Marine / Air

Marine / Air: Covers the interest of shippers, consignees, distributors, and others in goods and merchandise shipped primarily by water or Air.

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Your Resident Country *

Your Resident Currency *

Corporate Information

Company Name *

Activity Of The Company *

Title*

First Name*

Last Name*

Occupation *

Mobile *

Email *

Address *

Website

Marine or Air Data

Type Of Coverage

Type of Goods

Packing Method

Insurance Effective Date

Voyage From

Voyage To

Shipment Amount

Additional Cost

If yes, Enter Additional Cost Ammount

Currency

War and Strikes

Would you like to cover Delay Of Startup (DSU) ?

Remarks

We hereby acknowledge and confirm that all the submitted data above are correct and We did not hide any information related to the risk to be insured. And We authorize Brokerage Insurance Brokerage in executing this insurance request with the concerned insurance company and facilitate the policy issuance, renewals and claims follow-up and communicate specific information about us and our account to third parties if needed, in accordance with the privacy policy. We also accept that this insurance application and approval be the basis of the contract and an integral part of the insurance policy.