Form Application for Marina Operator’s Liability


Location number


(Fill out application for each location to be insured)

1. Applicant:


2. Total Gross Receipts:

Total Marina Receipts:

Expiring Policy Year ($):

Next Policy Year ($):

3. Marina Location:


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:




Intended Use:

Workboat 2:




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: