Business Name*

Email*

Phone

Name*

First Last

Desired Insurance Term*

Monthly
Quarterly
Annually

How long do you want coverage?

Description of Operations (type of drone work)*

Do you own, rent, or lease the equipment?*

OWN
RENT/LEASE

When would you like coverage to start?*

What is the make and model of the unit to be insured?*

Will the unit weigh less than 55 lbs (25kg)?*

YES
NO

What is the replacement value of the unit?

If you do not know, please leave blank.

How long will you be renting the equipment?*

Please make sure the time period matches up with the date of pick up and drop off. if not renting put N/A

Where will the payload equipment be stored when not in use?*

Does the location have a central alarm, security, padlocks, etc.?

Does this location have a central station (monitored) alarm that can dispatch the police and/or fire station?*

YES
NO

Average Number of flights per week?*

How many years of Commercial Operator experience do you have?

Will you always be operated in accordance with applicable (including FAA) regulations?*

YES
NO

Do you currently hold a FAA Remote Pilot Certificate?*

YES
NO

Do you currently hold a Manufacturer’s training certificate for use of equipment while being affixed to the drone?*

YES
NO

Will you ever fly within or above 100 feet of any structure?*

YES
NO

Will the payload and cargo always be flown below 400 feet above ground?*

YES
NO

Will the unit ever be flown over any body of water?*

YES
NO

Will they ever be in a controlled airspace such as an Airport?*

YES
NO

Will the unit ever be flown in adverse weather?*

YES
NO

Will the unit ever be flown in adverse weather?*

YES
NO

Have you had any claims or losses in the last 5 years?*

YES
NO

Are parachutes being used on all drones?*

YES
NO

Are you interested in other lines of insurance?

Our team of specialists can help with coverage such as General Liability, Aviation Liability, Workers Compensation, Errors & Omissions, Commercial Auto, and more.,

CTA-Drone Lidar Insurance Application

ANNUAL INSURANCE – RENTED, LEASED AND OWNED LIDAR

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