SECTION 2 Details of Call: Country and Port of Departure: Estimated Date of Departure from Port: Country and Port of Destination: Any additional port calls whilst in breach Yes / No area? If so please specify: Estimated number of days in breach Days area: Will the vessel be laden or in ballast? Laden / Ballast Will there be a return voyage? Yes / No Will the vessel be laden or in ballast for Laden / Ballast the return voyage? Will the vessel be carrying arms / ammunition or military equipment as Yes / No cargo? SECTION 3 Security Measures: Will there be armed or unarmed guards on board the vessel for the Yes / No Armed / Unarmed entire transit in the breach area? If so, please specify: Name of security company: Website of security company: Embark Where will the guards embark / disembark? Disembark Does the vessel have Razor Wire fitted for the entire transit in the Yes / No breach area? Is the vessel equipped with a citadel? Yes / No Are the crew properly trained to use the citadel? Yes / No Any other additional security measures implemented? If so, please Yes / No specify: SECTION 4 Kidnap & Ransom Coverage (If Required): Limit of Cover required per Insured Event: USD 5m USD 7m USD 10m Amount per day Loss of Hire: Limit (days) Has the Assured or Co-Assured suffered any Kidnap & Ransom related loss in the last 5 years on any vessels owned and/or Yes / No managed and/or chartered? If so, please provide full details: Further information applicable to the application Name: Company: Date: Please return this application form to your Underwriting contact
SECTION 2 Details of Call: Country and Port of Departure: Estimated Date of Departure from Port: Country and Port of Destination: Any additional port calls whilst in breach area? If so please specify: Yes / No Estimated number of days in breach area: Days Will the vessel be laden or in ballast? Laden / Ballast Will there be a return voyage? Yes / No Will the vessel be laden or in ballast for the return voyage? Laden / Ballast Will the vessel be carrying arms / ammunition or military equipment as cargo? Yes / No SECTION 3 Security Measures: Will there be armed or unarmed guards on board the vessel for the entire transit in the breach area? If so, please specify: Yes / No Armed / Unarmed Name of security company: Website of security company: Where will the guards embark / disembark? Embark Disembark Does the vessel have Razor Wire fitted for the entire transit in the breach area? Yes / No Is the vessel equipped with a citadel? Yes / No Are the crew properly trained to use the citadel? Yes / No Any other additional security measures implemented? If so, please specify: Yes / No SECTION 4 Kidnap & Ransom Coverage (If Required): Limit of Cover required per Insured Event: USD 5m USD 7m USD 10m Loss of Hire: Amount per day Limit (days) Has the Assured or Co-Assured suffered any Kidnap & Ransom related loss in the last 5 years on any vessels owned and/or managed and/or chartered? If so, please provide full details: Yes / No Further information applicable to the application Name: Company: Date: Please return this application form to your Underwriting contact
hullwarkidnapappform.docx