Municipal Airports

Heliports

Small & Private Airstrips

 
Airport/Heliport Owner/Operator
Insurance Quote Request

If you own or operate an airport or a heliport this is the form that you need to complete for an insurance quote.  Depending on what services you offer as the owner/operator will depend on what coverages you should carry.  If you do not provide any services you may only need to carry Premises Liability and Premises Medical coverages.  However, if you also provide any of the following services such as aircraft maintenance, aviation fuel, rental of hangars or tie-downs then you may need to carry additional coverages.

If you are looking for a quote to insure the buildings & contents (Physical Property Coverage), then please go to the Hangar Quote Request page.

There are four primary insurance coverages that you need to consider carrying. They are: 
*Premises Liability (this is the primary policy coverage that the other coverages are added to); 
*Premises Medical Coverage; 
*Products and Completed Operations; 
*Hangarkeepers Liability (Ground - Excludes Flight).

Please click the “Coverages” tab for an explanation of each of these coverages and for additional Optional Coverages that are available.

 
Contact Information: 

Name        Occupation/Business     

Individual     INC     LLC     Partnership     Trust     Municipality 

Contact name (if an organization) 

 Address: Street                          City    
                  State                            Zip

         Day Phone     Alternate Phone   

                      Fax                      Email   

Years in Business    You are the Airport's  Owner    Lessor    Manager

Do you Own/Lease/Manage Entire Airport    Only Runways & Taxiways    Other:


Insurance Information:

Present Ins. Company        Expires MM/DD/YY 

Has applicant had any losses/claims during last 5 years?    No     Yes*  
Has any insurer canceled, declined or refused to renew any aviation insurance?    No     Yes*  
*If yes, please explain: 
   


Airport Information:

Airport Name:      Airport Identifier:  

Type of Airport:    Private     Public     Heliport

Is the airport/heliport fenced:   None     100%     Percent fenced  %

Type of airport security:    Airport Police     Local Police     Private Security     None

Distance to fire department:    On airport        miles from airport

Number of aircraft based at airport:  

Who is responsible for the maintenance of the runway:   Applicant     Other: 

Are there any Ultralight, Parachuting or Agriculture Operations conducted on airport:   No

Yes - Explain:  

Do you own/lease any buildings on the airport:  No     Yes (if yes, complete following questions)

Size of Office:  Sq Ft.   
Hangar #1: Sq Ft.      Hangar #2: Sq Ft.   
Hangar #3: Sq Ft.      Hangar #4: Sq Ft. 

   Total Tie-Downs on premises:    
Avg Value of Aircraft Tied Out: $ 

   Number of aircraft hangared:    
Avg value of aircraft Hangared: $ 

Do you own or lease any other locations at other airports:  


Airport Insurance Coverages:

Airport General Liability Limits (Premises Liability)  
$500,000 Combined Single Limit  
$1,000,000 Combined Single Limit  
Other - Enter Amount:

Hangarkeepers Liability Limits 
$50,000 Each Aircraft, $100,000 Each Occurrence 
$100,000 Each Aircraft, $300,000 Each Occurrence 
$250,000 Each Aircraft, $500,000 Each Occurrence
$500,000 Each Aircraft, $1,000,000 Each Occurrence 
$1,000,000 Each Aircraft, $1,000,000 Each Occurrence 
Other - Enter Amounts: $ Each Aircraft, 
                                             $ Each Occurrence 

Products & Completed Operations Liability Limits  
$500,000 Combined Single Limit  
$1,000,000 Combined Single Limit  
Over $1,000,000 Combined Single Limit  -  Enter Amount: CSL

Optional Coverages 
  On Premises Auto     Contractual Liability     Host Liquor Liability   
  Advertising & Personal Injury Liability      Incidental Locations Liability


Services & Operations Information: 
Types of services provided by applicant and gross receipts for each operation (Select all that apply): 
Fueling-$      Maintenance-$     
Parts Sales-$     Avionics-$    
Aircraft Sales-$    Other-$  
Number of vehicles owned/used by applicant:  
Fuel Trucks:        Tugs:   

Fuel Information:  
Type and volume (gallons) of Fuel Sold: 
   Jet Fuel    AVGas  
Auto Fuel  
Type of Fuel Storage:   Underground   Above Ground   Fuel Truck   
Fuel is Dispensed from:  Truck    Fuel Island   Self Service  

Maintenance:   
Type of Aircraft Maintained:  Single Engine   Multi-Engine   Rotorcraft   Turbine 

Which of the following do you overhaul or manufacture?  Engines   Propellers   Kit Planes  Accessories

Comments or Questions: