Aviation Application Webinar

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    THE GENERAL AVI ATI ONRI SK AP P LICATION

    W EB I N A R

    Presen t ed by :

    BL AI S AVI ATI ON IN SURAN CE SERVI CES

    J ANUARY 28, 2010

    WWW.BL AI S AV IA TION.COM1

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    AVIATION INSURANCEAPPLICATIONS

    There are a number of aviation exposures and each hasits own application(s). This webinar will focus on the

    general aviation exposure application and pilotquestionnaire. You can view the various applications byvisiting the Blais Aviation Insurance Services website.

    www.blaisaviation.com

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    http://www.blaisaviation.com/http://www.blaisaviation.com/
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    INDUSTRIAL AI DP LEASURE &

    BUSINESSSINGLE ENGINE

    TYP ES OF AVIATION EXPOSURES

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    P LEASURE & BUSINESSROTORWING

    P LEASURE & BUSINESS

    MULTI ENGINE

    TYP ES OF AVIATION EXPOSURES

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    STUDENT P ILOTS AEROBATIC

    TYP ES OF AVIATI ON EXPOSURES

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    AIRSHOWS WARBIRDS

    TYP ES OF AVIATION EXPOSURES

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    SMALL AI RP ORTS LARGE AI RP ORTS

    TYP ES OF AVIATION EXPOSURES

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    FI XED BASEDOPERATORS FBOS

    MANUFACTURESPRODUCTSCOMPLETED

    OPERATIONS

    TYP ES OF AVIATION EXPOSURES

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    AVIATION UNDERWRITING & ANALYSIS

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    Every aviation insurance underwriter hasslightly different guidelines he/she follows to

    arrive at a rate, but virtually without exceptionthey 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/herchances of profit from your policy.

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    KEY FACTORS AVIATION UNDERWRITERS CONSIDER

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    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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    AIRCRAFT

    Pleasure & BusinessIndustrial Aid

    Instructional RentalCharter

    Pipeline PatrolPower Line Patrol

    Crop DustingBanner Towing

    StudentPrivateCommercial

    ATPInstrumentInstructor

    Type RatingTotal Hours

    Make & Model HoursSingle Engine Land Multi Engine LandSingle Engine Sea Multi Engine Sea

    Turbo Prop Turbo JetComplex Avionics Unusual Characistics

    TH E COMPONENT S OF AVIATI ON

    UNDERWRITING

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    FOR GENERAL AVIATION RISKS

    UNDERWRITERS WILL REQUIRETHE FOLLOWING APPLICATIONS

    PILOT QUESTIONNA IRE&

    AIRCRAFT APPLICATION

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    Name of Aircraft Owner:

    Name of Pilot: Date of Birth:

    Address:

    Pilots Occupation:

    Employer: Date Employed:

    PILOT QUESTIONNA IRE

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    PILOT QUESTIONNA IRE

    Check Al l Ce r t i f i c a t e s and Ra t ings Cur r en t ly He ld

    ( ) 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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    15PILOT QUESTI ONNAI RE

    Airmans Certificate No: Date Certified:

    If Student: (Name of instructor or FBO) - (Instruction airport location)

    Date of Last Medical: Class of Medical:

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

    Date of Last BiennialReview :

    Type of AircraftUsed:

    Date of Last SimulatorInstruction:

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

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    PILOT QUESTIONNA IRE

    High School:1. ( ) 2. ( ) 3. ( ) 4. ( )

    College:1. ( ) 2. ( ) 3 ( ) 4.( )

    Graduate School1. ( ) 2. ( ) 3 ( ) 4.( )

    Name Of School Years Attended Did You Graduate?

    EDUCATION

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    PILOT QUESTI ONNA IRE

    FLYING EXPERIENCEPlease show flying experience in logged hours.Do not group different aircraft of the same type inthe category for the make and model on whichapproval is being sought. If hours can not besubstantiated by log books, please explain howhours have been verified/reconstructed.

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    PILOT QUESTI ONNA IRE FLYI NG EXPERIENCE

    Single Engine Aircraft

    Make and Model of Aircraft Pilot inCommand

    Co-Pilot Total Time Total Last 12Months

    Total Last 90Days

    Total Single Engine:

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    PILOT QUESTI ONNA IRE FLYI NG EXPERIENCE

    Multi Engine Aircraft & Jet Aircraft

    Make and Model ofAircraft

    Pilot inCommand

    Co-Pilot

    TotalTime

    Total Last12 Months

    Total Last90 Days

    Total Multi-Engine:

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    PILOT QUESTI ONNA IRE FLYI NG EXPERIENCE

    Seaplanes and Helicopters

    Make and Modelof Aircraft

    Pilot inCommand

    Co-Pilot TotalTime

    Total Last12 Months

    Total Last90 Days

    Total Sea/Helo. :

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    PILOT QUESTI ONNA IRE FLYI NG EXPERIENCE

    Single Engine AircraftMake and Model of Aircraft Pilot in

    CommandCo-Pilot Total Time Total Last 12

    MonthsTotal Last 90Days

    Total Single Engine: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 Pilot inCommand Co-Pilot Total Time Total Last 12Months Total Last 90DaysTotal Sea/Helo.:

    Grand Total

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    PILOT QUESTI ONNA IRE

    Have you ever been involved in an aircraft accident?( ) Yes ( ) NoIf Yes please explain:

    Location Date Make and Model Remarks

    AIRCRAFT ACCIDENTS

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    PILOT QUESTI ONNA IRE

    Please Ex p la in Ci rc um s t anc es :

    1.If you have a physical impairment, waiver, limitation, or conditions on yourMedical or Pilot Certificate.

    2.If an FAA, Transport Canada, Military Pilot or other similar Certificate held byyou has been suspended or revoked.

    3.If you have ever been cited for a violation of any aviation regulation in anycountry.

    4.If you have ever been convicted of or pleaded guilty to a felony or drivingwhile intoxicated.

    Explanations:

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    PILOT QUESTI ONNA IRE

    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 thisapplication and the terms and conditions of the policy in use by the insurer shall be thebasis of any contract between Me/Us and the Insurer. I herby authorize the insurer toinvestigate all or any qualifications and/or statements contained herein.

    Date: Applicants Signature (s):THIS APPLICATION DOES NOT COMMIT THE INSURER TO ANY LIABILITY NORMAKE THE APPLICANT LIABLE FOR ANY PREMIUM UNLESS AND UNTIL THE

    COMPANY AGREES TO EFFECT THE INSURANCE.

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    BLAIS AVIATIONINSURANCE SERVICES

    Phone: 972-818-4090Fax 972-818-4088www.blaisaviation.com

    Agent or BrokerAddress

    PhoneFaxE-Mail

    Named Insured & Address:

    E-Mail Address:

    Current Insurance Company:

    Effective Date:

    Business Occupation:

    Insurance is requested from: 12:01 AM to 12:01 AM

    Phone: Residence ( ) Phone: Business ( ) Phone: Fax ( )E-Mail Address:

    AIRCRAFT INSURAN CE APPLICATION

    http://www.blaisaviation.com/http://www.blaisaviation.com/
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    AIRCRAFT INSURAN CE APPLICATION

    Year, Make & Model FAA

    Number

    Total

    Seats

    Engine

    Hours

    Engine

    Horsepower

    AIRCRAFT

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    AIRCRAFT INSURAN CE APPLICATION

    AIRCRAFT

    Aircraft usually based and ( ) Hangered ( ) Tied Down at (City &State):________________________________________________

    Airport: __________________________________ ( ) Private Airport ( ) Public AirportPaved Runways Yes ( ) No ( )

    Are any flights contemplated outside continental U.S.? ( ) Yes ( ) NoIf Yes, where: _____________________________________

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    AIRCRAFT INSURAN CE APPLICATION

    LIABILITY COVERAGE LIMITSEach Person Each Occurrence

    Premiums

    A. Bodily Injury, excluding passengers $ $ $

    B. Passenger Bodily Injury $ $ $C. Property Damage XXXXXX $ $

    D. Combined Single Limit Bodily Injury andProperty Damage,

    ( ) Including Passengers ( ) ExcludingPassengers

    Limiting Each( ) person or ( ) Passenger to $

    $ Each Occurrence

    $

    E. Medical Payments: ___including Crew $ $ $

    PHYSICAL DAMAGE COVERAGE Insured Value DeductibleF. While Not In Motion $ $ $

    G. While In Motion $ $ $

    Other $

    COVERAGES AND LIMITS

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    AIRCRAFT INSURAN CE 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 INSURAN CE APPLICATION

    Applicant is:( ) Sole Owner( ) Owner subject to mortgage or conditional sales contract.( ) Lessee ( ) Other explainApplicant 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

    OWNERSHIP INFORMATION

    PILOT INFORMATION

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    AIRCRAFT INSURAN CE APPLICATION

    PILOT

    NAMEOFPILOT

    DateOfBirth

    Certification (s)& RatingsPlease List

    MedicalCertificateDateClass

    Hours Logged as Pilot inCommand

    All AircraftMake and ModelTotalSELMELTotalLast 90 days12 Months

    Pilot No. 1 Pilot No. 2 Pilot No. 3

    PILOT INFORMATION

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    AIRCRAFT INSURAN CE APPLICATION

    PILOT

    Pilot No. 1 Pilot No. 2 Pilot No. 3

    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 INSURAN CE APPLICATION

    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 pilotslisted in the Pilot Information Section of this application?

