Okaloosa County BOCC — January 21, 2014 — Timberview Helicopters Lease_Minimum Standards_Certificate of Insurance_Internal Coordination Sheet — reading text

self-contained, front instrument panel- mounted navigation and communication devices that employ tray- mounted connectors that connect the unit when the unit is installed into the instrument panel, (excluding automatic flight control systems, transponders, and microwave frequency distance measuring equipment (DME)). The approved unit must be designed to be readily and repeatedly removed and replaced, and pertinent instructions must be provided. Prior to the unit’s intended use, and operational check must be performed in accordance with the applicable sections of part 91 of NFPA 409. Updating self-contained, front instrument panel-mounted Air Traffic Control (ATC) navigational software data bases (excluding those of automatic flight control systems, transponders, and microwave frequency distance measuring equipment (DME)) provided no disassembly of the unit is required and pertinent instructions are provided. Prior to the unit’s intended use, and operational check must be performed in accordance with applicable sections of part 91 of this chapter. 3. Owners of aircraft and/or their employees who do not have a hangar lease with Okaloosa County are permitted to perform these maintenance activities on the paved apron, provided however, the Airports Director determines that the area is safe and will not interfere with airport operations. The type of maintenance activity and duration will determine the location after review with the aircraft owner. 4, No personal refueling of aircraft is permitted. 5. Any maintenance or fueling operations performed by persons other than owners and/or their employees are considered to be performing a commercial operation and requires a fully executed lease agreement with the Board of County Commissioners. The term “EMPLOYEE” shall be defined as an individual who is on the payroll of the aircraft owner and is receiving compensation on a regular basis with federal income tax and social security taxes being deducted from his/her salary. Services provided by ‘contract are considered to be a commercial activity and requires a fully executed agreement between the Board of County Commissioners and the Contractor. 8/28/2013 uly authorized personnel, passengers lly conducted by the airport attendants taxi space or aprons. However, this unrestricted use of the aces in connection 6. No person or persons, except airmen, d going to or from aircraft, or persons being persona shall be permitted to enter the landing area proper, does not give any person or persons so accepted the privilege of Airport. The privileges are confined to the necessary use of these sp with the flights, inspections and routine duties. 7. Airport Operating Restrictions: a) All banner towing by fixed, rotary or any other type of aircraft, to include pick-up and drop-off is prohibited at the Destin/Ft. Walton Beach Airport (DTS). b) As DTS and CEW do not have designated heliports, all rotary wing aircraft are required to operate in compliance with non-air traffic control tower procedures. Sunil Harman, A.A.E., IAP Airports Director 8/28/2013 ACORLY CERTIFICATE OF AIRCRAFT INSURANCE SATS RAPA yy 04/10/2014 Wenner” . (THS CERTIFICATE EB BSUED ASA MATTER OF INFORMATION ORLY AND GORFERS NO RIGHTS” URON THE CERTIFICATE HOLDER THS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER IMPORTANT: if tha certificate folderis an ADDITONAL INSURED, the pollcy(lea) must he endorsed, FSUBROGATION [5 WAIVED, sub]nct to the terms and conditions ofthe policy, cartain poles may require an endorsement. A etafamant on this certificate does not confer rights to the certificate holder In leu of such enctorsament(s), PRODUCER BO, BOX 458 AIR CAPITAL INSURANCE, LL.0 WICHITA, KS 87201 CONTACT NAME; FAX (AG Nol FONE nfl, Hoe Far EMAIL ADORGES: 7 . PRODUCER QUSIAER ON TMBERVIEW HELICOPTERS, INC. INSURER (8) AFFORDING COVERAGE % NA: No, 2142 N. SQORD. NEURER A:U.S. SPECIALTY INSURANCE COMPANY 400% WELLSVILLE, KS 66092 MAREE 8: NEURER 0: NEURER OD: NGURER Ey REURER OF: THIS TS TG CERTIEY THAT THE POLICIES OOF TNEURARICE TIS TELY ETC FAVE TERA RSE! Ty THE INSURED NAMED ABOVE FOR INE POCICY PERTIG INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN iS SUBJECT TO ALL THE TERMS, EXCLUSIONS ANO CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. REVISION NUM BER: POLICY INFORMATION CERTIFICATE NUMBER: ICY TE Ne GENERE SOI OUST RAT PERSURE € [* EGMMERCTA AIRBTANE KT HERO ER MIRED FLEE I EXCESS QUOTA aD BUS | | SHARE Po") NON-OWNED [7 ro RABY PR ULL UAB ALITY HULL ONLY ONLY AIRCRAFT INFORMATION =| | ACORD 333, Aircraft Schedule attached TER RE NRK ERI RUE REGSTRATION” ROMER 2004 ROBINSON Ra4 fi N7512N THT ORY. AIRCRAFT COVERAGES REPRE TEER ROT NER TEPEC TE TATE EXIRATON CATE ADOMIORAL KROES? WT) [SUBROGATION WAVER (TN) RW00181830-00 01/0142014 01/01/2015 Y N COMRAGE OPTIONS UMIT APPLIES 10 UuMIT APPUES TO x [AI Risk Ground and 5 300,000 $ 4,060 |Ded.- Notin motion ARORART HULL pond Fight AGREED VALUE $ 30,000 | Bed. - in motion Including Passengers ¥ 4,000,000 [RA OGC $ EA PER AIRCRAFT LIABILITY bans — g 100,000 | rapasa $ AGGR ROTDING CREW AROIGAL PAYMENTS eee oA PE EA O00 EDN, PELUDING CREW $ 5,000 | eA PER $ 20,000 [EA COVERAGE CODE DESCRIPTION OPTIONS imi APPLIES TO LIMIT APPLIES TO - 3 i] 5 3 5 } ty 5 > $ iS DESCRIPTION OF OPERATIONS / REMARKS (Aftach ACORD 104, Additional Remarks Schedule, ff more s pace Is re quired) Certiisate halter ig included aa an Additional tisured. CERTIFICATE HOLDER ORALOOST COUNTY 602-6 NORTH PEARL CRESTVIEW, FL 32836 TOUTE ATT OR THE AT OVE GESERIBEL POLICIES BET AN CELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED (N MC CORDANCE WITH THE POLICY PROVISIONS. Fron ELLATION AUTHORIZED REE ESENT ATIVE Merah me me, hemching see 5. ed ere >) Canaan itt mn teaan 4 ACORD 21 (200917) 2009 ACORO CORPORATION. All rights reserved, The ACORD name and logo are registered marks of ACORD was) ee ACCORD CERTIFICATE OF AIRCRAFT INSURANCE ov HAE PEON AY 10/2014 “THS CERTIFICATE i BSUED ASA MATTER GF RFORMATION ONLY AND CONFERS NO RGHTS” TRON THE CERTIFICATE HOLDER. “TH CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUNG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. certificate holdar in lleu of such endorsament(s), IMPORTANT: If the certificate holder is an ADOMIONAL INSURED, the pollcy(ies)m tat be endorsed. f SUBROGATION [8 WAIVED, au hjectto the tarms and conditions of the poly, certain polkks may requke an endorsament. A statament on this certificate doas not confer rights fo the FROCLCER AIR CARITAL INSURANCE, LLC. PHONE FAX P.O, BOX 458 ING, fle Ba (NC, Mok WICHITA, KS 67201 EoMAIL ADDRES: PRODUCER CUSTOMER 01 No RSORED x 3 COVERAGE fy NAIC No, TIMBERVIEW HELICOPTERS, INC. INSURER(8) AFFORD ING COVERAGE Bi AIC No, 2142 N. 300RD. NORE A: U.S, SPECIALTY INSURANCE COMPANY 10% WELLSVILLE, KS 68092 NSURER_B: PRURER C. NGLRER D: _NORER E: TES TET CERTIET TAT THE POLICIES CF INSTITANCE LTS TEL BELOW HAVE BREN TSSUIELY TO TTS TUE NAMEL) RECITES EDIT THis POLICY PERTH INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPEGT TO WHIOH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANGE AFFORDED BY THE POLICIES DESCRISED HEREIN [S SUBJECT TO ALL THE TERMS , EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POUCY