Maritime Mutual Application for Membership

Please enter in the Maritime Mutual Association Limited (MMAL) the undersigned as members of MMAL in accordance with MMAL’s Memorandum & Articles as from time to time in force. The rights and liabilities of the undersigned as Member(s) shall be subject to any alteration, amendment or addition from time to time duly made to the Memorandum & Articles and from the date of each alteration, amendment or amendment taking place.

Please also accept this as the undersigned’s application for insurance in relation to the vessel detailed below, under the terms and conditions of the Master Insurance Policy issued by Maritime Mutual Insurance Association (NZ) Limited to MMAL whereby the Association agreed, subject to the General and Class Rules of the Association (as altered from time to time) and subject to any particular terms and conditions relating to each insurance incepting under such Master Policy, to provide insurance cover to members of MMAL.

* Indicates mandatory fields

It is agreed that the aforementioned vessel may form part of a fleet at the time of entry or at some date in the future.

Additional Entities

You can provide additional names for entry under this section by uploading a PDF document containing full details, as above, and specifying the category of membership required.

A schedule for all vessels owned or operated during the past five years is required. This obligation applies to both applications for insurance and applications for reinsurance. You can upload documents or complete a schedule for up to 5 loss incidents below or upload a recently produced loss record print-out from previous insurers.

Loss Schedule

Warranty

The Applicant warrants that the information provided above is complete and accurate to the best of his knowledge and belief. It is understood that MMAL and the Association shall rely upon the information and representations listed herein in determining the acceptability, rates and conditions of coverage. Any misrepresentation or omission shall constitute grounds for immediate cancellation of coverage and denial of claims, if any.

It is further noted and understood that the Applicant is under continuing obligation to immediately notify the Managers on behalf of both MMAL and the Association of any material alteration to the nature, extent or size of his operation as described herein.

This application shall be attached to and form part of the Certificate of Insurance and Entry.