French Boat / Yacht / Marine Insurance

Proposer Details

Last name: *

First name: *

Date of Birth:

Address in France:

Town:

Postcode:

Telephone:

Fax:

Email: *

Occupation in France:

Are you... Salaried Self Employed Retired

Boat Details

Make/shipbuilder:

Exact model:

Boat name:

House flag:

Boat value:

Personal objects value:

Sea accessories & Sea clothes value:

Type of hull: Please select... Sail boat Petrol engine ship Diesel engine ship Inflatable Other

Self built or finished? Self built Finished

Year of build:

Boat length (metres):

Boat material: Please select... Aluminium Steel Wood Polyester/composite Inflatable Other

Usual place of mooring:

Is it mortgaged? Yes No

Is it leased? Yes No

Motor Details

Number of motor:

Make:

Year of motor:

Motor type: Onboard Outboard

HP in CCs:

Fuel: Petrol Diesel

Second motor Make
(if any):

HP in CCs:

Trailer Details

Make of trailer:

Registration number:

Value:

Year manufactured:

Insurance History

Have you been insured with another company in the past 24 months without any claim? Yes No

Insurance Company name:

Policy number:

Has your previous boat insurance contract been cancelled by the insurers? Yes No

Use of the Boat

Zone of Navigation

If other:

Cover Required

Date insurance is expected to commence:

I accept and understand the above statement: