LLOYD’S AIRCRAFT LIABILITY POLICY (U.S.A.

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WE, UNDERWRITERS AT LLOYD’S, London, agree with the Insured, named in the
Declarations made a part hereof, in consideration of the payment of the premium and in
reliance upon the statements in the Declarations and subject to the limits of liability,
Exclusions, Conditions and other Terms of this Policy.

INSURING AGREEMENTS
I COVERAGE A—BODILY INJURY LIABILITY (EXCLUDING PASSENGERS)
To pay on behalf of the Insured all sums which the Insured shall become legally
obligated to pay as damages, including damages for care and loss of services, because of
bodily injury, sickness or disease, including death at any time resulting therefrom, sustained
by any person, excluding any passenger, caused by an occurrence and arising out of the
ownership, maintenance or use of the Aircraft.

COVERAGE B—PROPERTY DAMAGE LIABILITY

To pay on behalf of the Insured all sums which the Insured shall become legally
obligated to pay as damages because of injury to or destruction of property, including the loss
of use thereof, caused by an occurrence and arising out of the ownership, maintenance or use
of the Aircraft.
COVERAGE C—PASSENGER BODILY INJURY LIABILITY
To pay on behalf of the Insured all sums which the Insured shall become legally
obligated to pay as damages, including damages for care and loss of services, because of
bodily injury, sickness or disease, including death at any time resulting therefrom, sustained
by any passenger, caused by an occurrence and arising out of the ownership, maintenance or
use of the Aircraft.
COVERAGE D—SINGLE LIMIT—BODILY INJURY (INCLUDING PASSENGERS)
AND PROPERTY DAMAGE LIABILITY
To pay on behalf of the Insured all sums which the Insured shall become legally
obligated to pay as damages, including damages for care and loss of services, because of
bodily injury, sickness or disease, including death at any time resulting therefrom, sustained
by any person, and for damages because of injury to or destruction of property, including loss
of use thereof, caused by an occurrence and arising out of the ownership, maintenance or use
of the Aircraft.
COVERAGE E—SINGLE LIMIT—BODILY INJURY (EXCLUDING PASSENGERS)
AND PROPERTY DAMAGE LIABILITY
To pay on behalf of the Insured all sums which the Insured shall become legally
obligated to pay as damages, including damages for care and loss of services, because of
bodily injury, sickness or disease, including death at any time resulting therefrom, sustained
by any person, excluding any passenger, and for damages because of injury to or destruction
of property, including loss of use thereof, caused by an occurrence and arising out of the
ownership, maintenance or use of the Aircraft.
COVERAGE F—MEDICAL PAYMENTS
To pay all reasonable expenses incurred within one year from the date of accident for
necessary medical, surgical, ambulance, hospital, professional nursing and funeral services, to
or for each person except the pilot or crew unless specifically stated as “included’’ in the
Declarations, who sustains bodily injury, sickness or disease, caused by accident, while in,
entering or alighting from the Aircraft if the Aircraft is being used by the Named Insured or
with his permission.

AVN 20 1.11.64

With respect to Insuring Agreements IV and V the insurance afforded by this coverage
shall be excess insurance over any other valid and collectible medical payments insurance
applicable thereto.

II DEFENSE, SETTLEMENT, SUPPLEMENTARY PAYMENTS

 Coverages A, B, C, D and E.
As respects such insurance as is afforded by the other terms of this Policy the
Underwriters shall:

(a) defend in the name of and on behalf of the Insured any suit or other
proceedings, even if groundless, false or fraudulent, brought against the
Insured alleging such injury, sickness, disease or destruction and seeking
damages on account thereof; but the Underwriters shall have the right to
make such investigation, negotiation and settlement of any claim or suit as
they deem expedient;

(b) pay all premiums on bonds to release attachments for an amount not in excess
of the applicable limit of liability of this Policy, all premiums on appeal
bonds required in any such defended suit, but without any obligation to apply
for or furnish any such bonds;

(c) pay all costs taxed against the Insured in any such suit or proceedings and all
interest accruing after entry of judgment until the Underwriters have paid,
tendered or deposited in court, such part of such judgment as does not exceed
the applicable limit of Underwriters’ liability as stated herein; provided that in
the event of the amount of such judgment exceeding the applicable limit of
Underwriters’ liability, the Underwriters shall only be liable to pay for that
proportion of the said costs and interest which the applicable limit of
Underwriters’ liability bears to the amount of such judgment;

(d) pay expenses incurred by the Insured for such immediate medical and
surgical relief to others as shall be imperative at the time of the accident;

(e) pay all expenses incurred by the Underwriters for investigation, adjustment
and defense, and reimburse the Insured for all reasonable expenses, other than
loss of earnings, incurred at the Underwriters’ request.

The amounts incurred under this Insuring Agreement, except settlements of claims and
suits, are payable by the Underwriters in addition to the applicable limit of liability of this
Policy.

III DEFINITION OF INSURED

The term Named Insured shall mean only the Insured specified in Declaration 1.

The unqualified term Insured wherever used in this Policy with respect to Coverages A,
B, C, D and E includes not only the Named Insured but also, within the scope of the
Declarations, any person while using the Aircraft on behalf of or with approval of the Named
Insured, or any person or organization legally responsible for its use, provided the actual use
is with the expressed permission of the Named Insured.

Notwithstanding the provisions of this Insuring Agreement the coverage provided by

this Policy for persons or organizations other than the Named Insured does not apply:—

(a) to any person or organization with respect to bodily injury, sickness, disease
or death of any person who is a Named Insured;
 (b) to any employee or official of an Insured with respect to any action brought
against said employee or official because of bodily injury, sickness, disease or death of
another employee of the same Insured injured in the course of such employment in an
occurrence arising out of the maintenance or use of the Aircraft in the business of such
Insured;

(c) to any person or organization, or to any agent or employee thereof (other than
agents or employees of the Named Insured) engaged in the manufacture of aircraft, aircraft
engines, or aircraft accessories, or operating an aircraft repair shop, airport, hangar, aircraft
sales agency, flying club or flying school, with respect to any occurrence arising out of such
manufacture or operation;

(d) to any person receiving instruction, either dual or solo, nor to any renter pilot,
unless such use is declared in (D) of Item 4 of the Declarations;

(e) to any person or organization with respect to any loss against which he has
other valid and collectible insurance.

IV TEMPORARY USE OF SUBSTITUTE AIRCRAFT

While an Aircraft owned by the Named Insured is withdrawn from normal use because
of its breakdown, repair, servicing, loss or destruction, such insurance as is afforded by this
Policy with respect to such Aircraft applies also with respect to another Aircraft of similar
type, horse-power, and seating capacity, not so owned while temporarily used as the
substitute for such Aircraft. This Insuring Agreement does not cover as an Insured the owner
of the substitute Aircraft or any agent or employee of such owner.

V AUTOMATIC INSURANCE OF NEWLY ACQUIRED AIRCRAFT

(1) If the Named Insured who is the owner of the Aircraft the uses of which are
declared under Item 4 of the Declarations acquires ownership of another Aircraft of similar
type, horse-power, and seating capacity, and so notifies the Underwriters within thirty days
following the date of its delivery to him, such insurance as is afforded by this Policy applies
also to such Aircraft as of such delivery date;

(a) if it replaces an Aircraft described in this Policy, but only to the extent the
insurance is applicable to the replaced Aircraft, or

(b) if it is an additional Aircraft and if the Underwriters insure all Aircraft owned
by the Named Insured at such delivery date, but only to the extent the insurance is applicable
to all such previously owned Aircraft. In no event, however, shall the Underwriters be liable
under this provision for more than the highest limit applicable for each person or accident as
stated in the Declarations of this Policy.

(2) This Insuring Agreement does not apply:

(a) to any loss against which the Named Insured has other valid and collectible
insurance, or

(b) except during the Policy period, but if such delivery date is prior to the
effective date of this Policy, the insurance applies as of such effective date.

The Named Insured shall pay the prescribed additional premium required because of the
application of the insurance to such other Aircraft.

The insurance terminates upon the replaced Aircraft on such delivery date.

VI POLICY PERIOD, TERRITORY, PURPOSES OF USE

This Policy applies only in respect of accidents or occurrences happening during the Policy
period while the Aircraft is within the Continental limits of the United States of America
(excluding Alaska), Canada, or the Republic of Mexico, and is owned, maintained and used
for the purposes stated as applicable thereto in the Declarations.

VII TWO OR MORE AIRCRAFT

When two or more Aircraft are insured hereunder the terms of this Policy shall apply
separately to each.

EXCLUSIONS

THIS POLICY DOES NOT APPLY:-

(1) To liability assumed by the Insured under any contract or agreement unless such
liability would have attached to the Insured even in the absence of such Agreement.

(2) While the Aircraft is in flight unless its Airworthiness Certificate is in full force
and effect.

(3) While the Aircraft is used for any unlawful purpose or is operated otherwise than
in compliance with the terms of its Airworthiness Certificate and the approved operating
limitations contained in its Airplane Flight Manual or other documents associated with the
Airworthiness Certificate or is being operated by any person other than the pilot(s) stated in
Item 5 of the Declarations (other than taxying by certificated pilots or licensed mechanics) or
is operated by any such person in violation of the terms and limitations of his Pilot’s
Certificate or Medical Certificate, as issued by the appropriate authority.

(4) If the total number of passengers carried in the Aircraft at the time of the
happening of any loss or damage exceeds the Declared Maximum stated in Item 3 of the
Declarations.

(5) While with the knowledge and consent of the Insured or of any executive officer
or partner if the Insured be a corporation or partnership the Aircraft is being operated in
violation of the Civil Air Regulations applying to acrobatic flying, instrument flying, repairs,
maintenance, inspection, alterations and night flying.

(6) While the Aircraft is used for any purpose other than as stated in the Declarations.

(7) While the Aircraft is being used for or in connection with any race, speed or
endurance test, any attempt at record breaking, acrobatic flying, crop dusting, spraying,
seeding, fertilisation, hunting, bird or fowl herding unless such use is declared in (D) of Item
4 of the Declarations; or any use in respect of which a waiver or special authority issued by
the Civil Aeronautics Authority or the appropriate Authority is required, whether granted or
not.

(8) To bodily injury to or sickness, disease or death of any employee of the Insured
arising out of and in the course of his employment, or to any obligation for which the Insured
or any company as his insurer may be held liable under any workmen’s compensation law.

(9) To injury to or destruction of property owned, rented, occupied or used by or in

the care, custody or control of the Insured or carried in or on the Aircraft.

(10) To loss or damage or any liability of the Insured directly or indirectly occasioned
by, happening through or in consequence of military, naval or usurped power whether in time
of peace or war and whether lawful or unlawful, war, invasion, civil war, revolution,
rebellion, insurrection or warlike operations, whether there be a declaration of war or not.

DEFINITIONS

‘‘IN FLIGHT’’. The Aircraft shall be deemed to be in flight from the time the Aircraft
moves forward in taking off or in attempting to take off for air transit, while in the air and
until the Aircraft comes to rest after landing or, the landing run having been safely completed,
power is applied for taxying. A rotorcraft shall be deemed to be in flight when the rotors are
in motion.
 ‘‘PASSENGER’’ shall mean any person while in, on or boarding the Aircraft for the
purpose of riding or flying therein or alighting from the Aircraft following flight or attempted
flight therein.

‘‘CIVIL AERONAUTICS AUTHORITY’’ shall mean the duly constituted Authority

of the government of the United States of America, or the Authority of the recognized
government of any other country in which this Policy may apply, having jurisdiction over
Civil Aviation.

‘‘OCCURRENCE’’ shall mean an accident, or a continued or repeated exposure to

conditions occurring during the Policy period, which results in injury during the Policy
period, provided the injury is accidentally caused. All damages arising out of such exposure
to substantially the same general conditions shall be deemed to arise out of one occurrence.

CONDITIONS

1. NOTICE OF ACCIDENT
When an accident or an occurrence takes place which is liable to result in a claim under
this Policy, written notice shall be given by or on behalf of the Insured to the Underwriters or
any of their representatives as soon as practicable. Such notice shall contain particulars
sufficient to identify the Insured and also reasonably obtainable information respecting the
time, place and circumstances of the accident or occurrence, the names and addresses of the
injured and of available witnesses.

2. NOTICE OF CLAIM OR SUIT—EXCEPT IN RESPECT TO COVERAGE F

If claim is made or suit is brought against the Insured the Insured shall immediately
forward to the Underwriters or any of their representatives every demand, notice, summons or
other process received by him or his representative.

3. MEDICAL REPORTS; PROOF AND PAYMENT OF CLAIM—IN RESPECT TO

COVERAGE F ONLY
As soon as practicable, the injured person or someone on his behalf shall give to the
Underwriters or any of their representatives written proof of claim, under oath if required, and
shall, after each request from the Underwriters, execute authorization to enable the
Underwriters to obtain medical reports and copies of records. The injured person shall submit
to physical examination by physicians selected by the Underwriters when and as often as the
Underwriters may reasonably require. The Underwriters may pay the injured person or any
person or organization on account of the services rendered and such payment shall reduce the
amount payable hereunder to or for such injured person for such injury. Such payment shall
not constitute admission of liability of the Insured or of the Underwriters under any other
Coverage hereunder.

4. ASSISTANCE AND CO-OPERATION OF THE INSURED EXCEPT IN RESPECT

OF COVERAGE F
The Insured shall co-operate with the Underwriters and, upon the Underwriters’
request, shall attend hearings and trials and shall assist in effecting settlements, securing and
giving evidence, obtaining the attendance of witnesses and in the conduct of suits. The
Insured shall not, except at his own cost, voluntarily make any payment assume any
obligation or incur any expense, other than for such immediate medical and surgical relief to
others as shall be imperative at the time of accident.

5. LIMITS OF LIABILITY
(a) The limit of liability stated in the Declarations for Coverages A and C as
applicable to ‘‘each person’’ is the limit of the Underwriters’ liability for
all damages arising out of bodily injury, sickness or disease, including
death at any time resulting therefrom, sustained by one person in any one
occurrence; the limit of such liability stated as applicable to ‘‘each
occurrence’’ is, subject to the above provision respecting each person, the
total limit of the Underwriters’ liability for all damages, arising out of
bodily injury, sickness, or disease, including death at any time resulting
therefrom, sustained by two or more persons in any one occurrence.
 (b) The limit of liability stated in the Declarations for Coverage B is the limit
of the Underwriters’ liability for all damages arising out of any one
occurrence.
(c) The limit of liability stated in the Declarations for Coverages D & E is the
limit of the Underwriters’ liability for all damages arising out of any one
occurrence.
(d) The limit of liability stated in the Declarations for Coverage F as
applicable to ‘‘each person’’ is the limit of the Underwriters’ liability for
all expenses incurred by or on behalf of each person who sustains bodily
injury, sickness or disease, including death resulting therefrom, in any one
accident; the limit of liability stated herein as applicable to ‘‘each
accident’’ is, subject to the above provision respecting each person, the
total limit of the Underwriters’ liability for all expenses incurred by or on
behalf of two or more persons who sustain bodily injury, sickness or
disease, including death resulting therefrom in any one accident.
Notwithstanding the inclusion herein of more than one Insured whether by
endorsement or otherwise, the total liability of the Underwriters under each Coverage in
respect of any or all Insureds shall not exceed the limit(s) stated in the Declarations.
6. FINANCIAL RESPONSIBILITY LAWS—COVERAGES A, B, C, D AND E
Such insurance as is afforded by this Policy under coverages A, B, C, D and E shall
comply with the provisions of any Financial Responsibility Law, or other Law applicable to
Aircraft with respect to financial responsibility or liability arising out of the ownership,
maintenance or use of Aircraft during the Policy period. However, the foregoing shall not
apply to any type of coverage not afforded by this Policy nor shall it apply to any amount or
amounts in excess of the limit or limits of liability provided in the Policy. The Insured agrees
to reimburse the Underwriters for any payment made by the Underwriters which the
Underwriters would not have been obligated to make under the terms of this Policy but for the
agreement contained in this paragraph.
7. OTHER INSURANCE
If the Insured has other insurance against a loss covered by this Policy, the
Underwriters shall not be liable under this Policy for a greater proportion of such loss than the
applicable limit of liability stated in the Declarations bears to the total applicable limit of
liability of all valid and collectible insurance against such loss; provided, however, the
insurance under Insuring Agreements IV and V shall be excess insurance over any other valid
and collectible insurance available to the Insured, either as an Insured under a Policy
applicable with respect to the Aircraft or otherwise against a loss covered under either or both
of said Insuring Agreements.
8. CHANGES
Notice to any agent or knowledge possessed by any agent or by any other person shall
not effect a waiver or a change in any part of this Policy or estop the Underwriters from
asserting any right under this Policy; nor shall any part of this Policy be waived or changed,
except by endorsement signed by the Underwriters and issued to form part of this Policy.

