Proposer Details
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AIRPORT OPERATORS PROPOSAL
PROPOSER
Proposer Details
| Name of Insured | Email Address | Contact Name |
|---|---|---|
| [text your-insuredname] | [text your-email] | [text your-contactname] |
| Street/Area | Postal Town | Post Code |
| [text your-street] | [text your-town] | [text your-postcode] |
| Contact Number | Renewal Date | |
| [text your-contactnumber] | [text your-renewaldate] |
Premises Liability Details
| Does applicant own or occupy any airport premises? If yes, please list airport name(s | List all buildings, hangars, ramps and all other premises to be insured. | Applicant occupies: All / part of premises and is Owner / Tenant / General lessee of premises |
|---|---|---|
| [text your-PremisesOccupier] | [text your-PremisesList] | [text your-OwnerTenant] |
| List all vehicles and mobile equipment, such as aircraft tugs and fuel trucks, used on the airport premises. | Describe your main activities. | Anticipated revenue from this source of business. |
| [text your-VehicleEquipment] | [text your-ActivityDescription] | [text your-PremisesRevenue] |
Hangarkeeper Liability Details
| Does applicant ever have non-owned aircraft in his care, custody or control at his premises? If yes, please provide the following details | Average value any one aircraft | Average total value at any one time |
|---|---|---|
| [text your-ThirdPartyAircraft] | [text your-AveValOneAC] | [text your-AveTotal] |
| Maximum value any one aircraft | Maximum value at any time | Maximum value any one hangar |
| [text your-MaxValOneAC] | [text your-MaxValOneTime] | [text your-MaxValAnyOneHangar] |
| Maximum Value Outside Hangars | Average Number Of Aircraft in your Care, Custody and Control | Details of any Rotor Wing aircraft in the above |
| [text your-MaxValOutHangar] | [text your-AveNumACccc] | [text your-RotWing] |
| Average number of engines in your care, custody and control | Do you require in flight hangarkeepers cover | Anticipated revenue from this source of business |
| [text your-AveEngccc] | [text your-InFlightHK] | [text your-HKRev] |
Product Liability Details
| Name any Subsidiaries with Aviation Products | ||
|---|---|---|
| [text your-SubsWithAP] | ||
| Sales Last 12 Months Fixed Wing split Civil/Military | Sales Last 12 Months Rotor Wing split Civil/Military | Total Sales Last 12 Months split Civil/Military |
| [text your-SalesFW] | [text your-SalesRW] | [text your-TotalSales] |
| Fuel Sales last 12 months £/litres split civil/miltary | Estimate FW sales next 12 months | Estimate RW sales next 12 months |
| [text your-FuelSalesLast] | [text your-EstFWsalesNext12] | [text your-EstRWsalesNext12] |
| Estimated Fuel Sales next 12 months £/litres | How long has the insured been in business | Describe main activities (e.g. repair station, paint spray shop, refueller, avionics specialist, engine or propeller shop) |
| [text your-EstFuelNext12] | [text your-TimeInBusiness] | [text your-ActivityDescription] |
| On what aircraft types does the insured normally work? | Does the insured manufacture any aviation products | Does the insured represent any manufacturers of aviation products? |
| [text your-AircraftTypesWorked] | [text your-ManufactureAvProducts] | [text your-RepManProducts] |
Has the Insured signed any aviation contracts that include additional Insured, hold harmless, waiver of subrogation or indemnity provisions that may affect this insurance? | As far as known has the Insured exposed itself, or, protected itself when signing contracts affecting this insurance? | Does the Insured do any business with customers or agents domiciled in the USA? |
| [text your-SignedConSubro] | [text your-SignConExp] | [text your-USAbusiness] |
Describe the experience and general training levels of Insured’s aviation personnel. | Have any claims been made against the Insured during the past 10 years? If so, what were the details and amounts involved? | If previously uninsured, give details of any payments made to claimants. |
| [text your-TrainingExperience] | [text your-ClaimsLast10Years] | [text your-PrevUninsured] |
| Does the Insured currently buy aviation products liability coverage? If so, with whom? | All aviation products liability policies contain an aggregate limit of liability. What limit of liability do you require? | Any other information |
| [text your-CurrentInsurer] | [text your-ProductLimitofLiability] | [text your-OtherInformation] |
