Marine Insurance - Quotation Request

Proposer's Name

E-mail address

Telephone No

Postal address

Postcode

Your Occupation

Are you an existing Rowett Insurance client

  Yes

  No

What class of craft do you wish to insure?

select >>> Small Craft Large Craft Pleasure Craft

Who was the vessel's builder?

Year Built

Do you have a survey?

Yes No

If yes, when was this carried out

Estimated Value

Material of Hull

select >>> GRP Wood Other  

Vessel's length

Vessel's beam

 dimensions are in select > metres feet  

Make of Engine

Engine HP

Is the engine

  Inboard

  Outboard

  Petrol

  Diesel

  Single

  Twin

Max Speed

  knots

Main Usage

select >>> UK Non-Tidal Uk Coastal & Inland UK Brest/Elbe Mediterranean Other  

Months in commission from

 to

Where is the vessel, when

in water?

out of water?

Does the vessel have a tender?

Yes No

Is it used for waterskiing?

Yes No

Do you require cover in transit?

Yes No

Private and cruising?

Yes No

Liability Amount

choose >>> £1 million £2 million  

Does the vessel have any security measures

Yes No

if yes, please give details

Have you made any claims?

Yes No

if yes, please give details with dates

Do you have any no claims bonus?

Yes No

if yes, how much?

  select >>> years percent  

Renewal date of present insurance (if applicable)

Preferred Payment Method

choose >>> Credit Card Debit Card Cheque Direct Debit