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Aviation Airport Insurance
Insured Information
Named Insured
Insured is a
Corporation
Individual(s)
Partnership
Nature of Business of Named Insured
Contact Name
Address
City
State
Telephone
Cell Phone
Fax
Email
Airport Information
Location
Description
Premises Operations
Describe Office Space for Insured
Describe Premises Operations for the Insured:
How many vehicle(s) are used on premises?
List all activities to be conducted in the hangar
Number of Years in this Business
Work Experience
Aircraft Exposure
Types of Aircraft Stored
Are any aircraft moved?
Average value any one aircraft?
Average value all aircraft?
A copy of a proposed lease agreement (the insurance section) to be used for tenants.
Will a waiver of subrogation be used?
Yes
No
Will landlord be included as an additional insured?
Yes
No
Coverages & Limits
Premises Liability
Premises Medical
Fire Legal Liability
Hangarkeepers Legal any one aircraft
Hangarkeepers Legal all aircraft
Would like to review a copy of the proposed lease agreement for the tenants (the insurance section)
Will the lease require a waiver of subrogation?
Yes
No
Comments & Questions
Any other comments or questions
Phone: 1-818-904-9081
Fax: 1-818-904-9193
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Contact
Response Aviation Insurance Services P.O. Box 12027 Glendale, CA 91224