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A Division of Air Capital Insurance, LLC
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Airmeet Liability Coverage

Date(s) of Event: Alternate/Rain Date(s)(if applicable)
Select Date Select Date
Select Date Select Date
Date(s) for arrivals/departures/media, set-up/tear-down: Night shows:
Select Date Select Date
Select Date Select Date

Name of Event:

Name of Insured: (Sponsoring Organization)

Location of Event: (airport and/or facilities where the event will take place)

Event Address:

Event City:

Event State:

Event Zip:

Additional Insureds:
(name of person/organization)
Relationship to the Event:

Liability Limit Requested:
$

Who will be performing in your event?
It is important that you obtain a Certificate of Insurance from each participating performer.

Will you have any jet-powered vehicles, monster trucks, or other vehicle acts?
You MUST provide a Certificate of Insurance from each of these performers.

Will there be remote-controlled aircraft at the event?

If yes to the above, please describe:

Are these remote-controlled aircraft Fast Trac certified?

Will there be balloons or powered parachutes at your event?

If yes, how many?

Will you have grandstands or bleachers?

If yes, how many?

List dimensions and seating capacity:

Have you obtained a Certificate of Insurance from your Bleacher Contractor?

Are you named as an Additional Insured on their coverage?

Describe planned crowd control:

Will you sell food, beverages, or souvenirs at your event?

How are the products sold?

Do you want Products Liability coverage added to your policy?

Will alcoholic beverages be SOLD at the event?

In what name is the liquor license held?

Do you want Liquor Legal Liability Coverage on this policy?

If there will be Air Races, what type will they be?

Describe the Air Races:

Will any Fireworks or Explosives be used?

If yes, describe:

Name and License Number of Pyrotechnic Contractor to be used:

Do you want Explosives Liability Coverage on this policy?
In order to affect coverage, you MUST provide a Certificate of Insurance from the Pyrotechnic Contractor naming the event as an Additional Insured.

Will there be ANY aircraft or balloon rides before, during, or after your event?
Note: Airmeet Liability policy excludes coverage for participants or passengers in aircraft or balloons.

Will there be any Non-Owned Vehicles used strictly ON Airmeet premises, i.e. crowd control/security?

Please describe your Non-Owned Vehicle exposure, excluding Performer Vehicles:

Type: How Many: Use:
ATVs and/or Golf Carts
Private Passenger Vehicles, Trucks, Vans
Buses
Other (describe):

Do you want Limited Vehicle Non-Ownership Liability coverage for these vehicles?

Do you need coverage for your Courtesy/Rental Vehicles used on and off airmeet premises?
If yes, please complete separate application.

Do you need coverage for your Rented or Leased Property/Equipment?
If yes, please complete separate application.

Do you need coverage on Non-Owned aircraft while in your care, custody, or control?

Maximum Value for any one aircraft:
$

Total Value of ALL aircrafts:
$

How many years have you held this event?

Has there ever been an accident at your previous events?

If yes, describe below:

Will there be any Non-Aviation activities?

If yes, describe below:

Are you a member of the International Council of Air Shows?

Has anyone within your organization attended the following seminars within the past two years?
ICAS Air & Ground Operations
ICAS Event Controller

Contact Name:

Phone:

Fax:

Email:

Mailing Address:

City:

State:

Zip:

Please enter any additional info below:

Note: Coverage will not take effect unless payment has been received and a binder or policy has been issued.

 
INSURANCE TECHNOLOGIES & PROGRAMS
(A Division of Air Capital Insurance, LLC)
P.O. Box 148 - Wichita, KS 67201
For Overnight Payments: 127 E. 2nd St - Wichita, KS 67202
Toll Free: (866) 585-4590 - Phone: (316) 303-1272 - Fax: (316) 491-2245
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