Volume 119

NOVEMBER 2016

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RISK SURVEY

Questionnaire Selection Coverage

PERSONAL LINES WATERCRAFT

List all owned watercraft.

Unit #

Year

Manufacturer

Type

Power Type

Horsepower

Length

1.

 

 

 

 

 

 

2.

 

 

 

 

 

 

3.

 

 

 

 

 

 

4.

 

 

 

 

 

 

5.

 

 

 

 

 

 

6.

 

 

 

 

 

 

Using the unit number from above, where does each watercraft operate? (%)

Unit #

On Premises–Lake

On Premises–River

On Premises–Ocean

Off Premises–Lake

Off Premises–River

Off Premises–Ocean

1.

_____ %

_____ %

_____ %

_____ %

_____ %

_____ %

2.

_____ %

_____ %

_____ %

_____ %

_____ %

_____ %

3.

_____ %

_____ %

_____ %

_____ %

_____ %

_____ %

4.

_____ %

_____ %

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_____ %

_____ %

_____ %

5.

_____ %

_____ %

_____ %

_____ %

_____ %

_____ %

6.

_____ %

_____ %

_____ %

_____ %

_____ %

_____ %

 

Using the unit number above, what is the watercraft’s lay-up period and where is it stored during lay-up?

Unit #

Lay-up time period

Lay-up location

1.

 

 

2.

 

 

3.

 

 

4.

 

 

5.

 

 

6.

 

 

 

Is the watercraft available for charter by others? ___ Yes ___ No

If yes, identify the watercraft and describe the type of charter.

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Is any watercraft used for business purposes? ___ Yes ___ No

If yes, identify the watercraft (s) and describe the business purpose.

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Is the watercraft available for rent or loan to others? ___ Yes ___ No

If yes, identify the watercraft and describe the rental or loan terms and conditions?

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Is any watercraft used for racing? ___ Yes ___ No

If yes, identify the watercraft, the operator(s), the frequency, and the types of events?

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List all operators who the household. Include students who are away at school.

Name

Age

Years of Experience

Student? (Y/N)

Operates Watercraft #

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Does any operator use non-owned watercraft? ___ Yes ___ No

If yes, identify the operator(s) and describe the type of watercraft.

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Is watercraft taken outside United States territorial waters? ___ Yes ___ No

If yes, identify the operator(s) and the watercraft. Describe their navigation routes.

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