Marine Insurance Application - Alliance for Contractors

ALLIANCE FOR CONTRACTORS

Marine Insurance Application

Waterfront & Marine Construction Coverage

Comprehensive Marine Protection: This application covers marine liability, vessel operations, waterfront construction, and specialized marine project risks. Alliance provides integrated project management support and comprehensive marine construction protection.
APPLICANT INFORMATION
Company Name:
DBA/Trade Name:
Business Address:
Mailing Address:
Phone Number:
Email Address:
Federal Tax ID:
Years in Business:
MARINE BUSINESS OPERATIONS
Primary Marine Operations:
Annual Marine Revenue:
Number of Marine Employees:
Types of Marine Work Performed:
Dock Construction & Repair
Marina Development
Waterfront Construction
Pile Driving Operations
Dredging Services
Seawall Construction
Marine Equipment Installation
Underwater Construction
Other: ___________________________
VESSEL INFORMATION & OPERATIONS
Number of Owned Vessels:
Number of Chartered Vessels:
Vessel Name/Type Length Value Primary Use Operating Area
Vessel Operations Include:
Construction Support
Material Transport
Crew Transport
Equipment Transport
Towing Operations
Diving Support
WATERFRONT PROJECT DETAILS
Typical Project Value Range:
Largest Single Project Value:
Primary Work Locations:
Maximum Water Depth:
Project Types:
Commercial Marine Facilities
Residential Waterfront
Government/Municipal Projects
Industrial Marine Facilities
Environmental Restoration
Port & Harbor Development
MARINE LIABILITY COVERAGE NEEDS
Desired General Liability Limit:
Desired Marine Liability Limit:
Coverage Components Needed:
Marine General Liability
Protection & Indemnity (P&I)
Jones Act Coverage
Longshore & Harbor Workers
Pollution Liability
Marine Professional Liability
Maritime Employers Liability
Waterfront Property Coverage
RISK ASSESSMENT
Safety Program in Place:
☐ Yes ☐ No
Marine Safety Certification:
☐ Yes ☐ No
Claims in Last 5 Years:
☐ Yes ☐ No
Environmental Violations:
☐ Yes ☐ No
Current Insurance Carrier:
Current Premium:

If you answered "Yes" to any risk questions above, please provide details:

COVERAGE OPTIONS & LIMITS
Coverage Type Requested Limit Deductible Required
Marine General Liability ☐
Vessel Hull & Machinery ☐
Protection & Indemnity ☐
Marine Pollution Liability ☐
Marine Equipment Coverage ☐
Marine Professional Liability ☐
Maritime Employers Liability ☐

Alliance Integration Benefits

Marine Project Management Support: Alliance provides comprehensive project coordination, marine liability management, and vessel operations oversight to ensure seamless marine construction protection.

Specialized Use Cases:

  • Marine construction projects with complex liability exposures
  • Waterfront development requiring specialized coverage
  • Vessel operations supporting construction activities
  • Multi-phase marine projects with evolving risks
  • Dock construction and marina development
  • Maritime services requiring comprehensive protection
ADDITIONAL INFORMATION

Please describe any unique aspects of your marine operations or special coverage needs:

Applicant Signature

Print Name

Date

Title

SUBMISSION & NEXT STEPS

Required Documents:

  • Completed application form
  • Current insurance declarations pages
  • 5-year loss history
  • Vessel documentation and surveys
  • Safety program documentation
  • Recent financial statements
  • Marine certification documents

Submission Methods:

  • Email: [email protected]
  • Fax: (555) 123-4568
  • Mail: Alliance for Contractors, Marine Division, [Address]

Processing Timeline: Applications are typically processed within 5-7 business days. Complex marine risks may require additional underwriting time.

Contact Information: For questions about this application or marine coverage options, contact our Marine Insurance Specialists at (555) 123-4567.

Alliance for Contractors - Marine Insurance Division
Comprehensive Marine Construction Protection & Project Management Support