Yacht Proposal Form

Please complete the following form and we will provide you with a complete insurance quotation.

Generated with MOOJ Proforms Basic Version 1.3
* Required information.

ASSURED INFORMATION

OWNER *
LEGAL REPRESENTATIVE & USER IN CASE OF CORPORATION STATE *
OCCUPATION *
ADDRESS *
TELEPHONE *
TAX No *
SEA EXPERIENCE *
5 YEARS RECORD FOR VESSEL & OWNER: *

PARTICULARS OF VESSEL

NAME *
TYPE *
REG. PORT *
REG. No *
BUILDER *
YEAR BUILT *
LENGTH *
WIDTH *
MATERIAL OF HULL *
FLAG *

PARTICULARS OF MACHINERY

MANUFACTURER *
YEAR MADE *
TYPE OF ENGINE *
MODEL & SERIAL No. *
TYPE OF FUEL *
HORSEPOWER *
MANUFACTURER OF AUX. MOTOR *
YEAR BUILT *
MODEL *
HP *

USE OF VESSEL

CRUISING AREA *
MOORING PLACE *
LAY UP LOCATION *
PORT-MARINA *
PROFESSIONAL CREW INCL. CAPTAIN *
USE *

VALUES TO BE INSURED

HULL VALUE *
ENGINE VALUE *
TRAILER VALUE *
DINGHY VALUE *
AUX. MOTOR VALUE *
MATERIAL OF HULL *
EXTRA EQUIPMENT *
TOTAL INSURED VALUE *

Αρμενακης Ασφαλιστικες Υπηρεσιες - Συνεργάτες

Armenakis Insurance Services

Sygrou Avenue 19, 117 43 Athens
Tel.: 210 9215022
Fax: 210 9215067
This email address is being protected from spambots. You need JavaScript enabled to view it.

Find us on Facebook

Facebook

 

Contect with us on Linkedin

Linkedin

Visit Us...

Guests Online

We have 82 guests and no members online