Master / Crew: (Full Name, Age, Experience)
Please identify all occurrences, events or accidents that have taken place within the last 5 years, in which the Yacht and/or the Insured and/or any other party involved in the operation or management of the Yacht were involved, whether or not such occurrence event or accident gave rise to a claim under any policy of insurance, stating the date, brief circumstances and the value of any loss or damage suffered or any cost or liability incurred. Please provide full details of the claim(s) in the field below:
Material Information : Please state any other fact or facts material to the risk which is the subject of the proposal for insurance submitted through this Proposal Form and which is not addressed elsewhere on this form.