Watercraft
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Application for Mexican Watercraft Insurance

Effective date:

Expiry date:

 

 

OWNER (INSURED)

First Name:

Last Name:
Address:
City:

State/Province:

Zip/Postal Code:
Home Phone:
Bus. Phone:

Cell Phone:

E-Mail

Occupation:
Driver's License#:

State/Province

 

# Years of watercraft experience:
   
Current Insurance Company:

Expiration Date: (MM/DD/YY)

 

Previous Losses:
   
Mooring Location in Mexico:
 
Commercial Use? (Used for transportation of equipment, goods, cargo, etc.) YesNo
If "yes" explain:
   
Charter Use? (Use of watercraft by person(s)/passenger(s) for hire) YesNo
If "yes" explain:
WATERCRAFT
Name/Make D.O.C./I.D. Number:
Model: Sail Cruiser RunaboutOther:
Year: Length(In Feet): Construction:
 
EQUIPMENT
Fixed CO2 RDF Radar Radio Auto Pilot Fath GPS
Furniture Tackle Apparel Other:
 
AUXILIARY POWER
Diesel Gas Sail
 
MOTOR(s)
Make: Year: HP: Number of Motor(s): 1 2 3
 
TENDER/DINGY: Year: Length (in feet): HP:

 

Total Value (including: equipment, motor, tenders etc)

 

Liability limits automatically equal to Total Value of Watercraft. 

Excess liability limits available on request.

NAVIGATIONAL AREA:

Policies only cover watercraft when in use in the territorial waters of the Republic of Mexico including inland lakes and rivers and the insured hereby warrants that the described/insured watercraft will not be navigated, docked or stored in Mexican territorial waters, including the Sea of Cortez, south of 24 degrees north latitude between June 1 and November 1,

Extensions are available upon request.

Information Request

 

 

 

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Last modified: 03/25/02