9. ASSIGNMENT
This Policy shall not be assigned in whole or in part except with the consent of the
Underwriters verified by endorsement signed by the Underwriters and issued to form part of
this Policy; if, however, the Named Insured shall die or be adjudged bankrupt or insolvent
within the Policy period, this Policy, unless cancelled, shall, if written notice be given to the
Underwriters within thirty days after the date of such death or adjudication, cover (a) the
Named Insured’s legal representative as the Named Insured and (b) under Coverages A, B, C,
D and E subject otherwise to the provisions of Insuring Agreement III, any person having
proper temporary custody of the Aircraft, as an Insured, and under Coverage F while the
Aircraft is used by such person, until the appointment and qualification of such legal
representative but in no event for a period of more than thirty days after the date of such death
or adjudication.

10. CANCELLATION
 This Policy may be cancelled by the Named Insured by surrender thereof or by mailing
to the Underwriters written notice stating when thereafter such cancellation shall be effective.
This Policy may be cancelled by the Underwriters by mailing to the Named Insured at the
address shown in this Policy written notice stating when not less than ten days thereafter such
cancellation shall be effective. The mailing of notice as aforesaid shall be sufficient proof of
notice and the effective date and hour of cancellation stated in the notice shall become the end
of the Policy period. Delivery of such written notice either by the Named Insured or by the
Underwriters shall be equivalent to mailing.

If the Named Insured cancels, earned premiums shall be computed in accordance with
the customary short rate table and procedure. If the Underwriters cancel, earned premiums
shall be computed pro rata. Premium adjustment may be made at the time cancellation is
effected and, if not then made, shall be made as soon as practicable after cancellation
becomes effective. The Underwriters’ check or the check of their representative mailed or
delivered as aforesaid shall be sufficient tender of any refund of premium due to the Named
Insured.

11. SERVICE OF SUIT

It is agreed that in the event of the failure of the Underwriters to pay any amount
claimed to be due hereunder, the Underwriters, at the request of the Named Insured, will
submit to the jurisdiction of any Court of competent jurisdiction within the United States and
will comply with all requirements necessary to give such Court jurisdiction and all matters
arising hereunder shall be determined in accordance with the law and practice of such Court.

It is further agreed that service of process in such suit may be made upon
, and
that in any suit instituted against any one of them upon this Policy, the Underwriters will
abide by the final decision of such Court or of any Appellate Court in the event of an appeal.

The above-named are authorised and directed to accept service of process on behalf of
the Underwriters in any such suit and/or upon the request of the Named Insured to give
written undertaking to the Named Insured that they will enter a general appearance upon the
Underwriters’ behalf in the event such a suit shall be instituted.

Further, pursuant to any statute of any state, territory or district of the United States
which makes provision therefor, the Underwriters hereby designate the Superintendent,
Commissioner or Director of Insurance or other officer specified for that purpose in the
statute or his successor or successors in office, as their true and lawful attorney upon whom
may be served any lawful process in any action, suit or proceeding instituted by or on behalf
of the Named Insured or any beneficiary hereunder arising out of this Policy and hereby
designate the above-named as the person to whom the said officer is authorised to mail such
process or a true copy thereof.

12. ACTION AGAINST UNDERWRITERS—COVERAGES A, B, C, D AND E

No action shall lie against the Underwriters unless, as a condition precedent thereto, the
Insured shall have fully complied with all of the terms of this Policy, nor until the amount of
the Insured’s obligation to pay shall have been finally determined either by judgment against
the Insured after actual trial or by written agreement of the Insured, the Claimant and the
Underwriters. Any person or organization or the legal representative thereof who has secured
such judgment or written agreement shall thereafter be entitled to recover under this Policy to
the extent of the insurance afforded by this Policy. Nothing contained in this Policy shall give
any person or organization any right to join the Underwriters as a co-defendant in any action
against the Insured to determine the Insured’s liability. Bankruptcy or insolvency of the
Insured or of the Insured’s estate shall not relieve the Underwriters of any of their obligations
hereunder.

