Proposer Details


Premises Liability Details


Hangarkeeper Liability Details


Product Liability Details


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

Other code
AIRPORT OPERATORS PROPOSAL
PROPOSER


PREMISES LIABILITY DETAILS


HANGARKEEPERS LIABILITY DETAILS


PRODUCT LIABILITY DETAILS

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

Proposer Details

Name of InsuredEmail AddressContact Name
[text your-insuredname][text your-email][text your-contactname]
Street/AreaPostal TownPost Code
[text your-street][text your-town][text your-postcode]
Contact NumberRenewal 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 aircraftAverage total value at any one time
[text your-ThirdPartyAircraft][text your-AveValOneAC][text your-AveTotal]
Maximum value any one aircraftMaximum value at any timeMaximum value any one hangar
[text your-MaxValOneAC][text your-MaxValOneTime][text your-MaxValAnyOneHangar]
Maximum Value Outside HangarsAverage Number Of Aircraft in your Care, Custody and ControlDetails 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 controlDo you require in flight hangarkeepers coverAnticipated 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/MilitarySales Last 12 Months Rotor Wing split Civil/MilitaryTotal Sales Last 12 Months split Civil/Military
[text your-SalesFW][text your-SalesRW][text your-TotalSales]
Fuel Sales last 12 months £/litres split civil/miltaryEstimate FW sales next 12 monthsEstimate RW sales next 12 months
[text your-FuelSalesLast][text your-EstFWsalesNext12][text your-EstRWsalesNext12]
Estimated Fuel Sales next 12 months £/litresHow long has the insured been in businessDescribe 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 productsDoes 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.