homeaboutsecurityinsurance guidecontact

MARINE QUOTATION FORM - Back

  Personal Details
   
  Owners Name:   *  
  Occupation:   *  
  DOB    
  Date Cover is to Commence:   (22/12/2007) *  
  Address:    
  Post Code:   *  
  Tel No:    
         
  Boat Details
   
  Name Of Vessel:  
 

Type:

   *  
  Length:   (Foot) *  
  Beam:   (Foot)  
  Draft:   (Foot)  
  Max Designed Speed:   (Knots)  
         
  Builders Name:   *  
  Year Made:   *  
  Price Paid £:   *  
  Material of Hull:   *  
         
  Make of Engine:   *  
  Engine Type:    
  Date Made:   *  
  Horse Power:   *  
  Fuel Type:   *  
         
  Sum Insured £      
         
  Boat:   *  
  Engine:  
  Dinghy:  
  Trailer:  
       
  Crusing Range: *    
 
Lough Erne Only (Inland NI)
Lough Erne & Erne Shannon Canal (Inland of Erin & NI)
Inland & Coastal Waters
 
         
  Months in Commission:    
  Months Laid Up    
  Boat Use:    
  Years Experience:   Year(s)  
  Moored At    
  Type Of Mooring:    
  Laid Up   at  
         
  Claims:  
Yes No
 
  NCB:   Year(s)  
         
  Water Skiing / Wake Boarding:  
Yes No
 
  Water Toys: (Inc. Ring, Biscuit, Sled, Knee Board, etc )  
Yes No
 
         
  Please Include Cover For Underwater Gear  
         
  Do you wish to include cover for waterskiing and watertoys?  

 
         
  Comments:    

 
  * Required Field  
Brady Insurance is a trading name of Brady Insurance Services Ltd. Registered in Northern Ireland, No: NI28419.
Authorised and regulated by the Financial Services Authority (FSA) under firm reference number 303976.
You may check this on the FSA’s register by visiting the FSA website, www.fsa.gov.uk/register or by contacting the FSA on 0845 606 1234.
Email: info@bradyinsurance.co.uk | Terms of Business | Privacy | Feedback | Registered office: 13 Dublin Road, Enniskillen, BT74 6HQ