Quote Request Form

Quote Request Form
Webform For
Reply to Email
maidstone@havenkjspecialist.com
Sub Date

DayMonthYear
What date would you like your cover to start? (If you are unsure of the date, please use todays date)

DayMonthYear
Title
Title (other)
First Name
Surname
Date of Birth

DayMonthYear
Occupation
Address

House Name/No. and Street

Street Address Line 2

Town/CityCounty

Post Code
Email Address

Confirmation Email
Phone Number
How did you hear about us?
Name of Referrer
How did you hear about us (other)
Data Processing Consent
In order for Haven Knox-Johnston to provide you with a quote, Data Processing Consent must be set to Yes. If you would prefer to speak to one of our specialists please call 01843 603345.
Marketing Consent
How would you like to receive marketing information?
By providing this information you consent to Haven Knox-Johnston contacting you by any of the methods that you have provided details for, and that we will process such information in accordance with our privacy notice https://www.howdengroup.com/uk-en/privacy-data-protection-policy

How many years experience with this type of craft?
Do you have any boating qualifications?
Boating Qualifications
Do you have a no claims bonus?
Any claims or convictions within the last 5 years?
Number of claims in the last 5 years?
Please provide details of claim or conviction, including date of claim, details of incident and how much was paid if applicable.
What type of vessel are you insuring?
Boat Name
Make and Model
Length (Feet) OLD
Length (Feet)
Year of Build
Type of Main Engine
Engine Make
Engine Horsepower.
Engine Horsepower OLD
Construction of Hull
Construction (Other)
Top Speed in Knots
Top Speed in Knots OLD
Year of Purchase
Price Paid (£) OLD
Price Paid (£)

Please enter the sum insured where applicable

Country of Registry / Flag Authority
Cruising Range
Cruising Range (Other)
Use of Vessel
Type of Mooring
Type of Mooring (Other)
Type of Mooring (Ashore)
Ashore Mooring (Other)
Location of Mooring
Optional Cover
Do you require racing risks?
Value of MSSR (£) OLD
Total value of Mast, Spars, Sails and Rigging
Value of MSSR (£)
Total value of Mast, Spars, Sails and Rigging
Water Skiers Liability Required
Towing of Toys Liability Required
Latest Survey & Valuation
Please attach a copy of your latest survey and valuation if applicable.

Cancelof
Should be Empty:

Optional Cover