Lloyd & Whyte International


	UK: Portugal: Spain: France: Italy: Bulgaria: Greece: Cyprus:

Please complete the sections below as comprehensively as possible in order
that we can deliver the best service to you. It is important that any information
you supply is complete and accurate as this is the basis upon which your
quotation will be based, failure to provide correct information could invalidate the cover or void a claim. Any information you provide will be verified throughout the quotation process.


Contact info
Title		*
Name		*
D.O.B		*
Marital Status		*
Occupation		*
Contact Address		*
Town		*
County		*
Country		*
Postcode		*
Tel		*
Email		*

Overseas Address
Town		*
County		*
Country		*
Postcode		*
Tel		*
Email		*

Craft details
Type of craft
Year Built
Where is the vessel registered
Make
Model
Hull material
Length
Beam
Engine make
In/Out Board		In / Out
Year of make
Horsepower
CC
Max Speed

Sums Insured
Hull, Machinery, gear and equipment
Outboard 1
Outboard 2
Tender / life raft
Trailer
Personal Effects
Special equipment
Total sums insured
Use of vessel
Cruising Range
Water Skiing risks		yes no
Racing Risks		yes no

Mooring Details
Type of mooring

Location
Location when ashore
Months in commission
No claims bonus
No of years experience

Mooring Details

Location