Need a Quote for the Operation of a UAV or Drone?
Please Complete this Form and Someone will Contact You.

Sorry, we are unable to assist if the UAV is used only for pleasure. The insurance company will quote only if there is some business use.

Year Built
Make/Model/Include model number i.e. DJI Phantom 2 Vision Plus
Who manufactured the aircraft?

Aircraft Data
UAV/Drone #2 (if only 1 aircraft skip questions pertaining to additional aircraft by clicking here.)

Year Built
Make/Model/Include model number i.e. DJI Phantom 2 Vision Plus
***List additional UAVs to be quoted in the Comments section at the bottom of this survey. Be sure to give the year, make, and model.
Who manufactured the aircraft?

Business. I.e. Real Estate Aerial Photography. No charge to others. Commercial. A charge will be made to others for the operation of the aircraft. Pleasure. No business or commercial uses at all. Just pleasure flying.

In what states will the aircraft generally be operated?
Will the aircraft be operated in other countries? If yes, please list.

$500,000 Combined Single Limit of bodily and property damage $1,000,000 Combined Single Limit of bodily and property damage Other (please list):

During the last 3 years have you had any aviation accidents or FAR violations? If yes, please provide details.

Pilots/Operators
	Pilot 1	Pilot 2	Pilot 3
First Name
Last Name
Age
FAA Pilot Certificates, if any
Total hours piloting general aviation aircraft (not UAVs)
Total hours piloting UAVs
Total hours piloting this make and model aircraft
Any accidents in the last 3 years while piloting aircraft or UAVs? If yes, please provide details.	Yes No	Yes No	Yes No

Comments Please list the year, make, & model of any additional UAVs to be quoted as well as any questions or comments below: