Resume Of Personal Boating Experience Form
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1Hull
Southern California
Northern California
Pacific Islands
P: (949) 477-5030
P: (209) 474-9100
P: (808) 840-1980
F: (949) 477-5040
F: (866) 217-1815
F: (866) 859-8302
& Company
Lic. #0F60641
RESUME OF PERSONAL BOATING EXPERIENCE
For higher Watercraft Liability limits (typically $300,000.00 and up), for Prior FAST catamaran style
experience or for other reasons the Underwriters have requested the following boating experience resume
and associated information be completed for each of the NAMED OPERATOR(s) on the policy.
1. Name of Operator
_________________________________________________________________
Address
_________________________________________________________________
City _______________________________________ St. ______ Zip _______-_____
2. Drivers License Number______________________________________
State __________
3. Date of Birth _____/_____/_____
Age of Operator ______
4. Occupation ________________________________________________________________________
5. Years of general boating experience ____ Years of “fast catamaran or tunnel hull” experience ____
(define the cat style crafts operated below)
6. Years of titled boat ownership ________
7 a. Prior boats you have OWNED: COMPLETE ALL CATEGORIES
Year
Length
Manufacturer
Model (CAT)
Max.
Dates operated
Dates operated (to
Speed
(from year)
year)
b. Prior boats you have OPERATED: COMPLETE ALL CATEGORIES
.
Year
Length
Manufacturer
Model (CAT)
Max.
Dates operated
Dates operated (to
Speed
(from year)
year)
8. List all waters or areas you have navigated: (Atlantic, Great Lakes, Bays, Bahamas, Caribbean, etc,)
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
9. List Licenses, Boating Courses, Boating Education Classes, etc. completed (if none, write “None”):
__________________________________________________________________________________
__________________________________________________________________________________
10. List all marine insurance claims and/or prior marine loss history in past 5 years (if none, write
“None”):
__________________________________________________________________________________
__________________________________________________________________________________
I HEREBY AFFIRM THAT ALL STATEMENTS MADE HEREIN HAVE BEEN ANSWERED TO
THE BEST OF MY ABILITY AND ARE TRUE.
Signature of Insured: _____________________________________________ Date: ____/____/__
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