Marine Coverage
Options: Stock Throughput, Stock Only, Cargo Only
Insured Details
Named Insured
Insured Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Effective Date
/
Month
/
Day
Year
Date
Expiration Date
-
Month
-
Day
Year
Date
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Product Selection:
Please Select ONE of the Following Options:
Stock Throughput
Stock Only
Cargo Only
Description of Goods:
Full Details of Packing & Protection:
Estimated Sales for Upcoming Policy Period ($USD)
Transits
NOTE: If all Incoming or all Outgoing transits are "0", please select "other" for the Basis of Valuation then enter "Not applicable."
Estimated Annual Incoming Transits
Rows
$USD Amount
Domestic
International
Estimated Annual Incoming Transits: Basis of Valuation
Please Select
Cost, Insurance, and Freight plus 10%
Selling Price
Replacement Cost
Other
Estimated Annual Outgoing Transits
Rows
$USD Amount
Domestic
International
Estimated Annual Outgoing Transits: Basis of Valuation
Please Select
Cost, Insurance, and Freight plus 10%
Selling Price
Replacement Cost
Other
Transit Limit (in $USD)
Maximum Value Any One Conveyance
Additional Information:
Stock/Storage
Estimated Annual Outgoing Transits
Rows
$USD Amount
Average Values Across All Locations
Maximum Values Across All Locations
Maximum value any one location
Annual Aggregate Limit In Respect Of Earthquake / Windstorm / Flood EACH PERIL SEPARATELY
Stock/Storage: Basis of Valuation
Please Select
Cost, Insurance, and Freight plus 10%
Selling Price
Replacement Cost
Other
SOV - Temperature Sensitive Goods
Standard SOV - NO Temperature Sensitive Goods
Please Upload SOV using the one of the Templates above (SOV MUST BE IN ONE OF THE FORMATs ABOVE):
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Is the Product Temperature Controlled?
Yes
No
What is the approximate % of temperature sensitive Product?
Does the Insured have back up generators at all locations with at least 3 days worth of fuel?
Yes
No
Please provide details of alternative contingency measures in event of power failure:
Please share any further files which may assist underwriters with reviewing this account, including any recent surveys:
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Loss History
If no losses in the last 5 years, please check the box below:
No Losses
Configurable list
*
Loss Record Documentation (Non-Mandatory)
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Agent Info
Agent Name
First Name
Last Name
Agent Email
example@example.com
Agent Phone
Please enter a valid phone number.
Format: (000) 000-0000.
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Should be Empty: