Submersible Application

Applicant & Operation Details

Business Name

Street Address

City

State

Zip Code

Years of Operation

Description of Operation

Describe how the submersible will normally be used? (e.g., deep-sea research, underwater survey, private pleasure, business use)

Location of Operation

Where will the submersible be operated? (Geographical Limits)

Vessel/Submersible Details

Name of Submarine

Classification Society

(e.g., ABS, DNV, Lloyd's)

Class Number

Date of Next Inspection

Month

Day

Year

Maximum Operating Depth

Hull Construction Material

Built Year

Builder

Primary Propulsion/Power System

Lifespan of Pressure Hull

(Hours/Cycles)

Emergency Life Support

(Duration in Hours)

Communication Systems

(Surface to Sub)

ROV's (Remotely Operated Vehicles)

Year

Make/Model

Description

Serial Number

Modifications

Value

Year

Make/Model

Description

Serial Number

Modifications

Value

Year

Make/Model

Description

Serial Number

Modifications

Value

Year

Make/Model

Description

Serial Number

Modifications

Value

Year

Make/Model

Description

Serial Number

Modifications

Value

Crew & Operator Information

Name of Captain/Pilot

Experience

(Hours in sub type)

Certifications/Licenses

Check if passengers will be carried

Maximum Passengers Per Dive

Coverage Requirements

Hull & Machinery Value (Value of sub):

(Value of sub)

Liability/Protection & Indemnity Limit

Check if pollution liability is required

Check if there is Emergency Extraction/Salvage Coverage

Loss History

Check if the applicant had any marine claims in the last 5 years

If yes, provide details:

Date

Month

Day

Year

Type of Loss

Amount