THE GENERAL AVIATION RISK APPLICATION

WEBINAR
Presented by: BLAIS AVIATION INSURANCE SERVICES
JANUARY 28, 2010 WWW.BLAIS AVIATION.COM
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AVIATION INSURANCE APPLICATIONS

There are a number of aviation exposures and each has its own application(s). This webinar will focus on the general aviation exposure application and pilot questionnaire. You can view the various applications by visiting the Blais Aviation Insurance Services website. www.blaisaviation.com

TYPES OF AVIATION EXPOSURES

INDUSTRIAL AID

PLEASURE & BUSINESS SINGLE ENGINE

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TYPES OF AVIATION EXPOSURES

PLEASURE & BUSINESS ROTORWING

PLEASURE & BUSINESS MULTI ENGINE

TYPES OF AVIATION EXPOSURES

STUDENT PILOTS

AEROBATIC

TYPES OF AVIATION EXPOSURES

AIRSHOWS

WARBIRDS

TYPES OF AVIATION EXPOSURES

SMALL AIRPORTS

LARGE AIRPORTS

TYPES OF AVIATION EXPOSURES

FIXED BASED OPERATORS FBOS

MANUFACTURES PRODUCTS COMPLETED OPERATIONS

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AVIATION UNDERWRITING & ANALYSIS

Every aviation insurance underwriter has slightly different guidelines he/she follows to arrive at a rate, but virtually without exception they all take the following into consideration somewhere in their deliberations. Each factor, to the Underwriter, represents a change in the chance of an accident or affects his/her chances of profit from your policy.
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KEY FACTORS AVIATION UNDERWRITERS CONSIDER

What kind of aircraft & age Avionics Control Panel Value Common locations flown to Who are the pilots skills! How is the aircraft used Where is the aircraft kept Claim data

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THE COMPONENTS OF AVIATION UNDERWRITING

Pleasure & Business Industrial Aid Instructional Rental Charter Pipeline Patrol Power Line Patrol Crop Dusting Banner Towing

AIRCRAFT

Student Private Commercial ATP Instrument Instructor Type Rating Total Hours Make & Model Hours

Single Engine Land Multi Engine Land Single Engine Sea Multi Engine Sea Turbo Prop Turbo Jet Complex Avionics Unusual Characistics
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FOR GENERAL AVIATION RISKS UNDERWRITERS WILL REQUIRE THE FOLLOWING APPLICATIONS PILOT QUESTIONNAIRE & AIRCRAFT APPLICATION

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PILOT QUESTIONNAIRE
Name of Aircraft Owner: Name of Pilot: Address: Pilots Occupation: Employer: Date Employed: Date of Birth:

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PILOT QUESTIONNAIRE
Check All Certificates and Ratings Currently Held
( ) Student ( ) Private ( ) Instrument ( ) Commercial ( ) Instructor ( ) Airline Transport ( ) Single Engine Land ( ) Single Engine Sea ( ) Multi Engine Land ( ) Multi Engine Sea ( ) Rotorwing ( ) Centerline Thrust ( ) Mechanic Airframe ( ) Mechanic Powerplant ( ) Other (Specify) ( ) Type Rating
(Specify Aircraft)

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Airmans Certificate No:

Date Certified:

If Student: (Name of instructor or FBO) - (Instruction airport location) Date of Last Medical: Date of Last Biennial Review : Class of Medical: Type of Aircraft Date of Last Simulator Used: Instruction:

Medical Waivers ( ) Yes ( ) No If Yes please explain:

Manufacturers Ground and Attended and Dates: AOPA Membership #: EAA Membership #:

PILOT QUESTIONNAIRE

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PILOT QUESTIONNAIRE
EDUCATION
High School: 1. ( ) 2. ( ) 3. ( ) 4. ( ) College: Graduate School 1. ( ) 2. ( ) 3 ( ) 4.( ) 1. ( ) 2. ( ) 3 ( ) 4.( )

Name Of School

Years Attended

Did You Graduate?

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PILOT QUESTIONNAIRE

FLYING EXPERIENCE
Please show flying experience in logged hours. Do not group different aircraft of the same type in the category for the make and model on which approval is being sought. If hours can not be substantiated by log books, please explain how hours have been verified/reconstructed.
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PILOT QUESTIONNAIRE FLYING EXPERIENCE

Single Engine Aircraft Co-Pilot Make and Model of Aircraft Pilot in Command Total Time Total Last 12 Months Total Last 90 Days

Total Single Engine:

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PILOT QUESTIONNAIRE FLYING EXPERIENCE

Multi Engine Aircraft & Jet Aircraft Make and Model of Aircraft Pilot in CoCommand Pilot Total Time Total Last Total Last 12 Months 90 Days

Total Multi-Engine:
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PILOT QUESTIONNAIRE FLYING EXPERIENCE

Seaplanes and Helicopters Make and Model Pilot in of Aircraft Command Co-Pilot Total Time Total Last Total Last 12 Months 90 Days

Total Sea/Helo. :

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PILOT QUESTIONNAIRE FLYING EXPERIENCE

Single Engine Aircraft Make and Model of Aircraft

Pilot in Command

Co-Pilot Total Time Total Single Engine:

Total Last 12 Months

Total Last 90 Days

Multi Engine Aircraft & Jet Aircraft Make and Model of Aircraft

Pilot in Command

Co-Pilot Total Time

Total Last 12 Months

Total Last 90 Days

Total Multi-Engine: Seaplanes and Helicopters Make and Model of Aircraft Co-Pilot Total Time Pilot in Command Total Sea/Helo.: Total Last 12 Months Total Last 90 Days

Grand Total
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PILOT QUESTIONNAIRE

AIRCRAFT ACCIDENTS
Have you ever been involved in an aircraft accident? ( ) Yes ( ) No If Yes please explain: Location Date Make and Model Remarks

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PILOT QUESTIONNAIRE

Please Explain Circumstances: 1.If you have a physical impairment, waiver, limitation, or conditions on your Medical or Pilot Certificate. 2.If an FAA, Transport Canada, Military Pilot or other similar Certificate held by you has been suspended or revoked. 3.If you have ever been cited for a violation of any aviation regulation in any country. 4.If you have ever been convicted of or pleaded guilty to a felony or driving while intoxicated. Explanations:
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PILOT QUESTIONNAIRE
Name of Agent or Broker: Address:

All particulars herein are declared to be true and complete to the best of my/our knowledge and no information has been withheld or omitted. I/We agree that this application and the terms and conditions of the policy in use by the insurer shall be the basis of any contract between Me/Us and the Insurer. I herby authorize the insurer to investigate all or any qualifications and/or statements contained herein. Date: Applicants Signature (s):

THIS APPLICATION DOES NOT COMMIT THE INSURER TO ANY LIABILITY NOR MAKE THE APPLICANT LIABLE FOR ANY PREMIUM UNLESS AND UNTIL THE COMPANY AGREES TO EFFECT THE INSURANCE.
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AIRCRAFT INSURANCE APPLICATION

BLAIS AVIATION INSURANCE SERVICES Phone: 972-818-4090 Fax 972-818-4088 www.blaisaviation.com Agent or Broker Address Phone Fax E-Mail

Named Insured & Address: E-Mail Address: Business Occupation: Insurance is requested from: 12:01 AM Phone: Residence ( )

Current Insurance Company: Effective Date:

to 12:01 AM ) Phone: Fax ( ) E-Mail Address:

Phone: Business (

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AIRCRAFT INSURANCE APPLICATION

AIRCRAFT
Year, Make & Model FAA Total Number Seats Engine Hours Engine Horsepower

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AIRCRAFT INSURANCE APPLICATION

AIRCRAFT Aircraft usually based and ( ) Hangered ( ) Tied Down at (City & State):________________________________________________ Airport: __________________________________ ( ) Private Airport ( ) Public Airport Paved Runways Yes ( ) No ( ) Are any flights contemplated outside continental U.S.? ( ) Yes ( ) No If Yes, where: _____________________________________

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AIRCRAFT INSURANCE APPLICATION

COVERAGES AND LIMITS
LIABILITY COVERAGE Each Person Premiums A. B. C. Bodily Injury, excluding passengers Passenger Bodily Injury Property Damage $ $ XXXXXX $ $ $ $ $ $ $ LIMITS Each Occurrence

D. Combined Single Limit Bodily Injury and Property Damage, $ ( ) Including Passengers ( ) Excluding Passengers

Limiting Each ) person or ( ) Passenger to $ Each Occurrence

E.

