Insurance Quotation Statement 1 I confirm the following: My boat is used only for Private Use My boat is not under construction My boat has been professionally built My boat to be insured will be located inside Australian waters Yes No Statement 2 I confirm the following: In the past 5 years I have NOT had any insurances cancelled, refused nor had special conditions imposed on a boat policy In the past 5 years I have NOT been charged or convicted with any offence involving arson, theft, dishonesty, drugs, fraud or violence against any person or property I have NOT been declared bankrupt and not discharged within the last 12 months True False Have you, the proposer(s) in the past 5 years made any claims for marine insurance? Yes No