
PARK
INSURANCE SERVICES LTD.
Telephone:
888.917.1177 Fax: 866.372.2755
MEMORANDUM OF
INSURANCE
INSURER(S): Allianz
Global Risks US Insurance Company
INSURED:
POLICY #: AIM0512291
POLICY PERIOD: August
1, 2006 to August 1, 2007
AIRCRAFT INSURED: Cessna 172M
Registration C-GHUU
Amount of insurance on hull: $70,000
Landplane
Deductible: $500 All Losses
LIABILITY COVERAGE: $1,000,000 Third
Party plus $300,000 per Passenger
Limited to 3 passenger seat(s)
AIRCRAFT USE: Private
Business and Pleasure
APPROVED PILOTS: Properly
licensed Club Members per Endorsement Number 1
TERRITORIAL
LIMITS: Aircraft
may only be operated in
SPECIAL CONDITIONS: Premium is
non-refundable unless the aircraft is sold.
ANNUAL PREMIUM: $4,935.00
THIS IS NOT A POLICY OF
INSURANCE, IT IS A MEMORANDUM OF THE POLICY DESCRIBED HEREIN AT THE DATE OF
ISSUE HEREOF AND IS FURNISHED AS A MATTER OF INFORMATION ONLY, WITH THE
UNDERSTANDING THAT THE RIGHTS AND LIABILITIES OF THE PARTIES WILL BE GOVERNED
BY THE ORIGINAL POLICY AS IT MAY BE LAWFULLY AMENDED BY ENDORSEMENT FROM TIME
TO TIME.
THIS MEMORANDUM
ISSUED TO:
DATE: July 31, 2006