    Will other than the applicant and pilots listed in the Pilot Information Section of this applicationhave 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 everbeen involved in any aircraft accident?Has the applicant or any pilot listed in the Pilot Information Section of this application everbeen cited for violation of any aviation regulation in any country?

    SUPPLEMENTAL QUESTIONS

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    AIRCRAFT INSURAN CE APPLICATION

    Has the applicant or any pilot listed in the Pilot Information Section of this application ever hadan FAA, Military, or other pilot certificate suspended or revoked?

    Does the applicant or any pilot listed in the Pilot Information Section of this application haveany; (a) physical impairments, (b) waivers, limitations, conditions on their medical certificates oron their airman certificates? If Yes please explain.

    Has the applicant or any pilot listed in the Pilot Information Section of this application everbeen 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:

    SUPPLEMENTAL QUESTIONS

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    AIRCRAFT INSURAN CE APPLICATION

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

    INITIAL .USE REQUIREMENTSI/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 REQUIREMENTSI/We understand and acknowledge that there is no coverage in flight unless a standardairworthiness certificate in full effect

    INITIAL

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    AIRCRAFT INSURAN CE APPLICATION

    All particulars herein are declared to be true and complete to the best of my/our knowledge and noinformation has been withheld or omitted. I/We agree that this application and the terms andconditions of the policy in use by the insurer shall be the basis of any contract between Me/Us andthe Insurer. I herby authorize the insurer to investigate all or any qualifications and/or statementscontained herein.FRAUD WARNING: Any person who knowingly and with intent to defraud any insurance companyor other person files an application for insurance containing any materially false information orconceals, for the purpose of misleading, information concerning any fact material hereto commitsa fraudulent insurance act, which is a crime.

    I/We authorize to represent me/us in placing thisinsurance.Date: _____________________ Applicants Signature (s): __________________________

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

    EFFECT THE INSURANCE.

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    Other

    Aircraft

    Pilot

    Location

    Use

    PILOT WARRANTY

    Make sure you take noteof the pilot w arrantywording

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    HIGH W I NG AI RCRAFT

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    LOW W I NG AI RCRAFT

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    BI P LANE

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    AVI ATI ON PHONETIC A LPHAB ET

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    My aircraft tail number is 1935 Lima Tango and I am located on TaxiwayQuebec on the north side of airport Alpha Delta - Sierra

    TRANSLATIONMy aircraft tail number is 1935LT and I am located on Taxiway Q on the

    north side of airport ADS

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    The Aviation P honetic Alphabet

    CHARACTER TELEPHONY PHONIC (PRONUNCIATION)

    A Alfa (AL-FAH)

    B Bravo (BRAH-VOH)

    C Charlie (CHAR-LEE) or (SHAR-LEE)

    D Delta (DELL-TAH)

    E Echo (ECK-OH)

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    The Aviation P honetic Alphabet

    CHARACTER TELEPHONY PHONIC (PRONUNCIATION)

    F FOXTROT (FOX-TROT)

    G Golf (GOLF)

    H Hotel (HOH-TEL)

    I India (IN-DEE-AH)

    J Juliet (JEW-LEE-ETT)

    K Kilo (KEY-LOH)

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    The Aviation P honetic Alphabet

    CHARACTER TELEPHONY PHONIC (PRONUNCIATION)

    L Lima (LEE-MAH)

    M Mike (MIKE)

    N November (NO-VEM-BER)

    O Oscar (OSS-CAH)

    P Papa (PAH-PAH)

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    The Aviation P honetic Alphabet

    CHARACTER TELEPHONY PHONIC (PRONUNCIATION)

    Q Quebec (KEH-BECK)

    R Romeo (ROW-ME-OH)

    S Sierra (SEE-AIR-RAH)

    T Tango (TANG-GO)

    U Uniform (YOU-NEE-FORM) or (OO-NEE-FORM)

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    The Aviation P honetic Alphabet

    CHARACTER TELEPHONY PHONIC (PRONUNCIATION)

    V Victor (VIK-TAH)

    W Whiskey (WISS-KEY)

    X X ray (ECKS-RAY)

    Y Yankee (YANK-KEY)

    Z Zulu (ZOO-LOO)

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    AVIATI ON ABB REVI ATI ONS

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    I am willing to insure a CFI who will be using a Fixed CONV SEL to giveDual 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 planewith non retractable conventional gear with a tail wheel to give training by a

    qualified instructor to Private Licensed, Commercial Licensed or AirlineTransport Pilots. There will be no solo flying until 10 hours instruction in themake and model has been completed.

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    AVIATION ABBREVIATIONSThe following abbreviations are found in aviation insurance applications,policies, aircraft advertisements, manuals and pilot operating handbooks.

    Insurance abbreviationsPage 1 of 11

    AMES Aircraft multi engine, seaASES Aircraft single engine, sea

    ATP Airline Transport PilotBFR Biannual flight reviewC Commercial license

    CFI Certified flight instructorCFII Certified flight instructor, instrument

    Conv - Conventional landing gear with tail wheelDual training given by a qualified instructor

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    AVIATION ABBREVIATIONSThe following abbreviations are found in aviation insurance applications,

    policies, aircraft advertisements, manuals and pilot operating handbooks.

    Insurance abbreviationsPage 2 of 11

    Fixed non-retractable landing gearFixed tri Fixed tri-cycle landing gear

    FR Flight reviewG & F ground and flight

    GNIM ground not in motionGNIF Ground not in flight

    G & T Ground and taxiHeli helicopter or rotor wing

    Hr - Hours

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    AVIATION ABBREVIATIONSThe following abbreviations are found in aviation insurance applications,

    policies, aircraft advertisements, manuals and pilot operating handbooks.

    Insurance abbreviationsPage 3 of 11

    I Instrument ratedIFR Instrument rated

    ICC Instrument competency checkIPC Instrument proficiency check

    M multi engineMed medical paymentsMed pay medical payments

    ME Multi engineMEL Multi engine land

    MEI Multi engine instructorMM Make and modelM & M Make and model

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    AVIATION ABBREVIATIONSThe following abbreviations are found in aviation insurance applications,policies, aircraft advertisements, manuals and pilot operating handbooks.

    Insurance abbreviationsPage 4 of 11

    OPW Open pilot warrantyP Private licensePax - Passengers

    PIC - Pilot in command

    RG Retractable gearRotor Helicopter or rotorcraftRW Rotor wing

    SE Single engineSEL Single engine landSES Single engine sea

    SIC Second in commandSolo no passengers or flight instructor in aircraft

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    AVIATION ABBREVIATIONSThe following abbreviations are found in aviation insurance applications,policies, aircraft advertisements, manuals and pilot operating handbooks.

    Insurance abbreviationsPage 5 of 11

    TO Take off

    TO & L Take off and landingsTRI Tri-gearTW TailwheelTT Total time

    TTL Total time logged

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    AIRCRAFT ABBREVIATIONPage 6 OF 11

    0SFRM - zero time since a factory remanufacture0SMOH - Zero time since major engine overhaul

    FWF - Firewall forwardMDH - major damage history

    NDH - No damage history

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    AIRCRAFT ABBREVIATIONPage 7 OF 11

    SCMOH - Since chrome cylinder major overhaulSFRM - Since factory remanufactureSMOH - 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 ABBREVIATIONPage 8 of 11

    TBO - Time between overhauls (factory recommendations)TT - Total time

    TTA - Total time on the airframeTTAE - Total time on the airframe and engine

    TTE - Total time on the engineTTSN - Total time since new

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    AIRCRAFT PERFORMANCE AND SPECIFICATION ABBREVIATIONSPage 9 of 11

    Amp - Amperage of the alternator (electrical system rating)Alt - Alternator

    AOC - Angle of climbC/S - Constant speed (governed speed, adjustable pitch) propeller

    Cu. In. - Cubic inches displacement of enginesFixed 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 ABBREVIATIONSPage 10 of 11

    Gen - GeneratorGPH - Gallons per hour MPH - Miles per hour

    HP - Horsepower of engineKTS - 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 ABBREVIATIONSPage 11 of 11

    PSI - Pounds per square inch (tire and strut pressure)

    Ret. tri gear - Retractable tricycle landing gear with a nose wheelROC - Rate of climb

    SM - Statue mile = 5,280 ft.Sq. Ft. - Square feet regarding wing area.

    STD - Standard fuelV VoltsVis - Viscosity of oil

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    AVI ATI ON APPLI CATI ONQUESTION AN SWER

    SESSION

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    Bla i s Av iat ion Insu rance Se r v ic es

    (A d iv i s ion o f B la i s Exc ess & Surp lus Agency o f Texas , Lt d .)

    A w h o le s a le s p ec i a l t y f a c i l i t y d e d i c a t e d t o s e r v e as a na g e n t /b r o k e r s b a c k r o o m i n t h e d e s ig n , p l a c e m e n t a n d

    s e r v i c e o f a vi at i o n i ns u r a n c e .

    w w w. b l a i s a v i a t i o n . c o m

    Da l la s 9 7 2 8 18 -4 0 90

    H o us t o n 7 13 7 8 0-7 7 87Aus t in 512 894-3460

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    http://www.blaisaviation.com/http://www.blaisaviation.com/