Collision report
Collision report, damage with another party
A collision, damage to a pontoon or to somebody else's property: sheet 1 takes the incident and both craft involved, sheet 2 what happened with a sketch, the witnesses and the evidence, and the signatures. Write down only what you saw, and make no admission of fault.
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Only the sheet itself is printed, without the navigation and the footer. The other party's signature confirms only that the details were recorded, it is not an admission of fault.
Collision report, damage with another party
Collision, pontoon or third party damage: both sides on one sheet
NAMMERT
Fill in straight away
+49 3375 29 12 77 · nammert.com
01The incident
Date, time
Place / waters, position
Weather, wind, visibility, sea state
Police / water police informed (file no.)
Anybody injured (yes / no)
Outside help, tug, fire brigade
02The craft involved
A, my craft
Boat name, registration
Owner, telephone
Person at the helm, licence no.
Insurer, policy number
Damage to the craft (briefly)
B, the other party
Boat name, registration
Owner, telephone
Person at the helm, licence no.
Insurer, policy number
Damage to the craft (briefly)
03What happened, and a sketch
What happened, in your own words
Course, speed and manoeuvres before the impact
Sketch: craft, courses, fairway, buoys
Draw in A and B, arrows for the direction of travel, mark the point of contact.
Sheet 1 of 2, continued on sheet 2 with section 04. NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, Germany · +49 3375 29 12 77 · info@nammert.com.
Collision report, continued
Sheet 2 of 2
04Witnesses and evidence
| Name | Address | Telephone | on board of |
|---|---|---|---|
Please admit nothing
Write down only what you saw, and make no admission of fault, the assessment is our job. Report the case afterwards through “mein NAMMERT” or by telephone: +49 3375 566 75 05. As an Assekuradeur we settle claims ourselves, and we fend off unjustified claims on your behalf.
Place, date · signature A
Place, date · signature B (acknowledgement)
NAMMERT Assekuradeur GmbH, Karl-Marx-Straße 4, 15711 Königs Wusterhausen, Germany · +49 3375 29 12 77 · info@nammert.com. The other party's signature confirms only that the details were recorded, it is not an admission of fault.