**MARINE SUPPLEMENT**

INVENTORY (Please Do Not Include BPP)

ACV Deductible:

Blanket Limit / $
Loc #1 / Loc #2 / Loc #3 / Loc #4
Inventory/Stock
Inside/Outside Bldgs
Afloat
In Transit
Other Loc/Exhibit

Describe Inventory: ______

If vessels:

Maximum Values: ______

Average Values: ______

Peak Season Limit:From: ______To: ______

How is Inventory protected? ______

Comments:

DOCKSCONSTRUCTION & VALUE

Blanket Limit: ______Deductible ______ACV/RC ______

NO. of Docks: ______NO. of Slips: ______

NO. Covered ______NO. Open ______

Liveaboards NO______Yes_____If Yes, how many? ______

ITEMCONSTRUCTION TYPE AGE ACV RC

A. FLOATS______$______$______

B. DOCKS ______$______$______

C. PIERS ______$______$______

D. PILINGS ______$______$______

E. RAMPS ______$______$______

FLOATING BUILDINGS

Blanket Limit: ______Deductible ______ACV/RC ______

Building Contents Type

Loc #LimitLimit Description Constr Yr Built Sq Ft.

1
2
3
4

Sprinklered: Yes _____ No _____ Central Station: Yes _____ No _____

List types of utilities on docks and/or floats?

______

______

Where are the utilities mounted? ______

When were they installed? ______

If updated, when? ______

Is there a regular maintenance program? ______

Annual Maintenance budget? ______When was facility last inspected?______

Updates: Yes _____ No _____

Describe Updates (Type and Year): ______

How was value determined? If appraisal, enclose copy.______

Comments:

______

LOSS OF INCOME ON DOCKS/PIERS/FLOATING BUILDINGS

Blanket Limit: ______Co-Insurance %: ______

Loc #Limit

1
2
3
4

Is mooring area exposed to flow of ice or debris?Yes____No____

Is there a breakwater? Yes____No____

(Do not include value in limits)

Comments:

______
______

PROTECTION & INDEMNITY

Limit:______Deductible: ______

Marina Operators

Water Demonstration______How Often?______Waters where demos are conducted______

Owned Watercraft(Attach Schedule)

Rental Watercraft(Attach Schedule)

Towers Liability

Comments:

Maximum distance traveled to body of water: ______

Maximum distance traveled offshore: ______

MARINA OPERATORS LEGAL LIABILITY

Limit:______Deductible ______

Marina Operators Legal Liability

Boat Repairers Legal Liability

Boat Dealer/Broker Legal Liability

Comments:

BOAT STORAGE ON LAND

In Building On Rack In the Open

Loc / # of Units / Value / # of Units / Value / # of Units / Value
1
2
3
4

LAUNCHING & HAULING

Method Used______

Use by public permitted:Yes____No____

If yes, describe __

LEINHOLDERS

AI / LPName

Interest: ______Address

City State_____ Zip______

If there are additional Leinholders, please use a separate sheet.

REPAIR, ALTERATIONS & MAINTENANCE

Type of work done

______

Type of work subcontracted

______

Does subcontractor accept responsibility of customers property?

Do you obtain Certificates of Insurance from Subcontractors?

Are Customers permitted to work on their own boats on your premises?

Any service or repair of commercial watercraft?

______

PROTECTION

Loc 1 / Loc 2 / Loc 3 / Loc 4
Number of miles to nearest fire station
Number of hydrants within 500 feet
Located within city limits
Deadbolts / Padlocks
Heavily Patrolled Area
Fenced and floodlighted at night
Watchman on premises when not open for business
Motion detectors
Alarmed Fence
Fire Extinguishers are located: / Loc #1 / Loc #2 / Loc #3 / Loc #4
Store Area
Fueling Area
Repair Area
Storage Area
Each Dock

Date last serviced:

If restaurant or snack bar, is there an ansul system:Yes____No____

When was it last serviced?______

If no, explain protection devices, if any

Is the Public Fire Department Paid or Volunteer?...... ______

What is the size of the Public Fire Mains?...... ______

b. What is the pressure of the mains?...... ______

Do you have private fire protection? If yes, please describe______Yes _ No

______

Is area fenced in? If yes, please describe______Yes_No

______

What is adjacent to the docks and piers area?______

______

Is area locked entry or restricted entry?______

GEOGRAPHIC INFORMATION

Average tidal variations______

Minimum depth of water______

Maximum wind velocity at each location______

Direction from which wind originates______

Docks/Piers removed for winter? ____Yes ____No

Describe evacuation for approaching storms?______

GENERAL QUESTIONS

YES / NO
1. Does applicant typically deliver new boats to customers?
2. Does applicant typically deliver and pickup boats for repair?
3. Number of Boat Shows per year / number of days per show
4. Does applicant maintain a repair shop?
5. Are new employees required to furnish drivers’ license number?
6. Are new employees investigated?
Explain:
7. Does applicant furnish or loan boats or other property to salesmen, employees or customers?
8. Are boats loaned or furnished for personal or family use?
Explain:
9. Any lease or rental of boats?
Explain:
10. Does an employee accompany customer on all demos?
11. Are demonstrations equipped with full compliment of Coast Guard approved equipment?
12. Have you personally inspected the premises?
13. Do you feel that operations, housekeeping or other physical conditions present an unusual exposure?

Comments:

CLASSIFICATIONS

Payrolls

Clerical office Employees

Proprietors, Partners & Officers

If corporation, indicate # of active Officers

If partnership indicate # of partners

GL Code / Loc #1 / Loc #2 / Loc #3 / Loc #4

PAYROLL:

Boat Salesmen / 37312
Repair Employees / ---
Dock Service Employee / ---
Bldg & Ground Maintenance / ---
Others not listed above / ---
AREAS:
BoatSalesBuilding / 55971
Building leased to others / 65198
Retail Sales Store / 59991
RestaurantBuilding / 58151
Snack Bar / 58151
Grocery Store / 54131
Motel - # of Units / 7112
Others not Listed / ---
SALES & RECEIPTS
Repairs / 37312
Boat Sales / 55971
Brokerage Boats Gross Receipts / 55971
Brokerage Boats – Commissions / 55971
Slip Rental/Dock Rental / ---
Total Number of Slips & Docks / 44696
Accessory Sales / 59991
Grocery Sales / 54131
Retail Store receipts / 59991
Mobile Homes - # of Sites / 70310
Gasoline/Oil Sales Receipts / 59812
Restaurant – Food Sales / 58161
Liquor Sales
Hauling/Launching
Storage on Land

CRIS 07/05

1