Форма страхования яхт 1 THE SHIP2 SHIP CHARACTERISTICS 3 USE OF THE SHIP4 CONTACT DETAILS Ship Name*Ship Value*Введите число большее или равное 100000.Current Value+ Equipment + Personal EffectsCurrency*EURUSDGBPNavigation Limits*Europe& MediterraneanWorldwideEurope + CaribbeanEurope + Caribbean+USACaribbeanCarribean + USAUSA watersPacificAsiaIndian OceanIndian Ocean + AsiaOtherPlease describe your sailing trip* We are sorry, we are not able to find a cover yet for your ship. Effective date of coverage* Формат даты:ДД слеш ММ слеш ГГГГ Files Перетащите сюда файлы или DROP HERE: -A copy of the "Certificate of Registry" - Recent Survey-....Settings You can skip this part if you provide us documents of the ship If not, please fill the fields below. If any modification has been undertaken (refit, flag,...) please fill the corresponding fields.FlagBoat BuilderBuilding Year* If your ship is more than 12 years, Insurance companies may require a recent survey attesting her good condition and Market Value ModelGross TonnageEngine BuilderEngine year of contruction20162015201420132012201120102009200820072006200520042003200220012000199919981997199619951994199319921991199019891988198719861985198419831982198019791978197719761975197419731972197119701969Engine Number(s1234Total Horse PowerTender Number(s) ?012345678910Motorised Water Toy Number(s)012345678910Toys Model Home Port*Use*PrivateCharterRentalCrew Member Number*Permanent + seasonal Do you need a quote to insure the crew to be compliance with MLC2006?*YESNOSee DetailsDo you need a quote to insure the crew ?*YesNoSee DetailsPermanent Payroll*Permanent Crew Number*012345678910111213141516171819202122232425262728293031323334353637383940Seasonal Crew Number*012345678910111213141516171819202122232425262728293031323334353637383940 Number of claims (over the last 5 past years):*NoYesIf YES-Year ; Desciption ; Amout Name / Company*Position*OwnerCaptainManagerOtherOwner/ Company AddressYour email* Telephone*CAPTCHA Этот iframe содержит необходимую логику для обработки Ajax в Gravity Forms.
