Application to Charter Form - Fishermen Services

Instagram

This field is for validation purposes and should be left unchanged.

INFORMATION ABOUT INSURING YOUR BOAT FOR CHARTERING 1. Protection and Indemnity Insurance Policy of $300,000.00 or more is required to obtain approval for Chartering or any For- Hire Activity. 2. If you have a policy that does not meet this minimum requirement, your policy will automatically increase to $300,000.00. 3. This application will not approve more than six passengers for hire. 4. Federal law requires that you must have a Captain’s License (commonly called, a six pack license, to transport six or fewer passengers for hire. 5. Persons on Board-Other than Crew endorsement will be issued to you if this application is approved.

YOUR PROTECTION & INDEMNITY POLICY NUMBER:

NAME OF OFFICER, MANAGER OR PARTNER (IF OWNER IS A CORPORATION, LLC, OR LLP):

NAME OF APPLICANT (IF DIFFERENT THAN ABOVE):

ADDRESS OF INSURED OWNER:

Street Address Address Line 2 City State ZIP Code

TELEPHONE NUMBER:

EMAIL ADDRESS:(Required)

NAME OF INSURED VESSEL:

VESSEL REGISTRATION NUMBER:

PLEASE DESCRIBE IN DETAIL THE NATURE OF THE PROPOSED CHARTER OR FORHIRE ACTIVITY, INCLUDING ANY EQUIPMENT TO BE BROUGHT ON BOARD:

DO YOU NEED TO NAME AN ADDITIONAL INSURED ON YOUR POLICY IN CONNECTION WITH THIS CHARTER ACTIVITY ?

YES

IF YES, PLEASE COMPLETE THIS SECTION

FULL LEGAL NAME OF ADDITIONAL INSURED:

NAME OF OFFICER, PARTNER, OR MANAGER APPLYING FOR AND ACCEPTING THIS ENDORSEMENTIF THE ABOVE IS A CORPORATION, PARTNERSHIP, LIMITED LIABILITY PARTNERSHIP OR LIMITED LIABILITY COMPANY:

ADDRESS:

Street Address Address Line 2 City State ZIP Code

TELEPHONE NUMBER:

EMAIL ADDRESS: