Customer Job Request

GLADSTONE MARINA SHORE BASE

CUSTOMER DETAILS
Name*

First NameLast Name
Vessel Name*
Make and Model of Vessel*
Phone Number*

Area CodePhone Number
Email*
example@example.com
Does vessel need to be lifted?*

YESNO
Vessel Draft (in metres)*
Vessel Beam (in metres)*
Vessel Length (in metres)*
Vessel Weight (in Tonnes)*
Please acknowledge that your vessel will need to be brought up on our slip way if it is over 6 metre beam or 40 tonne.

I understand
Hull Type*

Mono HullCatamaran
Type of Yacht*

SailorCruiserFly Bridge
Please Supply Vessel Certificate of Currency for Insurance.*

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If you are planning to work on your vessel, please familiarise yourself with our induction. To be signed on site.
By checking this box, I blanks, agree that by accessing Port City Fabrications products and services, to accept, without limitation or qualification, the terms and conditions contained within the Agreement. I understand that the day rates prescribed in the Agreement will continue to accrue until full payment is made and failure to do so may result in Port City Fabrications exercising its rights to recovery under the Agreement.
I Understand the terms listed above.
If possible, could you please supply photos of your last haul out and any slip way or straddle carrier plans?

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Works to be Completed by Shore Base Personnel.
Work to be Completed by Vessel Owner.
Work to be Completed by External Contractors.
Preferred Date*

DayMonthYear
Date
Should be Empty:

GLADSTONE MARINA SHORE BASE