Aviation Insurance Quote

 

Current Aviation Insurance Information
Company Name (not agency):
Policy Expiration Date:	Premium Amount: $

 

Aircraft Information
Aircraft #1	Year	Make/Model:	FAA Reg. #:	# of seats:
Engine Type:		Horsepower:	Present Value $	Aircraft Cat. Exp. Std.
Airport Identifier:		Lienholder:	Additional Insured / Address

Aircraft #2	Year	Make/Model:	FAA Reg. #:	# of seats:
Engine Type:		Horsepower:	Present Value $	Aircraft Cat. Exp. Std.
Airport Identifier:		Lienholder:	Additional Insured / Address

Aircraft #3	Year	Make/Model:	FAA Reg. #:	# of seats:
Engine Type:		Horsepower:	Present Value $	Aircraft Cat. Exp. Std.
Airport Identifier:		Lienholder:	Additional Insured / Address

 

Pilots/Operators
(always list insured as Pilot #1)
#	Name	DOB	Ratings/ Certificates	Logged Hours
				Total Time	Tail Wheel	Retract. Gear	Multi- Engine	In Model
1
2
3
#	Claims, incidents, FAA Medical Waivers, FAR Violations, DUI, Felony Convictions:						MED & BFR
1
2
3

 

Liability Limit For ALL Aircrafts
Bodily Injury & Property Damage $500,000 smooth $500,000/$100K pass $1,000,000 smooth $1,000,000/$100K pass $2,000,000 smooth	Per seat   Medical $1,000 $2,000 $3,000 $4,000 $5,000

 

Hull Coverage For ALL Aircrafts
Coverage Type: All Risks (Ground Only) All Risks (Ground & Taxi) All Risks (Ground & Flight)	Hull Value: $

 

Miscellaneous Information
Aircraft Use:	Business & Pleasure   Pleasure Only
Competition:	Yes   No	Aerial Photography:	Yes   No
Airshows:	Yes   No	Banner Tow:	Yes   No
Dual Inst.:	Yes   No	On Floats:	Yes   No
Sightseeing:	Yes   No	Rental:	Yes   No
IAC or EAA Number:		AOPA #:

 

Additional Comments

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