 2007
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Revised: March 02, 2008

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