Summary of Products Liability coverage provided Bodily Injury or property damage arising out of the possession, use, consumption or handling of any goods or products manufactured, constructed, altered, repaired, serviced, treated, sold, supplied or distributed by the Insured or his employees after such Aviation goods or Aviation products have ceased to be in the possession or under the control of the Insured. The Products section of this questionnaire is not intended for operations involved in aircraft catering, aircraft refuelling or jet airliners. Declaration I hereby declare that by completing and emailing this form to the best of my knowledge and belief, the particulars and answers herein are true and correct and that I have not knowingly withheld any information which would influence the decision of the underwriters in regard to this proposal. It is understood and agreed that this proposal shall form the basis of the contract should this policy be issued. | [submit “Send”] |
Other code
AIRPORT OPERATORS PROPOSAL
PROPOSER
Name of Insured: [your-insuredname]
Email Address: [your-email]
Contact Name:[your-contactname]
Insured Street/Area: [your-street]
Insured Town: [your-town]
Insured Post Code: [your-postcode]
Contact Number: [your-contactnumber]
Renewal Date: [your-renewaldate]
PREMISES LIABILITY DETAILS
Owner/Occupier of Airport Premises: [your-PremisesOccupier]
List Of Premises:[your-PremisesList]
Owner/Tenant of All/Part of Premises(if fitted):[your-OwnerTenant]
Vehicle and Mobile Equipment List: [your-VehicleEquipment]
Description of activities: [your-ActivityDescription]
Anticipated revenue from this source
of business:[your-PremisesRevenue]
HANGARKEEPERS LIABILITY DETAILS
Third Party Aircraft in your Care, Custody and Control: [your-ThirdPartyAircraft]
Average Value Any One Aircraft:[your-AveValOneAC]
Average Total Value Any One Time(if fitted):[your-AveTotal]
Max Value Any One Aircraft: [your-MaxValOneAC]
Max Value Any One Time: [your-MaxOneTime]
Max Value Any One Hangar:[your-MaxValAnyOneHangar]
Maximum Value Outside Hangars: [your-MaxValOutHangar]
Average Number Of Aircraft in your Care, Custody and Control: [your-AveNumACccc]
Details of any Rotor Wing aircraft in the above: [your-RotWing]
Average Number Of Engines in your Care, Custody and Control: [your-AveEngccc]
In Flight Hangarkeepers Required: [your-InFlightHK]
Anticipate Revenue From Hangarkeepers: [your-HKRev]
PRODUCT LIABILITY DETAILS
Subsidiaries with Aviation Products: [your-SubsWithAP]
Fixed Wing Sales Last 12 Months:[your-SalesFW]
Rotor Wing Sales Last 12 Months:[your-SalesRW]
Total Sales Last 12 Months: [your-TotalSales]
Fuel Sales Last 12 months: [your-FuelSalesLast]
Estimated Fixed Wing Sales next 12 months:[your-EstFWsalesNext12]
Estimated Rotor Wing Sales next 12 months: [your-EstRWsalesNext12]
Estimated Fuel Sales next 12 months: [your-EstFuelNext12]
Time In Business: [your-TimeInBusiness]
Describe Your Main Activities: [your-ActivityDesciption]
On what aircraft types does the insured normally work? :[your-AircraftTypesWorked]
Does the insured manufacture any aviation products: [your-ManufactureAvProducts]
Does the insured represent any manufacturers of aviation products?: [your-RepManProducts]
Has the Insured signed any aviation contracts that include additional Insured, hold harmless, waiver of subrogation or indemnity provisions that may affect this insurance?: [your-SignConSubro]
As far as known has the Insured exposed itself, or, protected itself when signing contracts affecting this insurance?: [your-SignedConExp]
Does the Insured do any business with customers or agents domiciled in the USA?: [your-USAbusiness]
Describe the experience and general training levels of Insured’s aviation personnel.: [your-ClaimsLast10Years]
Have any claims been made against the Insured during the past 10 years?
If previously uninsured, give details of any payments made to claimants. [your-PrevUninsured]
Does the Insured currently buy aviation products liability coverage?
If so, with whom? [your-CurrentInsurer]
All aviation products liability policies contain an aggregate limit of liability. What limit of liability do you require? [your-ProductLimitofLiability]
Any Other Information [your-OtherInformation]
Summary of Products Liability coverage provided
Bodily Injury or property damage arising out of the possession, use, consumption or handling of any goods or products manufactured, constructed, altered, repaired, serviced, treated, sold, supplied or distributed by the Insured or his employees after such Aviation goods or Aviation products have ceased to be in the possession or under the control of the Insured.
The Products section of this questionnaire is not intended for operations involved in aircraft catering, aircraft refuelling or jet airliners.
Declaration
I hereby declare that by completing and emailing this form to the best of my knowledge and belief, the particulars and answers herein are true and correct and that I have not knowingly withheld any information which would influence the decision of the underwriters in regard to this proposal.
It is understood and agreed that this proposal shall form the basis of the contract should this policy be issued.