13. ACTION AGAINST UNDERWRITERS IN RESPECT TO COVERAGE F

No action shall lie against the Underwriters unless as a condition precedent thereto,
there shall have been full compliance with all the terms of this Policy, nor until thirty days
after the required statements of claim have been filed with the Underwriters.

14. SCHEDULE OF STATEMENTS

 By acceptance of this Policy the Named Insured agrees that the statements in the
Declarations are his agreements and representations, that this Policy is issued in reliance upon
the truth of such representations and that this Policy embodies all agreements existing
between himself and the Underwriters relating to this insurance.

15. MISREPRESENTATION AND FRAUD

This Policy shall be void if the Named Insured has concealed or misrepresented any
material fact or circumstance whether under the Declarations or not concerning this insurance
or the subject thereof or in case of any fraud, attempted fraud or false swearing by the Insured
touching any matter relating to this insurance or the subject thereof, whether before or after a
loss.
 DECLARATIONS
ITEM 1
Name of Insured........................................................................................................................................
(hereinafter referred to as the Insured)

Address......................................................................................................................................................

...................................................................................................................................................................

Business or Occupation of the Insured is..................................................................................................

The Insured’s interest in the Aircraft is that of.........................................................................................

ITEM 2
The period of insurance hereunder begins on the.....................................................................................
and ends on the ………………………………………. (both at 12.01 a.m. Standard Time at
the Insured’s address as stated).

ITEM 3
The insurance afforded is only with respect to such and so many of the following coverages as
are indicated by specific premium charge or charges. The limit of Underwriters’ liability against
each such coverage shall be as stated herein, subject to all the terms of the Policy having
reference thereto.

COVERAGES (As described in the Insuring Agreements)

LIMITS OF LIABILITY PREMIUMS
A BODILY INJURY LIABILITY $ each person
(excluding passengers) $ each occurrence
B PROPERTY DAMAGE LIABILITY $ each occurrence
C PASSENGER BODILY INJURY $ each person
LIABILITY $ each occurrence
D SINGLE LIMIT BODILY INJURY
(including passengers) and PROPERTY
DAMAGE LIABILITY $ each occurrence
E SINGLE LIMIT BODILY INJURY
(excluding passengers) and
PROPERTY DAMAGE LIABILITY $ each occurrence
F MEDICAL PAYMENTS
* Including/Excluding Pilot $ each person
* Including/Excluding Crew $ each accident
* Delete as required
Total Premium
DESCRIPTION OF AIRCRAFT
Declared maximum
number of passengers
Identification Category. Year built, Make, Type * Engine H.P., (excluding crew) to be
Marks. Model Serial No. Make, Model. carried at any one
time.

* Landplane, seaplane, skiplane, amphibian or rotorcraft.

ITEM 4
 USE: The purposes for which the Aircraft will be used are (Indicate those required.)

(A) ‘‘BUSINESS AND PLEASURE’’

(B ) ‘‘INDUSTRIAL AID’’

(C) ‘‘LIMITED COMMERCIAL’’

(D) ‘‘COMMERCIAL’’, including special uses (See (D) below)

..............................................................................................................................................................................

..............................................................................................................................................................................

(A) ‘‘BUSINESS AND PLEASURE’’ shall mean personal, pleasure, family and business use,
excluding any operation for hire or reward, or for instruction.

(B) ‘‘INDUSTRIAL AID’’ shall mean all the uses stated in (A) also the transportation of
executives, employees, guests of the Insured, goods and merchandise, but excluding any
operation for hire or reward, or for instruction.

(C) ‘‘LIMITED COMMERCIAL’’ shall mean all the uses stated in (A) and (B) also the carriage of
passengers and freight for hire or reward, but excluding any form of instruction or rental to
others.

(D) ‘‘COMMERCIAL’’ shall mean the uses stated in (A), (B) and (C) also use for any other
purpose as specifically declared above.

ITEM 5
The Aircraft will be operated in flight only by the following pilot(s):

Name Certificate and Number Pilot and Aircraft Ratings

ITEM 6
No Insurer has ever cancelled or declined to issue or renew any Aircraft insurance to the Named
Insured, except as follows:

..............................................................................................................................................................................

AVN 20 1.11.64