Private Jet Insurance
GET PRIVATE JET INSURANCE
Please enter applicant's info:
Applicant's First Name:
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Last Name:
(*)
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Email Address:
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Phone Number
(*)
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Address 1:
(*)
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Address 2:
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Postal Code:
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Please describe the aircraft type:
Helicopter
Fixed Wing Aircraft
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Primary Use:
Pleasure & Business
Pro Pilot Flown
Instruction & Rental
Charter
Flying Club
Other
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Please state the use:
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Is the aircraft to be operated outside of Canada?
Yes
No
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Please list the place where it will be operated:
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Does the aircraft have a standard airworthiness certificate in full effect?
Yes
No
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Has the aircraft been equipped with any modifications not provided by manufacturer?
Yes
No
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Is there any unrepaired damage to the aircraft?
Yes
No
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Has any pilot ever been involved in any accident or incident?
Yes
No
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Has the applicant had any aircraft/aviation losses/claims during the last 3 years?
Yes
No
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Please describe the situation:
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AIRCRAFT LIABILITY
Liability per Occurrence/Passenger:
$1,000,000 Each Occurrence / $100,000 Each Passenger
$1,000,000 Each Occurrence / $200,000 Each Passenger
$2,000,000 Each Occurrence / $250,000 Each Passenger
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Limits
$1,000,000 Combined Single Limit
$2,000,000 Combined Single Limit
Other Limits
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Please list other limits:
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Medical Payments
$3,000 Each Person
$5,000 Each Person
$10,000 Each Person
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Leinholder or Additional Insured?
Leinholder
Additional Insured
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Lein Amount: $
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