FORMATION CERTIRCATE NUMBER: REVISION NUM BER: RUICY WE TREO NESS GREAT NBUSTRAT. BEAST & PC GERE TAI AIRBTANE XT RACOPTER RIXED FLEET ERCESS GUOTA AID BUS ; SHARE mT NON-OWwNEO [7 —_ errr" LIABILITY = PX] HY Waeility "HULL ONLY ONLY AIRCRAFT INFORMATION | | ACORD 333, Alrcraft Schedule attached VaR WRE REEL SERA NMG PEPSTATIN HOMER 2004. ROBINSON R44 Il N7371T TERRITORY - AIRCRAFT COVERAGES REE TEER POC AMER FRRESTIVE TATE BARATION TRIE ATATIONAL NOUREG TY THY BUGRUOGATION WANVEDT TYTRY RW00181830-00 01/01/2014 01/01/2045 Y N COMRAGE OPTIONS LIMIT APPLIES TO UMiT APPLIES TO x [AIRisk Ground and g 360,000 $ 7,000” VBed? Not in motion ARCRAFT HULL formed Flight anosnd AGREED VALUE $ 30,000 Dad,» inmotion x Inaluding Passangere $ 1,000,000 | BA OGC $ BA PEK AIRGRABT LABILITY Lend 1 g 100,000 | gapags $ AGOR X TRONS” CRE EDICAL FYYMENTS arn A PES 20,000 Jes one MEDICAL CLUDING CREW $ 5,000 | BAPER $ COVERAGE COLE DESCRIPTION OPTIONS LIMIT APPLIES TO uM APRS TO b ) i 2 a ™ § h 34 a3 fran 3 ; DESCRIPTION OF OPERATIONS / REMARKS (Attach ACORD 104, Additional Ramarks Schedule, If more s pace Is re quirad) Cartticale Palderis ineluded aa an Add tonal rieurad. CERTIFICATE HOLDER ANGELL ATION OSACTUGA COUNTY 802-6 NORTH PEARL CRESTVIEW, FL 32686 STOULT ANY GE TTE ADOVE DESC RITE POLICIES BE CANCELLED BEFORE THE MXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN IWOCORDANCE WITH THE POLICY PROVISIONS, POTION RS HATESEATATIVE ti, ue sam eee ee ACORD 21 (200912) @ MH) ACORD CORPORATION, All rights reserved. The ACORD name and logo are registered marks of ACORD PTE TOA a ACORIY CERTIFICATE OF AIRCRAFT INSURANCE onroraot be awn THS CERTIFICATES ISSUED ASA MATIER OF INFORMATION CALY AND CONFERS NO HGHTS OPON THE CERTIFICATE HOLDER TH CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND ORALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE SUNG INSURER(S), AUTHORZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: Ifthe certificate hofderis a ADDITIONAL INSURED, tha poftey(ies) must bo andordart. FSUSROGATION 18 WAIVED, subject te the tarms and conditions ofthe polby, curtain pofcks may require an endorsement, A statomant on this certificate does not confer rights to the certlficate holderin Hau of such endorsements). COTINT FRODUCER NAME: AIR CAFITAL INSURANGE, LLC. FHIONE FAK P.O, BOX 458 (A, No. BM (NC, Nok: WICHITA, KS 67201 E-MAIL, ADDREBS: . PROOQUCER CUSTOMER D No RUFEG RDING COVERAGE % NAIC N TIMBERVIEW HELICOPTERS, INC. INSURER(8) AFFORDING COVERAGE a 2142 N, 300RD. NEURER A:U,S, SPECIALTY INSURANCE COMPANY 100% WELLSVILLE, KS 66092 NSURFR BE NOURER OC. NOIRER D: NEURER E: NSURER_ Fs THIS TS 1S CERTIFY THAT THE POLIGIES OF INSURANCE LISTED BELUW HAVE SEEN ISSUED IO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TQ WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUGH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, POLICY INFORMATION CERTIPCATE NOWBEFS: REVISION NUMBER: FOURY TW TRE OF RRINESS” RODE BT ET RAT ERIE S XP CCMMEREIAT RRBCANE XT PE COPTER MiXeh FLEET EXCESS ROT AD BUS | | SHARE —"T NON-OWNED —_ PP LARLY PC) HULL WABILITY, "HULL ONLY ONLY AIRCRAFT INFORMATION | | ACORD 333, Aircraft Schedule attached BAR WIE RCE SERV RONEER REGS TRATION” ROMER 2010 ROBINSON R44 N2117T8 TRE ORY AIRCRAFT COVERAGES WELREWC TENTS POLICY" ROREER ERECTED TAYE DUIRATION TATE GTN HIRED TY PSUR CREAT IT WAIVED TY TR RVW001 81830-00 01/01/2014 01/01/2015 Y N COMERAGE : OPTIONS LIMIT PAPPLES TO UMIT APPLIES TO X PAU Risk Ground ard § 400,000 $ 7,000 | Pau. Notin motion ARCRAFT HULL jon FiQht pea AGREED VALUE . 4 $ 80,000 | Pad. - In motion x | Including Passengers Ra 4,000,000 | FA Qce $ EA PER