MARKEL®MARINE
RESUME OF PERSONAL BOATING EXPERIENCE
Please complete all sections
Name: ___________________________________________________________
Address: _________________________________________________________
City: _____________________________ State: ________ Zip: ________-_____
Driver’s License Number: ____________________________ State: __________
Date of Birth: ______/______/______
Occupation: ______________________________________________________
Years of titled boat ownership: __________
Prior boats you have OWNED:
Year
Length
Manufacturer
Model
Speed
(MPH)
Hours of
experience
Dates operated
(from year)
Prior boats you have OPERATED:
List all waters or areas you have navigated: (Atlantic, Great Lakes, Bays, Bahamas, Caribbean, etc.)
_________________________________________________________________________________
_________________________________________________________________________________
List Licenses, Boating Courses, Boating Education Classes, etc. completed (if none, write None)
List all marine insurance claims and/or prior marine loss history (if none, write None)
I HEREBY AFFIRM THAT ALL STATEMENTS MADE HEREIN HAVE BEEN ANSWERED TO THE BEST
OF MY ABILITY AND ARE TRUE. I UNDERSTAND THAT MARKEL AMERICAN INSURANCE
COMPANY IS RELYING ON THIS DOCUMENT IN THE UNDERWRITING OF THE POLICY.
Signature: _______________________________________________ Date: ______/______/______
