Location number
OF
(Fill out application for each location to be insured)
1. Applicant:
Name:
2. Total Gross Receipts:
Total Marina Receipts:
Expiring Policy Year ($):
Next Policy Year ($):
3. Marina Location:
Address:
4. Marina Description:
Description (enclose diagram and/or pictures, if available):
Additional file:
Additional file:
Additional file:
5. Operations Performed:
a. Repair:
Repair: Annual Gross Receipts ($)?
Repair: Highest Value Yacht Repaired ($)?
Type of Work Performed:
Engine Work (%):
Hull Repair (%):
Other (%):
b. Storage:
Storage: Annual Gross Receipts ($)?
Storage: Maximum no. of Watercraft Stored (#)?
Estimated Average Value of Stored Watercraft ($)?
Method of Storage:
Racked Inside (%)?
Racked Outside (%)?
Cradle/Trailer Inside (%)?
Cradle/Trailer Outside (%)?
Other (%)?
If "Other", please explain:
c. Mooring
Mooring: Annual Gross Receipts ($)?
No. of Slip Moorings Available for Rental?
No. of Buoy Moorings available for rental?
What is the Estimated Average Value of Watercraft Moored?
Are any Commercial Watercraft Moored?
If "Yes", please explain:
Are any Mooring Slips Under a Common Roof?
If "Yes", please explain:
d. Fuel Sales:
Fuel Sales: Annual Gross Receipts ($)?
Are fuel tanks below ground?
Is Fueling Self Serve?
If "Yes", please explain:
e. Hauling/Launching:
Hauling/Launching: Annual Gross Receipts ($)?
Method used to Haul/Launch:
Rated Working Capacity of Travel Lift(s) (TONS):
Rated Working Capacity of Crane(s) (TONS):
f. Sale of Water-craft and Supplies:
Total Sales of new, used, and consignment watercraft and parts/motors ($)?
New Watercraft Sales ($)?
Used Watercraft Sales ($)?
Watercraft Sales on a Consignment Basis ($)?
Sales of Parts/Motors ($)?
Watercraft manufacturers represented (list)?
Parts/Motor Manufacturers represented (list)?
Do watercraft, parts and/or Motor Manufacturer(s) provide you with a broad form Vendor's Endorsement?
Annual number of boat shows in the water (#):
Annual number of boat shows out of the water (#):
g. Other:
Other: Annual Gross Receipts ($):
Fully describe these "Other" Operations:
6. Floating Docks:
Do you have floating docks?
If "Yes", Answer the Following:
Average age of the floating docks (years):
Describe the Construction (Pilings and Decking):
Type of Flotation Used:
7. Workboats:
Do you own and/or operate a workboat(s):
If "Yes", are they covered for P&I Insurance Including Crew?
Schedule of Workboats:
Workboat 1:
Name:
Description:
Horsepower:
Intended Use:
Workboat 2:
Name:
Description:
Horsepower:
Intended Use:
8. Fire Protection
Public Fire Department: Paid or Volunteer?
Public Fire Department: How Far Distant (Miles)?
Public Fire Hydrants: How Many (#)?
Remarks and/or Other Fire Protection Measures Taken:
9. Security
Number of watchmen employed (#):
Number of watchmen per shift (#):
Are there watchmen on duty 24 hours? YesNo
Is the Marina Fenced with Guard at Gate at all times when yard is operating?
Remarks and/or Other Security Measures Taken:
10. Adjacent Properties:
Describe adjacent properties to the location: