ACORD 327 (2014/12) - Airport and FBO Liability Supplement
ACORD 327 (2014/12) - Airport and FBO Liability Supplement
ACORD 327, Airport and FBO Liability Section, is used in conjunction with ACORD 325, Aviation Insurance Application - Applicant Information
Section, to describe airports and fixed base operators being insured. Attach ACORD 332, Hangar Schedule, and ACORD 331, Pilot Experience,
forms if applicable.
Form Page 1
Section Name
Field Name
Description
IDENTIFICATION SECTION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g., agency or
brokerage).
IDENTIFICATION SECTION
Date (MM/DD/YYYY)
Enter date: The date on which the form is completed. (MM/DD/YYYY)
IDENTIFICATION SECTION
Agency
Enter text: The full name of the producer / agency.
IDENTIFICATION SECTION
Policy Number
Enter identifier: The identifier assigned by the insurer to the policy, or submission, being
referenced exactly as it appears on the policy, including prefix and suffix symbols. If required for
self-insurance, the self-insured license or contract number.
IDENTIFICATION SECTION
Effective Date
Enter date: The effective date of the policy. The date that the terms and conditions of the policy
commence. (MM/DD/YYYY)
IDENTIFICATION SECTION
Carrier
Enter text: The insurer's full legal company name(s) as found in the file copy of the policy. Use
the actual name of the company within the group to which the policy has been issued. This is
not the insurer's group name or trade name.
IDENTIFICATION SECTION
NAIC Code
Enter code: The identification code assigned to the insurer by the NAIC.
IDENTIFICATION SECTION
Named Insured
Enter text: The named insured(s) as it / they will appear on the policy declarations page.
IDENTIFICATION SECTION
Estimated Annual Premium
Enter amount: The estimated annual premium amount for the Aircraft line of business.
AIRPORT INFORMATION
Loc #
Enter number: The location number for the premises.
AIRPORT INFORMATION
Airport ID
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -
O'Hare International Airport).
AIRPORT INFORMATION
Airport Name
Enter text: The full name of the location.
AIRPORT INFORMATION
Elevation
Enter number: The approximate distance, in feet, of the airport above or below sea level.
AIRPORT INFORMATION
Describe any sea lanes
Enter text: The description of any sea lanes at the airport.
AIRPORT INFORMATION
Applicant's Interest in
Airport - Tenant
Check the box (if applicable): Indicates the applicant's / insured's interest in the airport is as a
tenant.
AIRPORT INFORMATION
Applicant's Interest in
Airport - General Lessee
Check the box (if applicable): Indicates the applicant's / insured's interest in the airport is as a
general lessee.
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AIRPORT INFORMATION
Applicant's Interest in
Airport - Airport Owner
Check the box (if applicable): Indicates the applicant's / insured's interest in the airport is as an
owner.
AIRPORT INFORMATION
Applicant's Interest in
Airport - Sub-Tenant
Check the box (if applicable): Indicates the applicant's / insured's interest in the airport is as a
sub-tenant.
AIRPORT INFORMATION
Applicant's Interest in
Airport - Other
Check the box (if applicable): Indicates the applicant's / insured's interest in the airport is other
than those listed.
AIRPORT INFORMATION
Applicant's Interest in
Airport - Other Description
Enter text: The description of the applicant's / insured's interest in the airport.
AIRPORT INFORMATION
Airport Occupancy - Entire
Airport
Check the box (if applicable): Indicates the applicant / insured occupies the entire airport.
AIRPORT INFORMATION
Airport Occupancy - Portion
Check the box (if applicable): Indicates the applicant / insured occupies a portion of the airport.
AIRPORT INFORMATION
Airport Occupancy - Portion
Description
Enter text: The description of the applicant's / insured's occupancy of the airport. As used here,
this describes the portion of the airport the applicant / insured occupies if they do not occupy the
entire airport.
AIRPORT INFORMATION
Fire Station on Prem? Yes
Check the box (if applicable): Indicates a Yes response to the question, Is there a Fire Station
on premises?.
AIRPORT INFORMATION
Fire Station on Prem? No
Check the box (if applicable): Indicates a No response to the question, Is there a Fire Station
on premises?.
AIRPORT INFORMATION
Distance to Fire Station
Enter number: The distance in miles from the nearest fire station that supports the protection
class used.
AIRPORT INFORMATION
Airline Aircraft - Based at
the Airport
Enter number: The number of airline aircraft based at the airport.
AIRPORT INFORMATION
Airline Aircraft - Estimated
Arrivals / Departures this
Year
Enter number: The estimated number of airline aircraft arrivals / departures at the airport for the
current year.
AIRPORT INFORMATION
General Aviation Aircraft -
Based at the Airport
Enter number: The number of general aviation aircraft based at the airport.
AIRPORT INFORMATION
General Aviation Aircraft -
Estimated Arrivals /
Departures this Year
Enter number: The estimated number of general aviation aircraft arrivals / departures at the
airport for the current year.
AIRPORT INFORMATION
Military Aircraft - Based at
the Airport
Enter number: The number of military aircraft based at the airport.
AIRPORT INFORMATION
Military Aircraft - Estimated
Arrivals / Departures this
Year
Enter number: The estimated number of military aircraft arrivals / departures at the airport for
the current year.
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AIRPORT INFORMATION
Runways Construction -
Blacktop
Check the box (if applicable): Indicates the runways are constructed using blacktop.
AIRPORT INFORMATION
Runways Construction -
Concrete
Check the box (if applicable): Indicates the runways are constructed using concrete.
AIRPORT INFORMATION
Runways Construction -
Gravel
Check the box (if applicable): Indicates the runways are constructed using gravel.
AIRPORT INFORMATION
Runways Construction -
Turf
Check the box (if applicable): Indicates the runways are constructed using turf.
AIRPORT INFORMATION
Runways Construction -
Other
Check the box (if applicable): Indicates the runways are constructed using a material other than
those listed.
AIRPORT INFORMATION
Runways Construction -
Description
Enter text: The construction material used for runways.
AIRPORT INFORMATION
Runways Lighted? Yes
Check the box (if applicable): Indicates a Yes response to the question, Are runways
lighted?.
AIRPORT INFORMATION
Runways Lighted? No
Check the box (if applicable): Indicates a No response to the question, Are runways lighted?.
AIRPORT INFORMATION
Longest Runway
Enter number: The length of the longest runway in feet.
AIRPORT INFORMATION
Who maintains taxiways and
runways?
Enter text: The description of who maintains runways and taxiways.
AIRPORT GENERAL
INFORMATION
Are there any obstructions
to the approach? Yes
Check the box (if applicable): Indicates a Yes response to the question, Are there any
obstructions to the approach?.
AIRPORT GENERAL
INFORMATION
Are there any obstructions
to the approach? No
Check the box (if applicable): Indicates a No response to the question, Are there any
obstructions to the approach?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether there are any obstructions to the approach.
AIRPORT GENERAL
INFORMATION
Does the airport maintain an
air crash emergency plan?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the airport
maintain an air crash emergency plan?.
AIRPORT GENERAL
INFORMATION
Does the airport maintain an
air crash emergency plan?
No
Check the box (if applicable): Indicates a No response to the question, Does the airport
maintain an air crash emergency plan?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether the airport maintains an air crash emergency plan.
AIRPORT GENERAL
INFORMATION
Does the airport maintain an
anti-terrorist plan? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the airport
maintain an anti-terrorist plan?.
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AIRPORT GENERAL
INFORMATION
Does the airport maintain an
anti-terrorist plan? No
Check the box (if applicable): Indicates a No response to the question, Does the airport
maintain an anti-terrorist plan?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether the airport maintains an anti-terrorist plan.
AIRPORT GENERAL
INFORMATION
Does the airport employ
medical personnel? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the airport
employ medical personnel?.
AIRPORT GENERAL
INFORMATION
Does the airport employ
medical personnel? No
Check the box (if applicable): Indicates a No response to the question, Does the airport
employ medical personnel?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether the airport employs medical personnel.
AIRPORT GENERAL
INFORMATION
Does the airport maintain a
bird strike prevention
program? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the airport
maintain a bird strike prevention program?.
AIRPORT GENERAL
INFORMATION
Does the airport maintain a
bird strike prevention
program? No
Check the box (if applicable): Indicates a No response to the question, Does the airport
maintain a bird strike prevention program?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether the airport maintains an a bird strike prevention
program.
AIRPORT GENERAL
INFORMATION
Is the airport fenced? Yes
Check the box (if applicable): Indicates a Yes response to the question, Is the airport
fenced?.
AIRPORT GENERAL
INFORMATION
Is the airport fenced? No
Check the box (if applicable): Indicates a No response to the question, Is the airport fenced?.
AIRPORT GENERAL
INFORMATION
Explanation
Enter text: An explanation as to whether the airport is fenced.
AIRPORT GENERAL
INFORMATION
Is there a control tower on
the airport? Yes
Check the box (if applicable): Indicates a Yes response to the question, Is there an Air Traffic
Control Tower?.
AIRPORT GENERAL
INFORMATION
Is there a control tower on
the airport? No
Check the box (if applicable): Indicates a No response to the question, Is there an Air Traffic
Control Tower?.
AIRPORT GENERAL
INFORMATION
Name of Operator
Enter text: The full name of the air traffic control tower operator.
AIRPORT GENERAL
INFORMATION
Full Time
Check the box (if applicable): Indicates the air traffic control tower operator is employed full time.
AIRPORT GENERAL
INFORMATION
Part Time
Check the box (if applicable): Indicates the air traffic control tower operator is employed part
time.
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AIRPORT GENERAL
INFORMATION
Start Time
Enter time: The start time for part time air traffic control tower operations.
AIRPORT GENERAL
INFORMATION
Close Time
Enter time: The close time for part time air traffic control tower operations.
GENERAL LESSEE /
AIRPORT OWNER
# Bldgs
Enter number: The number of buildings at the airport.
GENERAL LESSEE /
AIRPORT OWNER
Brief Description of
Premises
Enter text: The brief description of the premises.
GENERAL LESSEE /
AIRPORT OWNER
Describe any ultralight,
parachuting or agriculture
activities allowed.
Enter text: The description of the activities allowed at the airport that include ultralights,
parachuting, or agriculture.
GENERAL LESSEE /
AIRPORT OWNER
Describe any recreational or
non-aviation use of the
airport.
Enter text: The description of recreational or non-aviation use of airport.
GENERAL LESSEE /
AIRPORT OWNER
Describe any air shows,
exhibitions, or other
aviation special events
scheduled or anticipated at
the airport.
Enter text: The description of any air shows, exhibitions, or other aviation special events
scheduled or anticipated at the airport.
GENERAL LESSEE /
AIRPORT OWNER
List airlines and scheduled
air taxis that will serve this
airport during the next year.
Enter text: The name of an airline or scheduled air taxis that will serve this airport during the
next year.
GENERAL LESSEE /
AIRPORT OWNER
List airlines and scheduled
air taxis that will serve this
airport during the next year.
Enter text: The name of an airline or scheduled air taxis that will serve this airport during the
next year.
GENERAL LESSEE /
AIRPORT OWNER
List airlines and scheduled
air taxis that will serve this
airport during the next year.
Enter text: The name of an airline or scheduled air taxis that will serve this airport during the
next year.
GENERAL LESSEE /
AIRPORT OWNER
List airlines and scheduled
air taxis that will serve this
airport during the next year.
Enter text: The name of an airline or scheduled air taxis that will serve this airport during the
next year.
GENERAL LESSEE /
AIRPORT OWNER
List the type of
airline/commuter equipment
Enter text: The description of the type of airline / commuter equipment used at the airport.
GENERAL LESSEE /
AIRPORT OWNER
List the type of
airline/commuter equipment
Enter text: The description of the type of airline / commuter equipment used at the airport.
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GENERAL LESSEE /
AIRPORT OWNER
List the type of
airline/commuter equipment
Enter text: The description of the type of airline / commuter equipment used at the airport.
GENERAL LESSEE /
AIRPORT OWNER
List the type of
airline/commuter equipment
Enter text: The description of the type of airline / commuter equipment used at the airport.
BUSINESS OWNER /
MANAGEMENT
Is there an airport manager?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Is there an airport
manager?.
BUSINESS OWNER /
MANAGEMENT
Is there an airport manager?
No
Check the box (if applicable): Indicates a No response to the question, Is there an airport
manager?.
BUSINESS OWNER /
MANAGEMENT
Is the airport manager an
employee of the insured?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Is the airport
manager an employee of the insured?.
BUSINESS OWNER /
MANAGEMENT
Is the airport manager an
employee of the insured?
No
Check the box (if applicable): Indicates a No response to the question, Is the airport manager
an employee of the insured?.
BUSINESS OWNER /
MANAGEMENT
Is there a manager on
premises during operation?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Is there a manager
on premises during operation?.
BUSINESS OWNER /
MANAGEMENT
Is there a manager on
premises during operation?
No
Check the box (if applicable): Indicates a No response to the question, Is there a manager on
premises during operation?.
BUSINESS OWNER /
MANAGEMENT
Manager of Flight
Operations Name
Enter text: The name or description of the flight operations manager.
BUSINESS OWNER /
MANAGEMENT
Manager of Flight
Operations Experience
Enter text: The description of the flight operations manager experience.
BUSINESS OWNER /
MANAGEMENT
Business Owner - Name
Enter text: The airport business owner's full name.
BUSINESS OWNER /
MANAGEMENT
Business Owner - Status
Absentee
Check the box (if applicable): Indicates the business owner is absent.
BUSINESS OWNER /
MANAGEMENT
Business Owner - Active
Owner
Check the box (if applicable): Indicates the business owner is active in the business.
BUSINESS OWNER /
MANAGEMENT
Business Owner - Employee
Status - Contracted
Check the box (if applicable): Indicates the business owner is a contracted employee.
BUSINESS OWNER /
MANAGEMENT
Business Owner - Employee
Status - Full Time
Check the box (if applicable): Indicates the business owner is a full time employee.
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BUSINESS OWNER /
MANAGEMENT
Business Owner - Employee
Status - Part Time
Check the box (if applicable): Indicates the business owner is a part time employee.
BUSINESS OWNER /
MANAGEMENT
Business Manager Name
Enter text: The name or description of who manages the business when the owner is absent.
BUSINESS OWNER /
MANAGEMENT
Business Manager
Experience
Enter text: The description of the experience of the business manager.
Form Page 2
Section Name
Field Name
Description
IDENTIFICATION SECTION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g., agency or
brokerage).
GROSS RECEIPTS
Fuel & Lubricants
Enter amount: The annual gross receipts amount for fuel and lubricants.
GROSS RECEIPTS
Aircraft Repair / Servicing
Enter amount: The annual gross receipts amount for aircraft repair and / or servicing.
GROSS RECEIPTS
Aircraft Parts (not installed)
Enter amount: The annual gross receipts amount for aircraft parts (not installed).
GROSS RECEIPTS
Sale of New Aircraft
Enter amount: The annual gross receipts amount for the sale of new aircraft.
GROSS RECEIPTS
Sale of Used Aircraft
Enter amount: The annual gross receipts amount for the sale of used aircraft.
GROSS RECEIPTS
Restaurant
Enter amount: The annual gross receipts amount for restaurants.
GROSS RECEIPTS
Aircraft Painting
Enter amount: The annual gross receipts amount for aircraft painting.
GROSS RECEIPTS
Engine Overhaul
Enter amount: The annual gross receipts amount for engine overhaul operations.
GROSS RECEIPTS
Tie-Down/Hangaring
Enter amount: The annual gross receipts amount for tie-downs and hangaring.
GROSS RECEIPTS
Propeller Repair
Enter amount: The annual gross receipts amount for propeller repair operations.
GROSS RECEIPTS
Aircraft Charter
Enter amount: The annual gross receipts amount for aircraft charter operations.
GROSS RECEIPTS
Rental- Instruction
Enter amount: The annual gross receipts amount for rental / instruction operations.
GROSS RECEIPTS
Helicopter Repairs
Enter amount: The annual gross receipts amount for helicopter repair operations.
GROSS RECEIPTS
Auto Parking
Enter amount: The annual gross receipts amount for auto parking operations.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
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GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Description
Enter text: The annual gross receipts amount for the operation.
GROSS RECEIPTS
Other Amount
Enter amount: The annual gross receipts amount for the operation.
FUELING
Is Fueling Done - By Self
Serve
Check the box (if applicable): Indicates the fueling is accomplished by self service.
FUELING
Is Fueling Done - By Truck
Check the box (if applicable): Indicates if fueling is done by a truck.
FUELING
Is Fueling Done - On
Premises
Check the box (if applicable): Indicates if fueling is available on premises.
FUELING
Is Fueling Done - By
Applicant
Check the box (if applicable): Indicates if the insured fuels vehicles and / or aircraft.
FUELING
Is Fueling Done - By Gas
Pump
Check the box (if applicable): Indicates if fueling is done using a gas pump.
FUELING
If not by applicant, by
whom?
Enter text: Describes who does the fueling if not the applicant / insured.
FUELING
Applicant Sells - AV Gas
Check the box (if applicable): Indicates if the insured sells aviation gasoline.
FUELING
Applicant Sells - Jet Fuel
Check the box (if applicable): Indicates if the insured sells jet fuel.
FUELING
Applicant Sells - Auto Fuel
Check the box (if applicable): Indicates if the insured sells auto fuel.
FUELING
Annual Gallonage - Airline
Enter number: The number of gallons of fuel annually used for airlines.
FUELING
Annual Gallonage - General
Aviation
Enter number: The number of gallons of fuel annually used for general aviation.
FUELING
Annual Gallonage - Military
Enter number: The number of gallons of fuel annually used for military aviation.
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FUELING
Annual Gallonage - Fuel
Stored Underground
Enter number: The number of gallons of fuel stored underground.
FUELING
Annual Gallonage - Fuel
Stored Above Ground
Enter number: The number of gallons of fuel stored above ground.
TIE-DOWNS / HANGARING
Location #
Enter number: The location number for the premises.
TIE-DOWNS / HANGARING
Building #
Enter number: The building number for the premises. Used when more than one building exists
at an individual location.
TIE-DOWNS / HANGARING
Airport ID
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -
O'Hare International Airport).
TIE-DOWNS / HANGARING
Tie-Down Provider
Enter text: The description of the tie-down provider.
TIE-DOWNS / HANGARING
Type of Tie-Downs
Enter text: The description of the type of tie-downs.
TIE-DOWNS / HANGARING
Number Tie-Down Spaces
Enter number: The number of tie-down spaces.
TIE-DOWNS / HANGARING
Describe Storage Hangars
Enter text: The description of storage hangars.
TIE-DOWNS / HANGARING
Maximum Value Of Aircraft -
Any one aircraft
Enter amount: The maximum value of any one aircraft in care and custody of applicant.
TIE-DOWNS / HANGARING
Maximum Value Of Aircraft -
All Aircraft
Enter amount: The maximum value of all aircraft in care and custody of applicant.
TIE-DOWNS / HANGARING
Storage Hangars
Construction Type
Enter code: The construction type of the storage hangars.
TIE-DOWNS / HANGARING
Storage Hangars Area
Enter number: The total area of this building, in square feet, counting both stories above ground
and basements.
HANGAR INFORMATION
Do You Require Hangar
Tenants To Carry
Insurance? Yes
Check the box (if applicable): Indicates a Yes response to the question, Do you require
hangar tenants to carry insurance?.
HANGAR INFORMATION
Do You Require Hangar
Tenants To Carry
Insurance? No
Check the box (if applicable): Indicates a No response to the question, Do you require hangar
tenants to carry insurance?.
HANGAR INFORMATION
If Yes, Does Their Insurance
Policy Name The Owner As
An Additional Insured? Yes
Check the box (if applicable): Indicates a Yes response to the question, If you require hangar
tenants to carry insurance, does their insurance policy name the owner as an additional
insured?.
HANGAR INFORMATION
If Yes, Does Their Insurance
Policy Name The Owner As
An Additional Insured? No
Check the box (if applicable): Indicates a No response to the question, If you require hangar
tenants to carry insurance, does their insurance policy name the owner as an additional
insured?.
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HANGAR INFORMATION
Do You Require Tenants To
Sign A Hangar Agreement
Holding You Harmless For
Losses Not Caused By You?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Do you require
tenants to sign hangar agreement holding you harmless for losses not caused by you?.
HANGAR INFORMATION
Do You Require Tenants To
Sign A Hangar Agreement
Holding You Harmless For
Losses Not Caused By You?
No
Check the box (if applicable): Indicates a No response to the question, Do you require tenants
to sign hangar agreement holding you harmless for losses not caused by you?.
HANGAR INFORMATION
Are Any Aircraft Of Others
Taxied, Towed Or Moved By
The Applicant? Yes
Check the box (if applicable): Indicates a Yes response to the question, Are any aircraft of
others taxied, towed or moved by applicant?.
HANGAR INFORMATION
Are Any Aircraft Of Others
Taxied, Towed Or Moved By
The Applicant? No
Check the box (if applicable): Indicates a No response to the question, Are any aircraft of
others taxied, towed or moved by applicant?.
CONTRACTS AND
CONSTRUCTION
Has Applicant Entered Into
Any Agreements Assuming
Liability Of Others Such As
Lease Of Premises, Fuel
Supplier, Equipment
Leases, Etc.? Yes
Check the box (if applicable): Indicates a Yes response to the question, Has applicant entered
into any agreements assuming liability of others such as lease of premises, fuel supplier,
equipment leases, etc.?.
CONTRACTS AND
CONSTRUCTION
Has Applicant Entered Into
Any Agreements Assuming
Liability Of Others Such As
Lease Of Premises, Fuel
Supplier, Equipment
Leases, Etc.? No
Check the box (if applicable): Indicates a No response to the question, Has applicant entered
into any agreements assuming liability of others such as lease of premises, fuel supplier,
equipment leases, etc.?.
CONTRACTS AND
CONSTRUCTION
Does Applicant Use
Contracts For Hangaring
And Tie-Down Service, Etc.?
Yes
Check the box (if applicable): Indicates a Yes response to the question, Does applicant use
contracts for hangaring and tie down service, etc.?.
CONTRACTS AND
CONSTRUCTION
Does Applicant Use
Contracts For Hangaring
And Tie-Down Service, Etc.?
No
Check the box (if applicable): Indicates a No response to the question, Does applicant use
contracts for hangaring and tie down service, etc.?.
CONTRACTS AND
CONSTRUCTION
Estimated Cost Of
Construction For Runways
And Taxiways:
Enter amount: The estimated cost of construction for runways and taxiways.
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VEHICLES, ELEVATORS
AND AIRCRAFT
Fuel Trucks
Enter number: The number of fuel trucks.
VEHICLES, ELEVATORS
AND AIRCRAFT
Snow Removal
Enter number: The number of snow removal trucks.
VEHICLES, ELEVATORS
AND AIRCRAFT
Fire Engines
Enter number: The number of fire engines.
VEHICLES, ELEVATORS
AND AIRCRAFT
Tugs
Enter number: The number of tugs.
VEHICLES, ELEVATORS
AND AIRCRAFT
Mowers
Enter number: The number of mowers.
VEHICLES, ELEVATORS
AND AIRCRAFT
Pickup Trucks
Enter number: The number of pickup trucks.
VEHICLES, ELEVATORS
AND AIRCRAFT
Passenger Cars
Enter number: The number of passenger cars.
VEHICLES, ELEVATORS
AND AIRCRAFT
Sweepers
Enter number: The number of sweepers.
VEHICLES, ELEVATORS
AND AIRCRAFT
Elevators
Enter number: The number of elevators.
VEHICLES, ELEVATORS
AND AIRCRAFT
Escalators
Enter number: The number of escalators.
VEHICLES, ELEVATORS
AND AIRCRAFT
Moving Sidewalks
Enter number: The number of moving sidewalks.
VEHICLES, ELEVATORS
AND AIRCRAFT
Aircraft Owned and
Operated by Applicant
Enter number: The number of aircraft owned and operated by the applicant / insured.
VEHICLES, ELEVATORS
AND AIRCRAFT
Helicopters Owned and
Operated by Applicant
Enter number: The number of helicopters owned and operated by applicant / insured.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
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VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
ACORD 327 (2014/12) rev. 04-29-2014
Page 12 of 27
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
ACORD 327 (2014/12) rev. 04-29-2014
Page 13 of 27
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Other Description
Enter text: The description of the type of vehicle.
VEHICLES, ELEVATORS
AND AIRCRAFT
Number of
Enter number: The number of vehicles.
VEHICLES, ELEVATORS
AND AIRCRAFT
Are Any Vehicles Operated
Off Airport? Yes
Check the box (if applicable): Indicates a Yes response to the question, Are any vehicles
operated off airport?.
VEHICLES, ELEVATORS
AND AIRCRAFT
Are Any Vehicles Operated
Off Airport? No
Check the box (if applicable): Indicates a No response to the question, Are any vehicles
operated off airport?.
VEHICLES, ELEVATORS
AND AIRCRAFT
Explanation
Enter text: An explanation as to whether any vehicles are operated off airport.
ADDITIONAL INTERESTS
Interest - Additional Insured
Check the box (if applicable): Indicates the additional interest type is an additional insured.
ADDITIONAL INTERESTS
Interest - Loss Payee
Check the box (if applicable): Indicates the additional interest type is a loss payee.
ADDITIONAL INTERESTS
Interest - Mortgagee
Check the box (if applicable): Indicates the additional interest type is a mortgagee.
ACORD 327 (2014/12) rev. 04-29-2014
Page 14 of 27
ADDITIONAL INTERESTS
Interest - Lienholder
Check the box (if applicable): Indicates the additional interest type is a lien holder.
ADDITIONAL INTERESTS
Interest - Breach of
Warranty
Check the box (if applicable): Indicates the additional interest type is a breach of warranty.
ADDITIONAL INTERESTS
Interest - Leaseback Owner
Check the box (if applicable): Indicates the additional interest type is a leaseback owner.
ADDITIONAL INTERESTS
Interest - Co-Owner
Check the box (if applicable): Indicates the additional interest type is a co-owner.
ADDITIONAL INTERESTS
Interest - Other
Check the box (if applicable): Indicates the additional interest is other than those listed.
ADDITIONAL INTERESTS
Interest - Other Description
Enter text: The description of the other type of additional interest.
ADDITIONAL INTERESTS
Rank
Enter number: The ranking of 'this' additional interest when multiple additional interests are
associated with the same item.
ADDITIONAL INTERESTS
Lien Amount
Enter amount: The amount of the loan.
ADDITIONAL INTERESTS
Certificate Required
Check the box (if applicable): Indicates if the additional interest requires a Certificate of
Insurance.
ADDITIONAL INTERESTS
Name And Address
Enter text: The additional interest's full name.
ADDITIONAL INTERESTS
Enter text: The additional interest's mailing address line one.
ADDITIONAL INTERESTS
Enter text: The additional interest's mailing address line two.
ADDITIONAL INTERESTS
Enter text: The additional interest's mailing address city name.
ADDITIONAL INTERESTS
Enter code: The additional interest's mailing address state or province code.
ADDITIONAL INTERESTS
Enter code: The additional interest's mailing address postal code.
ADDITIONAL INTERESTS
Enter code: The additional interest's country code.
ADDITIONAL INTERESTS
Phone
Enter number: The primary phone number of the additional interest.
ADDITIONAL INTERESTS
Fax
Enter number: The primary fax number of the additional interest.
ADDITIONAL INTERESTS
E-Mail
Enter text: The primary e-mail address for the additional interest.
ADDITIONAL INTERESTS
Reference #
Enter identifier: The loan number, account number or other controlling number that the
additional interest may have assigned the insured.
ADDITIONAL INTERESTS
Interest In Item Location
Enter number: The producer assigned number of the location which has an additional interest.
ADDITIONAL INTERESTS
Interest In Item Building
Enter number: The producer assigned number of the building which has an additional interest.
ADDITIONAL INTERESTS
Interest In Item Airport
Enter identifier: The Federal Aviation Administration's designator for the airport (e.g. ORD -
O'Hare International Airport).
ADDITIONAL INTERESTS
Interest In Item Aircraft
Enter number: The producer assigned number of the aircraft which has an additional interest.
ACORD 327 (2014/12) rev. 04-29-2014
Page 15 of 27
ADDITIONAL INTERESTS
Scheduled Item Number
Enter number: The producer assigned number of the scheduled item which has an additional
interest.
ADDITIONAL INTERESTS
Other
Enter text: The description of the item which has an additional interest.
ADDITIONAL INTERESTS
Reason For Interest
Enter text: The description for the interest in the item.
ADDITIONAL INTERESTS
Interest End Date
Enter date: The date the interest holder's interest terminates.
Form Page 3
Section Name
Field Name
Description
IDENTIFICATION SECTION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g., agency or
brokerage).
COVERAGES
Premises Liability Option
Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Premises Liability Option
Description
Enter text: The description of the option being requested.
COVERAGES
Premises Liability Option
Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Premises Liability Option
Description
Enter text: The description of the option being requested.
COVERAGES
Premises Liability Option
Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Premises Liability Option
Description
Enter text: The description of the option being requested.
COVERAGES
Premises Liability BI Ea
Pers
Enter limit: The bodily injury each person limit amount for premises liability coverage.
COVERAGES
Premises Liability Ea Occ
Enter limit: The each occurrence limit amount for premises liability coverage.
COVERAGES
Premises Liability PD
Enter limit: The property damage limit amount for premises liability coverage.
COVERAGES
Premises Liability
Deductible
Enter deductible: The deductible amount for premises liability coverage.
COVERAGES
Premises Liability
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premises Liability Premium
Enter amount: The premium amount for premises liability coverage.
ACORD 327 (2014/12) rev. 04-29-2014
Page 16 of 27
COVERAGES
Premises Medical Payments
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Premises Medical Payments
Option Description
Enter text: The description of the option being requested.
COVERAGES
Premises Medical Payments
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Premises Medical Payments
Option Description
Enter text: The description of the option being requested.
COVERAGES
Premises Medical Payments
Ea Pers
Enter limit: The each person limit amount for premises medical payments coverage.
COVERAGES
Premises Medical Payments
Ea Occ
Enter limit: The each occurrence limit amount for premises medical payments coverage.
COVERAGES
Premises Medical Payments
Premium
Enter amount: The premium amount for premises medical payments coverage.
COVERAGES
Products Liability Sales of
Fuel & Oil
Check the box (if applicable): Indicates the sale of fuel and oil option applies to the products
liability coverage.
COVERAGES
Products Liability Extended
Check the box (if applicable): Indicates the extended option applies to the products liability
coverage.
COVERAGES
Products Liability Option
Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Products Liability Option
Description
Enter text: The description of the option being requested. Examples: Sale of Used Aircraft, Sale
of New Aircraft, Parts Installed, Parts Not Installed, Food and Beverage, Pilot Supplies.
COVERAGES
Products Liability BI Ea Pers
Enter limit: The bodily injury each person limit amount for products liability coverage.
COVERAGES
Products Liability Ea Occ
Enter limit: The each occurrence limit amount for products liability coverage.
COVERAGES
Products Liability Aggr
Enter limit: The aggregate limit amount for products liability coverage.
COVERAGES
Products Liability Premium
Enter amount: The premium amount for products liability coverage.
COVERAGES
Completed Operations
Liability Extended
Check the box (if applicable): Indicates the extended option applies to the completed operations
liability coverage.
COVERAGES
Completed Operations
Liability Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Completed Operations
Liability Option Description
Enter text: The description of the option being requested. Examples: Sale of Fuel and Oil, Parts
Not Installed, Sale of New Aircraft, Sale of Used Aircraft, Restaurant Liability, Repair and
Services.
ACORD 327 (2014/12) rev. 04-29-2014
Page 17 of 27
COVERAGES
Completed Operations
Liability Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Completed Operations
Liability Option Description
Enter text: The description of the option being requested. Examples: Sale of Fuel and Oil, Parts
Not Installed, Sale of New Aircraft, Sale of Used Aircraft, Restaurant Liability, Repair and
Services.
COVERAGES
Completed Operations
Liability BI Ea Pers
Enter limit: The bodily injury each person limit amount for completed operations liability
coverage.
COVERAGES
Completed Operations
Liability Ea Occ
Enter limit: The each occurrence limit amount for completed operations liability coverage.
COVERAGES
Completed Operations
Liability Aggr
Enter limit: The aggregate limit amount for completed operations liability coverage.
COVERAGES
Completed Operations
Liability Premium
Enter amount: The premium amount for completed operations liability coverage.
COVERAGES
Hangarkeepers Legal
Liability Including Taxi
Check the box (if applicable): Indicates the including taxi option applies to the coverage.
COVERAGES
Hangarkeepers Legal
Liability In Flight
Check the box (if applicable): Indicates the in flight option applies to the coverage.
COVERAGES
Hangarkeepers Legal
Liability Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Hangarkeepers Legal
Liability Option Description
Enter text: The description of the option being requested. Example: Ground Only.
COVERAGES
Hangarkeepers Legal
Liability Ea Aircraft
Enter limit: The each aircraft limit amount for hangarkeepers legal liability coverage.
COVERAGES
Hangarkeepers Legal
Liability Ea Occ
Enter limit: The each occurrence limit amount for hangarkeepers legal liability coverage.
COVERAGES
Hangarkeepers Legal
Liability Deductible
Enter deductible: The deductible amount for hangarkeepers legal liability coverage.
COVERAGES
Hangarkeepers Legal
Liability Deductible Applies
to
Enter code: The code identifying what the deductible applies to. Examples: Each and Every
Loss, Turbine Aircraft, Airline, Property Damage, Each Occurrence
COVERAGES
Hangarkeepers Legal
Liability Deductible
Enter deductible: The deductible amount for hangarkeepers legal liability coverage.
ACORD 327 (2014/12) rev. 04-29-2014
Page 18 of 27
COVERAGES
Hangarkeepers Legal
Liability Deductible Applies
to
Enter code: The code identifying what the deductible applies to. Examples: Each and Every
Loss, Turbine Aircraft, Airline, Property Damage, Each Occurrence
COVERAGES
Hangarkeepers Legal
Liability Premium
Enter amount: The premium amount for hangarkeepers legal liability coverage.
COVERAGES
Fire Legal Liability Option
Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Fire Legal Liability Option
Description
Enter text: The description of the option being requested.
COVERAGES
Fire Legal Liability Any One
Fire
Enter limit: The any one fire limit amount for fire legal liability coverage.
COVERAGES
Fire Legal Liability Premium
Enter amount: The premium amount for fire legal liability coverage.
COVERAGES
Personal Injury Liability
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Personal Injury Liability
Option Description
Enter text: The description of the option being requested.
COVERAGES
Personal Injury Liability
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Personal Injury Liability
Option Description
Enter text: The description of the option being requested.
COVERAGES
Personal Injury Liability Ea
Occ
Enter limit: The each occurrence limit amount for personal injury liability coverage.
COVERAGES
Personal Injury Liability
Aggr
Enter limit: The aggregate limit amount for personal injury liability coverage.
COVERAGES
Personal Injury Liability
Premium
Enter amount: The premium amount for personal injury liability coverage.
COVERAGES
Advertising Liability Option
Checkbox
Check the box (if applicable): Indicates there is an option on advertising liability coverage.
COVERAGES
Advertising Liability Option
Description
Enter text: The description of the option being requested.
COVERAGES
Advertising Liability Option
Checkbox
Check the box (if applicable): Indicates there is an option on advertising liability coverage.
COVERAGES
Advertising Liability Option
Description
Enter text: The description of the option being requested.
ACORD 327 (2014/12) rev. 04-29-2014
Page 19 of 27
COVERAGES
Advertising Liability Ea Occ
Enter limit: The each occurrence limit amount for advertising liability coverage.
COVERAGES
Advertising Liability Aggr
Enter limit: The aggregate limit amount for advertising liability coverage.
COVERAGES
Advertising Liability
Premium
Enter amount: The premium amount for advertising liability coverage.
COVERAGES
Contractual Liability
Included
Check the box (if applicable): Indicates contractual liability coverage is included in the policy.
COVERAGES
Contractual Liability
Excluded
Check the box (if applicable): Indicates contractual liability coverage is excluded from the policy.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
ACORD 327 (2014/12) rev. 04-29-2014
Page 20 of 27
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
ACORD 327 (2014/12) rev. 04-29-2014
Page 21 of 27
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
ACORD 327 (2014/12) rev. 04-29-2014
Page 22 of 27
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
ACORD 327 (2014/12) rev. 04-29-2014
Page 23 of 27
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
COVERAGES
Coverage Code
Enter code: The code for the coverage.
COVERAGES
Coverage Description
Enter text: The description of other coverage (not the limit) on the policy. Any questions about
appropriate limits or applicable policy coverage(s) should be answered by the issuing insurer(s)
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
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COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Option Checkbox
Check the box (if applicable): Indicates a coverage option applies to the coverage.
COVERAGES
Option Description
Enter text: The description of the option being requested.
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Limit
Enter limit: The limit amount for the coverage.
COVERAGES
Limit Applies to
Enter code: The code identifying what the limit applies to (i.e. per occurrence).
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Deductible
Enter deductible: The deductible amount for the coverage.
COVERAGES
Deductible Applies to
Enter code: The code identifying what the deductible applies to.
COVERAGES
Premium
Enter amount: The premium amount for the coverage.
GENERAL INFORMATION
Any aircraft other than
single engine or
multi-engine maintained,
serviced, or repaired by
applicant? Yes
Check the box (if applicable): Indicates a Yes response to the question, Any aircraft other
than single engine or multi-engine maintained, serviced or repaired by applicant?. As used
here, If yes, enter number and type(s) of other aircraft.
GENERAL INFORMATION
Any aircraft other than
single engine or
multi-engine maintained,
serviced, or repaired by
applicant? No
Check the box (if applicable): Indicates a No response to the question, Any aircraft other than
single engine or multi-engine maintained, serviced or repaired by applicant?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether any aircraft other than single engine or multi-engine
maintained, serviced or repaired by the applicant.
GENERAL INFORMATION
Are aircraft owners
permitted to perform any
repair service or inspection
of aircraft under
supervision? Yes
Check the box (if applicable): Indicates a Yes response to the question, Aircraft owners
permitted to perform any repair service of inspection of Aircraft under supervision?.
GENERAL INFORMATION
Are aircraft owners
permitted to perform any
repair service or inspection
of aircraft under
supervision? No
Check the box (if applicable): Indicates a No response to the question, Aircraft owners
permitted to perform any repair service of inspection of Aircraft under supervision?.
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GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether aircraft owners are permitted to perform any repair
service or inspection of aircraft under supervision.
GENERAL INFORMATION
Highest value of aircraft
maintained, serviced, or
repaired:
Enter amount: The highest value of aircraft maintained, serviced, or repaired.
GENERAL INFORMATION
Does the applicant perform
engine overhauls? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the applicant
perform engine overhauls?.
GENERAL INFORMATION
Does the applicant perform
engine overhauls? No
Check the box (if applicable): Indicates a No response to the question, Does the applicant
perform engine overhauls?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether the applicant performs engine overhauls.
GENERAL INFORMATION
Does the applicant perform
propeller overhauls? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the applicant
perform propeller overhauls?.
GENERAL INFORMATION
Does the applicant perform
propeller overhauls? No
Check the box (if applicable): Indicates a No response to the question, Does the applicant
perform propeller overhauls?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether the applicant performs propeller overhauls.
GENERAL INFORMATION
Does the applicant perform
major airframe structural
repairs? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the applicant
perform major airframe structural repairs?.
GENERAL INFORMATION
Does the applicant perform
major airframe structural
repairs? No
Check the box (if applicable): Indicates a No response to the question, Does the applicant
perform major airframe structural repairs?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether the applicant performs major airframe structural
repairs.
GENERAL INFORMATION
Does the applicant perform
aircraft painting? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the applicant
perform aircraft painting?.
GENERAL INFORMATION
Does the applicant perform
aircraft painting? No
Check the box (if applicable): Indicates a No response to the question, Does the applicant
perform aircraft painting?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether the applicant performs aircraft painting.
GENERAL INFORMATION
Does the applicant
participate in the National
Air Transportation
Association (NATA) Safety
First program? Yes
Check the box (if applicable): Indicates a Yes response to the question, Does the applicant
participate in the National Air Transportation Association (NATA) Safety First program?.
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GENERAL INFORMATION
Does the applicant
participate in the National
Air Transportation
Association (NATA) Safety
First program? No
Check the box (if applicable): Indicates a No response to the question, Does the applicant
participate in the National Air Transportation Association (NATA) Safety First program?.
GENERAL INFORMATION
Explanation
Enter text: An explanation as to whether the applicant participates in the National Air
Transportation Association (NATA) Safety First Program.
Form Page 4
Section Name
Field Name
Description
IDENTIFICATION SECTION
Agency Customer ID
Enter identifier: The customer's identification number assigned by the producer (e.g., agency or
brokerage).
SIGNATURE
Producer's Signature
Sign here: Accommodates the signature of the authorized representative (e.g., producer, agent,
broker, etc.) of the company(ies) listed on the document. This is required in most states.
SIGNATURE
Producer's Name (Please
Print)
Enter text: The name of the authorized representative of the producer, agency and/or broker
that signed the form.
SIGNATURE
State Producer License No
(Required in FL)
Enter identifier: The State License Number of the producer.
SIGNATURE
Applicant's Signature
Sign here: Accommodates the signature of the applicant or named insured.
SIGNATURE
Date
Enter date: The date the form was signed by the named insured. (MM/DD/YYYY)
SIGNATURE
National Producer Number
Enter identifier: The National Producer Number (NPN) as defined in the National Insurance
Producer Registry (NIPR). Note: The NPN is not the same as the producer state license
number.
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