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Watercraft
First Name:                                                       Last name:
*       *
Phone number:                                                E-mail Address:
--*                                                 *
Information of the Watercraft:
Name of boat: *
Type of watercraft:

Make and Model of boat: *
Year:                      Where it was built?
 * *
Lenght:       Beam:        Draft:
Ft*  Ft*  Ft*
Material of the hull:
* Crew capacity:           Passengers capacity:
 *   * 		Port where is registered:      Flag: *   *
License plate number:
Engine Make:            Engine Model:
 Engine Year:             Engine HP:
Fuel:

Aux Boat:                 Value:
Trailer:                  Value:
Use:
   Will you rent For charters?      Times per week
   Will you rent For fishing?        Times per week
   wont't rent the boat, use private and enjoyment

Medical Expenses For Crew?           1,500   5000   1000   
Medical Expenses For passengers? 1,500   5000

Requested coverage plan: *
Liabiity only / Third party damages
Limited Coverage: Liability plus only total loss (material damages or total theft)
Full Coverage: Limited coverage plus partial loss (material damages & total theft)
Replacement values Amount
type of currency  USD  MX
Value of the Hull  
Insured Amount for Liability  
If Engine(s) are out of board, total value for the Engines
  
Navigation instruments (if they were adapted separately)         
  
Dingy with motor
  
Jetsky
  
Trailer
  
Fishing equipment & personal property  

Comments:


MT Los Cabos, S.C., representado por International Insurance Services, con domicilio en: Carretera Transpeninsular Km. 0.5 local 88, Colonia El Tezal, Cabo San Lucas, B.C.S. 23454, utilizará sus datos personales con la finalidad de permitir la intermediación de contratos de seguros, fianzas e inversiones, conforme a lo establecido en el Art. 19 de la LFPDPPP. Para conocer el tratamiento de sus datos personales puede acceder a nuestro Aviso de Privacidad en cualquier momento.

International Insurance Services on behalf of MT Los Cabos, S.C., with address at Carretera Transpeninsular K, 0.5 local 88, Colonia El Tezal, Cabo San Lucas, B.C.S. 23454, shall use your personal data with the purpose to allow the purchasing of insurance, fines and investments, based on the 19th article of the LFPDPPP (Law of Protection of Personal Data). To access to our Privacy Notice at any time.