OVERSEAS TRANSIT AND RACING INSURANCE PROPOSAL FORM

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YACHTING AUSTRALIA INC.

OVERSEAS TRANSIT AND RACING INSURANCE PROPOSAL

FORM

MIB is now part of Network Insurance Group http://www.masterman.com.au/

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Overseas Regatta Yacht Insurance

This policy Covers:

1. Loss or Damage to the insured yacht whilst:

 It is in transit by sea and/or land conveyance

 It is racing excluding ocean/bluewater racing 2. Legal Liability to Third Parties up to $10,000,000

Please note all acceptable off the beach yacht classes for Oversea Transit and Racing Cover:

125 BIC Techno 293 Flying Ant Laser Radial Otimist Skud 18 12’ Skiff Cadet Flying Dutchman Manly Junior OK Spiral 29’ers Cherub Formula 16 Maricat Paper Tiger Taipan

2.4m Contender Formula 18 MG14 Pelican Tasar

420 Corsair Heron Mirror Prindle Topper

470 Envy 4.3 Hobie Moth Raceboard Vagabond

49’ers Impulse Nacra RS 100 Vee E

505 Finn International 14 National E RS-X Vee Jay

Access Dinghies Fireball Laser Northbridge Junior Sabot Windrush

B14 Flying 11 Laser 4.7 NS14 Sharpie Windsurfer.

Flying 15 Open Bic Skate

Any boat not noted in the above list or all permanently moored yachts are a referral for quote and acceptance.

Endorsements to Policy Schedule:

Yachting Australia Inc Overseas Transit and Racing Insurance Cover

The cover under the Nautilus Marine Insurance Agency Pty Ltd boat Insurance is extended to include overseas/world wide use. Racing cover is not extended to include any Offshore/Blue Water events. The Policy Excess for this extension and for full policy coverage is 2% of the Sum Insured with a minimum of $500 for each and every claim. Cover is also extended for Transit by Sea under the contract conditions of the: 1. Institute Cargo Clauses (A), 2. Institute Strikes Clauses (cargo) and 3. Institute War Clauses (cargo) as per wordings incorporated in the Product Disclosure Statement. Transit by sea and land conveyance coverage commences from the time of handover to cartage contractor and/or ships agent, which ever shall be first occurring and ceasing at time of delivery and extends to include return transit to Australia.

SPECIAL NOTE FOR CHARTERING:

If coverage is required when chartering a yacht, when LIABILITY COVERAGE ONLY is required:

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1. INSURED(S):

Name of Insured(s): _____________________________________________________________ Postal Address: _________________________________________________________________ Email Address: ______________________________Phone No.__________________________ Driver Licence: _______________________________Expiry Date: _______/_______/_________

2. INSURED YACHT:

Type of Yacht to be insured:_______________________________________________________ Detail method of packing: ________________________________________________________

(Taking yacht overseas)

Name of ship or Carrier for Cargo: _________________________________________________ Name of Shipping Line (if Applicable): ______________________________________________ Transit: Country From: ________________________Country To: ________________________ And return voyage: _____________________________________________________________

Period of Cover: From: _______/______/______ To: _______/______/______

3.

THE INSURED YACHT (VESSEL):

HULL

Boat Name Reg/Sail No. Year Built Construction Material

___________________ ______________ ___________ ______________________________

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4. MAIN ENGINES

Engine Make HP Model Year Serial No: Fuel

_________________ _____ _________________ ______ ___________ ___ _________ 5.

EQUIPMENT & ACCESSORIES:

(Eg. Tender/s, Radio, Nav. Aids, Sat Nav., Safety Equipment, Covers ect.)

List items & values over $1,000 (add list if more space required) included in Equipment and Accessories Sum Insured.

a. ________________ $________________ d. ________________ $ ________________ b. ________________ $________________ e. ________________ $ ________________ c. ________________ $________________ f. ________________ $ ________________

Total Equipment & Accessories Sum Insured $ _______________________

6.

SAILS, MAST,SPARS AND RIGGING

Mast Construction ________________________

Type of Rig: Masthead Fractional

Rod Rigged: Yes No

Number of Spreaders: _______________ Type of Spreaders: Swept Back Inline: 7.

TRAILER:

Registration No. Make Age

_____________________ _______________ _______ (Years)

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8. HISTORY

Have you or any other owner of the boat:

Ever had a claim refused or cancelled or declined or special conditions imposed on a boat policy in the last 5 years?

No Yes

If yes, please attach details

Have you suffered claims of any nature in the last 5 years?

No Yes

If yes, please attach Date of Loss, Incident Details & Total Amount Incurred

Been convicted of or any fines or penalties imposed for any crime involving drugs, dishonesty, arson, theft, fraud, or violence against any person or property in the last 5 years?

No Yes

If yes, please attach details

Been declared bankrupt & not discharged within the last 12 months?

No Yes

If yes, please attach details

Are you a member of a Yacht Club or a Class Association?

No Yes

What is the name of Yacht Club or Class Association & What is your Membership Number:

Number of years yachting experience?

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YACHTING AUSTRALIA INC.

PREMIUM SCHEDULE

OVERSEAS TRANSIT AND COMPETITION COVER

HULL AND LIABILITY COVER

YACHT SUM INSURED VALUE

UP TO TWO MONTHS

ADDITIONAL MONTH

Up to $5,000 Or Liability Cover Only

$230.00 $37.50 $5,001 to $10,000 $315.00 $57.50 $10,001 to $20,000 $400.00 $72.50 $20,001 to $30,000 $465.00 $90.00 $30,001 to $40,000 $530.00 $110.00 $40,001 to $50,000 $605.00 $130.00 $50,001 to $60,000 $680.00 $140.00 $60,001 to $70,000 $765.00 $160.00

USA & Canada Add $55.00 plus $22.50 per month

THESE PREMIUMS ARE NON-REFUNDABLE DUE TO ANY CAUSE & INCLUDE BROKER’S FEE CHARGES Cover includes: Transit by sea and land conveyance, commencing from the time of hand

over to cartage contractor and/or ships agent, whichever shall be first occurring and ceasing at the time of delivery and extends to include return transit to Australia.

Hull: Includes Racing Risk Extension, excluding ocean/bluewater racing and terrorism. Covers for both competition and training use.

Liability: Limit of $10,000,000 is included.

Excess: 2% of Sum Insured with minimum of $500 each and every claim.

Insurer: Nautilus Marine Insurance Agency Pty Ltd 28-32 George Street, Sandringham VIC 3191 Telephone Number: 1300 780 533

www.nautilusinsurance.com.au

Nautilus Marine acts under a binding authority with AIG Insurance

PAYMENT DETAILS:

Please charge this purchase to by Mastercard / Visa (please circle one)

Card Number ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ (surcharge 1.50%) Valid from _____\_____ until end _____\_____ Card Security Number ________ (at the back of card)

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YACHTING AUSTRALIA INC.

OVERSEAS TRANSIT AND RACING INSURANCE PROPOSAL FORM LAW

The Insurance, if accepted, will be subject to Australian Law.

Depending on the use of the yacht, the insurance, if accepted, may be subject to the provisions of the Marine Insurance Act 1909 or the provisions of the Insurance Act 1984.

If this proposal form is completed in whole or in part by any person other than the Insured, then such person shall be deemed to be the agent of the Insured and not the agent of Nautilus Marine Insurance Agency Pty Ltd.

The Insured who completed the proposal form has his/her attention drawn to the terms of Section 23 to 27 of the Marine Insurance Act 1909 and in particular is informed that the contract of marine insurance that may be made and which may have as its basis the material contained herein, is a contact based upon the utmost good faith and in the absence of such good faith, may be avoided. Further, the Insured is informed that there is an obligation to disclose to the Insurers every material circumstance which is known to the proposed insurer. Every circumstance is material if it would influence the judgement of a prudent Insurer in fixing the premium or determining whether they will take the risk. If there is a failure to make such disclosure, the Insurers may avoid any contract of insurance that may be made. The Insured who completes this proposal form is advised that the Insurers will not be liable for any loss or damage attributable to unseaworthiness where the vessel is operated whilst in an unseaworthy condition with the privy of the owner. The Insured warrants that the vessel, which is subject to the proposed contract of marine insurance, will at all times be manned and operated as per all appropriate Government Regulations.

DUTY OF DISCLOSURE

Before you enter into a contract of general insurance with Insurers, you have a duty, under the Insurance Contracts Act 1984 to disclose to Insurers every matter that you know, or could reasonably be expected to know, is relevant to the insurers decision whether to accept the risk of the insurance and, if so, on what terms. You have the same duty to disclose those matters to the insurers before you renew, extend, vary or reinstate a contract of general insurance. Your duty does not require disclosure of matter:

 The diminishes the risk to be undertaken by the Insurers;

 That is common knowledge;

 That the Insurers know, or in the ordinary course of their business, ought to know;

 As to which compliance with your duty is waived by the insurers. NON-DISCLOSURE

If you fail to comply with your duty of disclosure, the insurers may be entitled to reduce their liability under the contract in respect of a claim or may cancel the contract. If your non-disclosure is fraudulent, the Insurers may also have the option of avoiding the contract from the beginning.

DECLARATION BY INSUREDS

I/We hereby declare that to the best of my/our knowledge and belief:

1. The information provided herein is true and correct in every respect and I/we have not withheld any material

information which would influence the decision of the Insurers in regard to this proposal.

2. The sums proposed for insurance represent the full value.

3. I/We have received the proposal/information sheet and agree to accept the insurance subject to the terms, conditions,

exclusions and limitation of the policy.

4. I/We agree that this proposal will be the basis of the contract of insurance should the proposal be accepted.

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