PROPOSAL FOR MARINE HULL

Name of  Vessel
Ex-Name
         
Name
Address
Telephone
Fax
E-Mail
      
Managers
Address
Telephone
Fax
E-Mail
     
Financiers
Address
Telephone
Fax
E-Mail
             
Vessel
             
Year of Built
DWT
GRT
LDT
Flag
Registry
     
Areas of
Operation
        
Value of Vessel in Dirhams/ U$S
            
Type of cover    Institute Time Clauses (Hulls),
ITC (Hulls) Total Loss Only or specify  
                 
I/We certify that the above information is true to the best of my/our knowledge and belief.
           
Date
Place


             


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