Your Hurricane Plan Where do you primarily moor your yacht between June and November?Private DockMarinaMarina NameSlip NumberMooring AddressStreet AddressAddress Line 2CityState/ProvinceZIP / Postal CodeWhat type of yacht do you have?Yacht Name *ManufacturerModelLength (ft)YearDo you plan on having any work done on the vessel between 6/30 – 11/1 that could prevent the execution of your Severe Weather Plan? (Examples: Engine overhaul, major maintenance, etc.)YesNoIf yes, provide full details, including name and location of the shipyard/facility, nature of work and estimated time frame.Who is responsible for the yacht BEFORE the storm?First Name *Last Name *Email *Phone *CompanyWho is responsible for the yacht AFTER the storm?Same as BEFOREFirst NameLast NameEmailPhoneCompanyHow frequently is the yacht visited during the season?WeeklyBi-WeeklyMonthlyQuarterlyEquipment needed to prepare yacht:Extra LinesChafe ProtectorsFendersAnchorsSwivelsShacklesDuct TapePlugs (Exhaust Ports)OthersEquipment to be STRIPPED from yacht:ElectronicsDinghyOutboard/FuelSailsBiminiGalley FuelShip's PapersPersonal EffectsOthersHurricane LocationIMPORTANT: If you do not have a reservation or guarantee that you can move your vessel to a specific marina, then do not put that marina on your hurricane plan, because when a hurricane is approaching marinas fill up almost instantly and you may not be able to get a reservation. The same goes for a hurricane haul out, if you do not have a hurricane haul out agreement, or your boat is not already on the hard, do not tell the carrier that you will haul your vessel. Where do you intend to store your boat during a hurricane?At DockHurricane HoleMooring/AnchorageHaul OutAt DockLocationStreet Address (if available)Address Line 2CityState/ProvinceZIP / Postal CodeHurricane HoleLocationTravel Time by Water (hrs)Are there any bridges that need to be opened?YesNoWill they need to be opened prior to hurricane?YesNoHas Owner of surrounding land been contacted?YesNoHow will you get ashore?Type of BottomDepth (ft)Additional Anchors NeededYesNoSize (lbs)TypeAdditional Lines NeededYesNoLength (ft)Size (lbs)Additional Chains NeededYesNoLength (ft)Size (lbs)Chafe GearSwivelsShacklesMooring/AnchorageHas the mooring been inspected within the last six months?YesNoHow will you get ashore?Type of BottomDepth (ft)Additional Anchors NeededYesNoSize (lbs)TypeAdditional Chains NeededYesNoLength (ft)Size (ft)Chafe GearSwivelsShacklesDiagram of proposed docking or mooring locationChoose FileNo file chosenDelete uploaded fileSample:Haul OutStorage LocationStorage AddressAddress Line 2CityState/ProvinceZIP / Postal CodeHow far is the inside storage facility or outside location from coastal waters?First NameLast NameEmailPhoneStorage TypeIndoor StorageOutdoor StorageConstruction Material of FacilityBuilt to Hurricane Code?YesNoWhat windspeed (mph) strength is it built to withstand?Windage reduced by stripping sails, furling gear, bimini, and antennas?YesNoExtra blocking available for storm conditions?YesNoDo you have a haulage contract specifying that your vessel will be automatically hauled and stored inside or hauled and secured outside in the case of a hurricane/named windstorm?YesNoIf not, what arrangements have been made for hauling?Will the vessel be moved on its own purpose built trailer?YesNoPlease upload any storage or hall-out agreements in place.Choose FileNo file chosenDelete uploaded fileYou understand and agree this application is a request for a quote based on the information provided herein. You understand and agree the actual coverage, terms and conditions offered by One80 may be different than your request contained herein. The actual terms and conditions for coverage provided are represented by the policies issued and supersede any request or representations made prior to issuance. Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime. The applicant represents that the above statements and facts are true and that no material facts have been suppressed or misstated.SignatureStart signing your signature hereYour browser does not support e-Signature field.DateFirst NameLast NameTitleSubmit
