Jim Potts Marine Services

Ready For Survey Form PRINT THIS FORM

Please complete in FULL and return by fax to (815) 385-8969

Type of Survey.

Circle One        Insurance/Reinsurance          Pre-Purchase           Other

Engine/System Survey

Special requests:

Client Information

Name:

Address:

Phone:

Fax:

Cell:

Email:

Vessel Information

Vessel Type:

Make:

Model:

Year:

Length:

Beam:

Draft:

Power:        Circle One      Gas       Diesel

Location of vessel:

Marina contact name and phone:

Marina security code or key along vessel keys:

Vessel ownership or registration papers available at the boat at time of the survey:

Circle One               Faxed                      Mailed                     On vessel

Prepare For Survey

• Vessel clean and ready for inspection
• Batteries charged
• Shore power available
• Shore water hose available on the boat
• Closets and Storage areas cleaned out
• All Minimum required safety gear in good condition and with the vessel at time of survey
• Safety Equipment must be with vessel at time of survey
• Loose clothing, materials and parts should be removed from lockers and storage areas to make the inspection possible
• All sea-cocks and through hulls should be accessible and operable prior to commencement of the survey

If vessel is in storage a detailed comprehensive signed list of all equipment normally carried on board when cruising is required separate list please

Approximate declared value.

List of extra gear and loose equipment (TV, Binoculars, Microwave, etc.) with age with approx value noted.

Spare repair parts and materials should be listed on a separate sheet with approximate declared value.

Declared intended use

Circle One        Recreational Pleasure           Charter        Docked only            Other

 Declared Intended cruising area

Circle One             Inland lake               River           Near shore 

Current Insurance Company.

Broker:                                                 Phone:

Current declared value for insurance:

Asking price for sale:

Agreed price for sale:

Special notes:

Special requirements or requests of vessel owner or purchaser: Use a separate sheet if required

Quoted rate per ft:                        vessel length:

Surcharge for old boat/wood boat or "special requests" or waiting time etc:

Travel time:                 Mileage rate:

Signed by Client:                                                           Date:

Signed by Surveyor:                                                      Date:

Survey Scope, Parameters and Limitations Governing Survey:

The intent of a marine survey is to record and report what is seen and found at the time and place of the inspection. A marine survey is not intended, prepared, represented, or offered, as a warranty or guarantee of the vessel's ongoing or future good or otherwise condition.  Unless otherwise specified in writing at time of ordering the survey, a general, visual, non-destructive, non-invasive inspection of the vessel and its accessible systems will be carried out. Inaccessible, closed, locked; obscured or otherwise enclosed areas will not be inspected. Components and or systems, which cannot be tested due to no power available, flat batteries, or other reasons, will not be inspected or reported. These items or systems may be noted as "not tested" or "not available for testing". Extra hourly rate or waiting charges may apply if the vessel is not made ready for survey prior to surveyor arriving on site. Engine and propulsion system surveys will include test start, run and an on-the-water performance tests.  Temperatures, pressures and other dynamic parameters will be monitored using instruments and test equipment to hand. GPS where available will be used to actual determine vessel speed. The vessel owner, or his approved designated and fully insured representative, will operate the vessel during dockside and dynamic on-the-water testing. Full vessel insurance coverage will be in effect for the area of operation at time of survey. It is the vessel owner's responsibility to make sure this is in place prior to survey. Visual inspection of the insurance "cover note” or "binder" may be required at time of the survey inspection. Basic electrical and peripheral systems inspection will be carried out at a "general" level, noting that equipment functions properly, or not, at time of the survey. An in depth electrical or deep systems survey takes more time than normally available at the time of an insurance or purchase survey. In depth electrical surveys should be carried out by a qualified marine electrical technician. Special request surveys like engine survey, electrical survey, hull gauging for metal vessels, corrosion surveys, detailed destructive testing and other tests will require the written permission of the owner and will be addressed as separate survey items at extra cost.  Specialist sub contractors may be used for this work. Survey reports are confidential documents, and will be prepared in good faith and without prejudice for the exclusive use of the commissioning agent or owner.