Repair and Service

Policy Contact Information
  • Business / Individual's Name:
  • Contact Person:
  • Primary Phone:
  • Secondary Phone: Email:
  • Location (City, State):
  • Airport Name:
  • Airport Identifier:
  • Business Status:
    • Click here if you're a new startup company
    • Click here if you're an existing business
    We're a new operation.
    We're an existing company.

    Number of years in business:

    Exp. Insurance Co.:

    Exp. Date:

Insured Employee
    Insured is:
  • A&P Mechanic
    I/A
  • If an A&P mechanic, please enter the number of years' experience:
  • Describe experience working for other operations:
  • Please list any management experience/responsibilities:
  • Are there going to be additional employees?
    • How many?
  • Do you carry Worker's Compensation insurance?
Premises Liability Limit:
  • $1,000,000
    $2,000,000
    $3,000,000
    $5,000,000
    $

Facility:

  • Hangar(s)?
    • How Many?
  •  
  • Office?
    • Total Area Square Footage: Year Built: Construction:
  • Alarm?
  • Sprinkler?
  • Tie Downs?
    • How Many?
Products & Completed Operations Liability
  • What type of maintenance do you perform?
    50 Hour and 100 Hour Inspections
    AD Repairs
    ADS-B Install
    Airframe
    Annual Inspections
    Avionics Install
    Avionics Repair
    Brakes
    Engine Overhauls
    Helicopters (RW)
    Inspections
    Insurance Repairs
    Line Items
    Light Aircraft
    Major Modifications
    Multi Engine Aircraft
    Oil Changes
    On Airport Auto Repair (e.g., Tugs, Golf Carts, etc)
    Pistons
    Pre Purchase Inspections
    Propeller Overhauls
    Routine Maintenance
    Single Engine Aircraft
    Tire Changes
    Troubleshooting
    Turbines
  •  
  • Please list any other maintenance performed:
    Estimated Annual Gross Receipts for Repair & Service
    Estimated Annual Gross Receipts for Avionics Repair
    Operations Liability Limit:
    $1,000,000
    $2,000,000
    $3,000,000
    $5,000,000
    $
  •  
  •  
  • HANGARKEEPERS LIABILITY COVERAGE EACH AIRCRAFT:
    $50,000
    $70,000
    $90,000
    $100,000
    $150,000
    $200,000
    $300,000
    $400,000
    $500,000
    $1,000,000
    $2,000,000
    Other: $