Premises Liability Form

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Name of Insured

Address of Insured

Telephone Number

1. Does applicant own or occupy any airport premises? If yes, please list airport name(s)

2. List all buildings, hangars, ramps and all other premises to be insured.

3. Applicant occupies: All / part of premises and is Owner / Tenant / General lessee of premises?

4. List all vehicles and mobile equipment, such as aircraft tugs and fuel trucks, used on the airport premises.

5. Describe the Insured’s main activities. (e.g. repair station, paint spray shop, refueller, avionic supplier, Engine ,Propellor over hauler etc)

6. Anticipated revenue from this source of business.

Insure every part, get instant peace of mind and earn extra income at the same time.