SIGCo Guaranty application

Please enter your contact details so that we can send confirmation that the guaranty application has been received by SIGCo. The SIGCo Reference number should be entered if you are revisiting an earlier application to add further required details. This number can be obtained from the premium quotation form previously sent to you by SIGCo.

Contact Info

SIGCo Reference Number (eg. 555-555-555)

Your name *

Are you a third party broker or agent ? *

Yes

No

Your email address *

If yes, what is the name of your company? *

Return email address (if different from your email address)

Note: All fields marked with a star * are required.

Insert SIGCo fleet reference only if it is an existing SIGCo fleet and the requested information is known. If the application is for a new fleet, please provide the name and SIGCo will assign a reference number.

Fleet details

Fleet Name *

Are you applying for a new fleet ? *

Yes

No

SIGCo fleet reference

Note: All fields marked with a star * are required.

Please enter required details concerning the vessel to be added to the fleet. After completion, SIGCo can provide a premium indication and a formal premium quotation and COFR facility agreement. Please note that you can return to complete the additional details on pages 4 and 5 at a later date if you do not have them currently available. To do this you must enter the SIGCo reference number that is shown on the premium quotation and COFR facility agreement on page 1 of the Guaranty application.

Vessel details

Vessel name *

Vessel type *

Dry

Tanker

Gross tonnage *

Cargo type * (tankers only)

Persistent

Non-persistent

Year built *

IMO number

Requested COFR guaranty inception date *

COFR Operator name *

Other information

P&I Club * Britannia P & I Club British Marine Managers Limited Carina P&I Gard P&I Hanseatic P&I Hydor P&I Ingosstrakh Insurance Company Japan P&I Club Korea P&I Loadstar Marine Mitsui Sumitomo Insurance Noord Nederlandsche P & I Club North of England P&I Association Limited Raets Marine Skuld Steamship Insurance Management Services Limited The American Club The London Steam-Ship Owners' Mutual Insurance Association Limited The Shipowners' Protection Ltd The Standard The Swedish Club The West of England Ship Owners Mutual Insurance Association UK P&I Club

Pollution deductible (if above $50,000)

Note: All fields marked with a star * are required.

Please enter details of the requested COFR operator and owner. This information must be supplied before SIGCo can issue a COFR guaranty to the US Coast Guard.

Operator/Owner details

COFR Operator name *

COFR Operator address

COFR Operator Email

COFR Operator Phone No

COFR Operator Fax No

Owner name (if different from COFR operator)

Owner address (if different from COFR operator)

Note: All fields marked with a star * are required.

CG5585 Application

Will you also require SIGCo to make the CG5585 application ? *

Yes

No

Do you wish to fill the application now ? *

Yes

No

Further documents required to complete issurance of a guaranty include P&I letters and letter of authority for CG5585 application. These can be uploaded here along with any other documents that you wish to acompany the application. You will need to repeat step 1 and 2 for every document you wish to upload.

Document Upload

STEP 1: Select document type

P&I Letters

Signed Premium Quotation & COFR Facility Agreement

Letter of authority

Other

Please specify document type

STEP 2: Select Document

Select files...

Uploaded Document(s)

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Additional comments