Enquiry form

Please fill the form below and hit the send button. We will process your enquiry as soon as possible.

Company Name   
Address   
Telephone   
Fax   
E-mail   
URL   

Broker

Broker Company Name   
Broker Contact   
Broker Telephone   
Broker Fax   
Broker E-mail   
Broker URL   
Signing this form does not bind the proposed company to entering into a policy of insurance but if a contract of insurance is entered into on the basis ofĘthe information contained herein, then this form, duly completed and signed, will formĘpart of that contract.
Is your company   Commodity trader
Importer/exporter of commodities
Vessel operating company
General Cargo operator
Liner Service
Special operations
Other
please specify   
How many years is your company chartering ships?   
What goods do you carry?   
Mostly third party cargo?   
Mostly own cargo?   
Main trading areas?   
How many ships do you expect to charter per annum?   
What is the expected total annual cargo volume in mt per annum for which you charter ships?   
What is the average charter period?   
What type of Charter Party do you most frequently use?   
Voyage Charter   
Time Charter   
Bills of Lading: Is your company named in the Bill of Lading?   yes
no
Do you have a written ship vetting policy?   yes
no
Are you currently insured for Charterers Liability?   Yes
No
current Charterers Liability Insurer   
expiry date of current Charterers Liability policy   
Are you currently insured for FDD cover?   Yes
No
current FDD Insurer   
expiry date of current FDD cover policy:   
Please provide claims record for last 5 years   
If you were not currently Insured for Charterers Liability please advise if you have ever been involved in incidents which have or would have resulted in claims?
Charterers Liability   Yes
No
please specify Charterers Liability   
FDD   Yes
No
please specify FDD