March 21, 2019
Coming Soon!

Aviation Property Application

Conour Insurance, Inc. | 2075 Columbiana Road Suite 1 Birmingham, AL 35216

Phone: (205) 822-7020 | Toll Free: (855) 755-2013 | Fax: (855) 755-7713

General Information:
Please enter exact information
Name of Applicant:
Mailing Address
City
State:
Zip Code
Contact Phone
Contact Fax
Contact Email *
Applicant's Business or Occupation:
Submitted Date:
Effective Date:
Property Description & Coverage Schedule: (Must Be Completed)
  Location/Bldg.#1 Location/Bldg.#2 Location/Bldg.#3 Location/Bldg.#4
Building Value
Your Business Personal Property
Personal Property of Others
Extra Expense
EDP
Misc. Tools
Employee Tools
Mobile Equipment
Flood
Fuel Tanks
Misc. Coverage
Misc. Coverage
Misc. Coverage
Misc. Coverage
Misc. Coverage
Misc. Coverage
Area in Square Feet
Building Construction
Sprinklered: Yes or No
Year Built
Airport Information
Airport Name:
Identifier
Address
City
State
Zip Code

Alarm System: Yes  No
Airport Fenced: Yes  No
Fire Department on Airport: Yes  No
Tower: Yes  No
Tower Hours:
Repair, Service Work or Painting done in Hangar: Yes  No
If answer was yes to the above question, describe:
Occupany (Type of Contents kept in Building)
Does Coverage Include Fuel Tanks? Yes  No
The Fuel Tanks are: Above Ground  Underground
Name/Address of Mortgagee/Loss Payee/Additional Insured:
Prior Insurance (Last 3 Years)
Name of Company (1):
Policy Term:
Effective Date
Policy Number:
Premium:
Name of Company (2):
Policy Term
Effective Date
Policy Number
Premium
Name of Company (3):
Policy term 3
Effective Date
Policy Number
Policy Premium
Loss Detail:
Loss Detail:
Agent's Comment & Recommendations:
Agent's Comment & Recommendations:
* = Required Field