Medical Payments: ___including Crew

$ Insured Value $ $

$ Deductible $ $

PHYSICAL DAMAGE COVERAGE F. G. While Not In Motion While In Motion

$ $ $

Other

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AIRCRAFT INSURANCE APPLICATION

USAGE AND OPERATION ( ) Pleasure and Business ( ) Industrial Aid ( ) Limited Commercial ( ) Commercial Excluding Instruction & Rental ( ) Commercial ( ) Flying Club ( ) Low Altitude Photography ( ) Air Ambulance ( ) Air Hearse ( ) Patrol Flights ( ) Banner Towing ( ) Crop Dusting ( ) Instruction of: (Name of Student): ( ) Special Uses Please Describe:

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AIRCRAFT INSURANCE APPLICATION

OWNERSHIP INFORMATION
Applicant is: ( ) Sole Owner ( ) Owner subject to mortgage or conditional sales contract. ( ) Lessee ( ) Other explain Applicant is: ( ) Individual ( ) Corporation ( ) Limited Liability Corporation ( ) Co-Ownership/Partnership If aircraft is encumbered, name and address of lienholder or lessor:

Amount of encumbrance (excluding interest and finance chargers):$ Will Lienholders Interest be required by lienholder? ( ) Yes ( ) No

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PILOT INFORMATION
Pilot No. 1 Pilot No. 2 Pilot No. 3

AIRCRAFT INSURANCE APPLICATION

PILOT
NAME OF PILOT Date Of Birth Certification (s) Medical & Ratings Certificate Please List Date Class Hours Logged as Pilot in Command All Aircraft Make and Model Total SEL MEL Total Last 90 days 12 Months

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PILOT INFORMATION
Pilot No. 1 Pilot No. 2 Pilot No. 3

AIRCRAFT INSURANCE APPLICATION

PILOT FAA Certificate Number Date of Last Biennial Flight Review Details of other proficiency training Name and address of pilots employer if other than applicant: Pilots AOPA or EAA Membership Number/s if a member:

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AIRCRAFT INSURANCE APPLICATION

SUPPLEMENTAL QUESTIONS Does the aircraft have OTHER than a standard airworthiness certificate in full effect? Are there any other aircraft owned by the applicant? Has the aircraft been equipped with modifications not provided by the manufacturer? Will the aircraft be normally operated in OTHER than paved public airports? Will the aircraft be used for student or pilot instruction OTHER than for recurrent training of pilots listed in the Pilot Information Section of this application? Will other than the applicant and pilots listed in the Pilot Information Section of this application have use of the aircraft? Will aircraft be used for any purpose (s) for which a charge is made? Is there any unrepaired damage to the aircraft? Has the applicant or any pilot listed in the Pilot Information Section of this application ever been involved in any aircraft accident? Has the applicant or any pilot listed in the Pilot Information Section of this application ever been cited for violation of any aviation regulation in any country?

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AIRCRAFT INSURANCE APPLICATION

SUPPLEMENTAL QUESTIONS
Has the applicant or any pilot listed in the Pilot Information Section of this application ever had an FAA, Military, or other pilot certificate suspended or revoked? Does the applicant or any pilot listed in the Pilot Information Section of this application have any; (a) physical impairments, (b) waivers, limitations, conditions on their medical certificates or on their airman certificates? If Yes please explain. Has the applicant or any pilot listed in the Pilot Information Section of this application ever been convicted of or plead guilty to a felony, possession of drugs, or of driving while intoxicated? Please Explain any Yes answer in the space below or on a separate sheet of paper:

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AIRCRAFT INSURANCE APPLICATION

MINIMUM PILOT REQUIREMENTS I/We understand and acknowledge that there is no coverage in flight unless the aircraft is being operated by the pilot(s) designated on this document who has/have at least the certificates, ratings, and pilot experience indicated, and who, is/are qualified for the flight involved. INITIAL .

USE REQUIREMENTS I/We understand and acknowledge that there is no coverage in flight if the aircraft is used for any purpose other than the use designated on this document. INITIAL .

AIRWORTHINESS REQUIREMENTS I/We understand and acknowledge that there is no coverage in flight unless a standard airworthiness certificate in full effect INITIAL

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AIRCRAFT INSURANCE APPLICATION

All particulars herein are declared to be true and complete to the best of my/our knowledge and no information has been withheld or omitted. I/We agree that this application and the terms and conditions of the policy in use by the insurer shall be the basis of any contract between Me/Us and the Insurer. I herby authorize the insurer to investigate all or any qualifications and/or statements contained herein. FRAUD WARNING: Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material hereto commits a fraudulent insurance act, which is a crime. to represent me/us in placing this I/We authorize insurance. Date: _____________________ Applicants Signature (s): __________________________

THIS APPLICATION DOES NOT COMMIT THE INSURER TO ANY LIABILITY NOR MAKE THE APPLICANT LIABLE FOR ANY PREMIUM UNLESS AND UNTIL THE COMPANY AGREES TO EFFECT THE INSURANCE.

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Make sure you take note of the pilot warranty wording

Aircraft Pilot

PILOT WARRANTY
Other

Location Use

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HIGH WING AIRCRAFT

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LOW WING AIRCRAFT

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BI PLANE

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AVIATION PHONETIC ALPHABET

My aircraft tail number is 1935 Lima Tango and I am located on Taxiway Quebec on the north side of airport Alpha Delta - Sierra TRANSLATION My aircraft tail number is 1935LT and I am located on Taxiway Q on the north side of airport ADS

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CHARACTER

TELEPHONY

PHONIC (PRONUNCIATION)

A B C D E

Alfa Bravo Charlie Delta Echo

(AL-FAH) (BRAH-VOH) (CHAR-LEE) or (SHAR-LEE) (DELL-TAH) (ECK-OH)

The Aviation Phonetic Alphabet

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CHARACTER

TELEPHONY

PHONIC (PRONUNCIATION)

F G H I J K

FOXTROT Golf Hotel India Juliet Kilo

(FOX-TROT) (GOLF) (HOH-TEL) (IN-DEE-AH) (JEW-LEE-ETT) (KEY-LOH)

The Aviation Phonetic Alphabet

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CHARACTER

TELEPHONY

PHONIC (PRONUNCIATION)

L M N O P

Lima Mike November Oscar Papa

(LEE-MAH) (MIKE) (NO-VEM-BER) (OSS-CAH) (PAH-PAH)

The Aviation Phonetic Alphabet

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CHARACTER

TELEPHONY

PHONIC (PRONUNCIATION)

Q R S T U

Quebec Romeo Sierra Tango Uniform

(KEH-BECK) (ROW-ME-OH) (SEE-AIR-RAH) (TANG-GO) (YOU-NEE-FORM) or (OO-NEE-FORM)

The Aviation Phonetic Alphabet

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CHARACTER

TELEPHONY

PHONIC (PRONUNCIATION)

V W X Y Z

Victor Whiskey X ray Yankee Zulu

(VIK-TAH) (WISS-KEY) (ECKS-RAY) (YANK-KEY) (ZOO-LOO)

The Aviation Phonetic Alphabet

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AVIATION ABBREVIATIONS

I am willing to insure a CFI who will be using a Fixed CONV SEL to give Dual to Ps, COMs, or ATPs; no SOLO until 10 hours in M&M TRANSLATION I am willing to insure a Certified Flight Instructor who will be using a plane with non retractable conventional gear with a tail wheel to give training by a qualified instructor to Private Licensed, Commercial Licensed or Airline Transport Pilots. There will be no solo flying until 10 hours instruction in the make and model has been completed.

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AVIATION ABBREVIATIONS The following abbreviations are found in aviation insurance applications, policies, aircraft advertisements, manuals and pilot operating handbooks. Insurance abbreviations Page 1 of 11 AMES Aircraft multi engine, sea ASES Aircraft single engine, sea ATP Airline Transport Pilot BFR Biannual flight review C Commercial license CFI Certified flight instructor CFII Certified flight instructor, instrument Conv - Conventional landing gear with tail wheel Dual training given by a qualified instructor

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AVIATION ABBREVIATIONS The following abbreviations are found in aviation insurance applications, policies, aircraft advertisements, manuals and pilot operating handbooks. Insurance abbreviations Page 2 of 11 Fixed non-retractable landing gear Fixed tri Fixed tri-cycle landing gear FR Flight review G & F ground and flight GNIM ground not in motion GNIF Ground not in flight G & T Ground and taxi Heli helicopter or rotor wing Hr - Hours

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AVIATION ABBREVIATIONS The following abbreviations are found in aviation insurance applications, policies, aircraft advertisements, manuals and pilot operating handbooks. Insurance abbreviations Page 3 of 11
I Instrument rated IFR Instrument rated ICC Instrument competency check IPC Instrument proficiency check M multi engine Med medical payments Med pay medical payments ME Multi engine MEL Multi engine land MEI Multi engine instructor MM Make and model M & M Make and model

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AVIATION ABBREVIATIONS The following abbreviations are found in aviation insurance applications, policies, aircraft advertisements, manuals and pilot operating handbooks. Insurance abbreviations Page 4 of 11
OPW Open pilot warranty P Private license Pax - Passengers PIC - Pilot in command RG Retractable gear Rotor Helicopter or rotorcraft RW Rotor wing SE Single engine SEL Single engine land SES Single engine sea SIC Second in command Solo no passengers or flight instructor in aircraft

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AVIATION ABBREVIATIONS The following abbreviations are found in aviation insurance applications, policies, aircraft advertisements, manuals and pilot operating handbooks. Insurance abbreviations Page 5 of 11 TO Take off TO & L Take off and landings TRI Tri-gear TW Tailwheel TT Total time TTL Total time logged

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AIRCRAFT ABBREVIATION Page 6 OF 11 0SFRM - zero time since a factory remanufacture 0SMOH - Zero time since major engine overhaul FWF - Firewall forward MDH - major damage history NDH - No damage history

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AIRCRAFT ABBREVIATION Page 7 OF 11 SCMOH - Since chrome cylinder major overhaul SFRM - Since factory remanufacture SMOH - Since major engine overhaul SOH - since engine overhaul (not necessarily a major) SPOH - Since prop overhaul STOH - Since top overhaul (pistons, cylinders and valve train)

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AIRCRAFT ABBREVIATION Page 8 of 11 TBO - Time between overhauls (factory recommendations) TT - Total time TTA - Total time on the airframe TTAE - Total time on the airframe and engine TTE - Total time on the engine TTSN - Total time since new

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AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS Page 9 of 11 Amp - Amperage of the alternator (electrical system rating) Alt - Alternator AOC - Angle of climb C/S - Constant speed (governed speed, adjustable pitch) propeller Cu. In. - Cubic inches displacement of engines Fixed tri gear - non retractable tricycle landing gear with a nose wheel F/P - Fixed pitch (non adjustable) propeller FPM - Feet per minute (usually regarding climb)

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AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS Page 10 of 11

Gen - Generator GPH - Gallons per hour MPH - Miles per hour HP - Horsepower of engine KTS - Knots (1 knot = 1.151 statue miles per hour, or 1852 kilometers per hour) L/R - Long-range fuel NM - Nautical mile = approximately 6,080 ft. Oct. - Octane rating of fuel.

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AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONS Page 11 of 11

PSI - Pounds per square inch (tire and strut pressure) Ret. tri gear - Retractable tricycle landing gear with a nose wheel ROC - Rate of climb SM - Statue mile = 5,280 ft. Sq. Ft. - Square feet regarding wing area. STD - Standard fuel V Volts Vis - Viscosity of oil

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AVIATION APPLICATION QUESTION ANSWER SESSION

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(A division of Blais Excess & Surplus Agency of Texas, Ltd.)

Blais Aviation Insurance Services

A wholesale specialty facility dedicated to serve as an agent/brokers backroom in the design, placement and service of aviation insurance. www.blaisaviation.com Dallas 972 818-4090 Houston 713 780-7787 Austin 512 894-3460

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