Air Traffic Control Individual Airports

Transcription

1 Air Traffic Control Individual Airports Proposal Form ADNIC is a Public Joint Stock Company incorporated in the United Arab Emirates by Law No. (4) of 1972, and it is governed by the provisions of the UAE Federal Law No. (6) of 2007 Establishment of the Insurance Authority & Organization of its Operations, with Registration No. (1). Completing this form In order to apply for this insurance, please complete all parts of this proposal form and the annexures, if any. You must provide full, accurate, and true answers to all questions listed below. Material facts which you know or ought to know should be fully and accurately disclosed. Failure to do so may result in rejecting your claim and/or terminating the insurance policy from inception. If you are in any doubt about what you should disclose, please do not hesitate to contact us. A material fact is one that would influence our decision whether to offer you insurance or the terms which we offer. If the space provided is inadequate, please provide details using an additional information sheet, signed and dated. Your insurance does not commence when you sign the proposal. Your cover will only commence once we have reviewed the proposal form and confirmed cover in writing. Please keep a copy of this proposal form for your record along with any correspondence/ information provided to us and policies/endorsements that are issued to you subsequently. 1/5

2 1. General information a. Name of the proposer: b. Address of the proposer: c. Name and location of the airports served: 2. Description of operations a. Please provide full details of all activities undertaken, including all associated services provided such as the provision of aeronautical information and Notams: b. Is there a full view of the maneuvering area from the tower? Yes No c. Is there a full view of the marshalling area from the tower? Yes No d. What is the largest type of aircraft regularly at the airport? Yes No e. Is heating, ventilation and cooling provided in the tower? Yes No f. Is the tower sound proofed? Yes No g. Are approach control and aerodrome services provided? Yes No h. Is radar used for approach control? Yes No If so, indicate type and operational cover given: i. Is radar used for any other use at the airfield? Yes No j. Is any secondary surveillance radar in use? Yes No k. Who is responsible for maintenance of navigation aids/landing aids (VORs, NDBs, ILS, etc.)? l. Is closed circuit television used for any purpose? Yes No m. State radio facilities provided: n. State radio standby services provided: o. Are the radio/telephone transmissions recorded? Yes No p. What direct telephone circuits are provided? 2/5

3 2. Description of operations (continued) q. Is there Direction Finding (DF) equipment available? Yes No r. What is the area of responsibility at the airport? s. Does the airport have any responsibility for any other airports nearby or for overflying traffic? Yes No t. How many controllers are on duty at any one time? u. How many controllers are allocated to the airport? v. What are their qualifications? w. Please provide details of training procedures including: i) Where does training takes place and how long does it last? ii) What arrangements exist for refresher training? x. State normal watch keeping periods: y. Are military controllers in the tower for liaison purposes? Yes No If so, under whose authority are they placed? z. State which Air Traffic Control Centre is responsible for the airspace beyond your airport: aa. Please supply copies of Air Traffic Control Holding and Approach Procedure Charts. 3. Aircraft control analysis a. Details of any accidents or near misses in the last 5 years: b. Type of aircraft using the airspace/airports including an indication of percentage split between wide body and narrow body aircraft and military aircraft: 3/5

4 3. Aircraft control analysis (continued) c. The number of annual aircraft movements i.e. take-offs/landings and overflights under your control including a split between (if possible) wide body jets, narrow body jets and smaller general aviation aircraft, identifying military and civil movements: d. If responsible for overflying, what number of aircraft are controlled annually and what are the largest aircraft controlled? e. Estimated receipts for flight charges for last 3 years: f. Any contractual agreements with third parties: 4/5

5 Declaration I/We hereby declare that the statements/information given by me/us in the Proposal Form are full, accurate and true. It is hereby understood and agreed that the statements, answers and particulars provided in this Proposal Form and as per the attachments are the basis on which the insurance policy is being issued/effected. If after the insurance policy is effected, it is found that any fact in the statements, answers or particulars in this Proposal Form is incorrect, untrue, inaccurate, misrepresented or non-disclosed in any material respect, ADNIC shall have no liability under the insurance policy and/or shall have the right to terminate the insurance policy from inception. Name of Proposer: Title: Signature: Stamp: Date: Note: Please note that each page of the proposal form should be signed by the Proposer or its legal representative 5/5