Site A-1/T-Hangar CondoTHIS CERTIFICATE ISSUED TO:
Kalispell City Airport
PO Box 1997
Kalispell, MT 59903
El (if checked) Certificate Holder listed as Additional Insured
AIRCRAFT LIABILITY AND PHYSICAL DAMAGE COVERAGE
Insurance Company Providing Coverage:
Policy Number:
Effective
INSURED'S NAME AND ADDRESS:
S27 T- Hangers Condominium Association
2216 Missoula Ave.
Missoula, MT 59802
Expires
NO.
AIRCRAFT COVERED
AMOUNT OF Hu I.I-
INSURANCE
TYPE OF COVERAGE
(Grounder Flight, Fxcl Flight, or NIM only)
DEDUCTIBLE S
NIM
IN MOTION
2.
3.
4.
LIMITS OF LIABILITY
Each Person Each Occurrence
A. Bodily Injury — Excluding Pas sen ers XXXXXXXXXX
B. Property Damage XXXXXXXXXX
C. Passenger Liability XXXXXXXXXX
D. Single Limit Bodily Iniury cluding Passengers & Prouerty Damage
AIRPORT LIABILITY
Insurance Company Providing Coverage: The Employer's Eire Insurance company
Policy Number: 710-03-07-14-000.1 Effective 04/03/2012 Expires 04/03/2013
LIMITS OF LIABILITY
Per Aircraft
Per Occurrence
A. Premises Liability
XXXXXXXXXX
1,000,000
B. Personal & Advertising Injury
XXXXXXXXXX
C. Products/Completed Operations
XXXXXXXXXX
D. Medical Expense ense
XXXXXXXXXX
E. Hanag Lr ers LiabilitI Deductible
REMARKS/ADDITIONAL PROVISIONS
Certificate holder included as additional insured but only as respects operations of the named
Location Covered:
A-1 Ryan Ln.
Kalispell, MT 59901
Absence of any entry indicates not applicable to this certificate. All coverages effective/expire 12:01 AM Standard Time at the insured's address
This is to certify that the Policy/Policies of Insurance as described herein have been insured by the company/companies listed and are in force as of the
date of this certificate. In the event o f cancellation of the policy/policies, the company/companies will endeavor to give the party to whom this certificate
is issued 30 days advance written notice of such cancellation but will not be liable in any way for failure to give such notice. In the event of cancellation
for non-payment of premium, the company/companies will endeavor to give the party to whom this certificate is issued 10 days advance written notice of
such cancella km but will not 'able in any way for failure to give such notice.
�p
# April 9, 2012
—IsInature of Authorize epresentative Date
Mountain Air Insurance Services, Inc.
P 0 Box 1918 m Hamilton, MT 59840 m Phone 406-363-1411 m Fax 406-363-1412
This endorsement modifies insurance provided under the following:
� f
Designation of Premises (Part Leased to You):
Location Building
1 1
Name of Person or Organization:
KALISPELL CITY AIRPORT
PO BOX 1997
KALISPELL, MT 59903-1997
(if no entry appears above, the information required to complete this endorsement will be shown in the.
Declarations as applicable to this endorsement.)
WHO IS AN INSURED (Section 11) is amended to
include as an insured the person or organization
shown in the Schedule but only with respect to li-
ability arising out of the ownership, maintenance or
use of that part of the land leased to you and shown
in the Schedule and subject to the following addi-
tional exclusions:
This insurance does not apply to:
1. Any "occurrence" which takes place after
you cease to lease that land;
2. Structural alterations, new construction or
demolition operations performed by or on be-
half of the person or organization shown in
the Schedule.
CG 20 24 11 85 Copyright, Insurance Services Office, Inc., 1984
INSURED
THIS CERTIFICA I E ISSUED TO.
Kalispell City Airport
PO Box 1997
Kalispell, MT 59903
❑x (if chccked) Certificate Holder listed as Additional Ensured
AIRCRAFT LIABILITY AND PHYSICAL DAMAGE COVERAGE
Insurance Company Providing Coverage:
Policy Number:
Effective
INSURED S NAME AND ADDRESS:
S27 T Hangers Condominium Association
2216 Missoula Ave.
Missoula, MT 59802
Expires
No.
AIRCRAFT COVERED
AMOUNT OF HULL
INStIR4NCE
TYPE OF COVERAGE
(Ground&Flight, Fxcl Flight, or NIM only)
DEDUCTIBLES
NIM
IN MOTION
2.
4.
LIMITS OF LIABILITY
Each Person Each Occurrence
A. Bodily Injury — Excluding Passengers _ XXXXXXXXXX
B. Property Damage XXXXXXXXXX _
C. Passcnaer Liability XXXXXXXXXX
D. Single Limit Bodilv Iniury I I eluding Passengers & Property Damage
AIRPORT LIABILITY
Insurance Company Providing Coverage: The Employer's Fire Insurance company
Policy Number: 710-03-07-14-0000 Effective 04/03/2011 Expires 04/03/2012
LIMITS OF LIABILITY
Per Aircraft
Per Occurrence
A. Premises Liability_ _
XXXXXXXXXX
1,000,000
B. Personal & Advertising Injury
XXXXXXXXXX
C. Products/CompletcdOperations
--
XXXXXXXXXX
� --
" ii. vlc:iicai False _
' XXXXXXXXXX
E. Hanagerkeepers Liability Deductible
REMARKS/ADDITIONAL PROVISIONS
Certificate holder included as additional insured but only as respects operations of the named insured.
Location Covered:
A-1 Rvan Ln.
Kalis yell, MT 59901
Absence of any entry indicates not applicable to this certificate. All coverages effective/expire 12:01 AM Standard Time at the insured's address
This is to certify that the Policy/Policies of Insurance as described herein have been insured by the company%companies listed and are in force as of the
date of this certificate. In the event o f cancellation of the policy/policies, the company/companies will endeavor to give the party to whom this certificate
is issued 30 days advance written notice of such cancellation but will not be liable in any way for failure to give such notice. In the event of cancellation
for non-payment of premium, the company/companies will endeavor to give the party to whom this certificate is issued 10 days advance written notice of
such cant anon (gut will no - liable in any way for failure to give such notice.
x September 15, 2011
Signature of Authorized Rep ative Date
Mountain Air Insurance Services, Inc.
P 0 Box 1918 is Hamilton, MT 59840 m Phone 406-363-1411. m Fax 406-363-1412