Certificate of Insurance
Certificate of Insurance
Certificate of Insurance
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<strong>Certificate</strong> <strong>of</strong> <strong>Insurance</strong>4. The policies listed in this certificate insure (fill in the appropriate service in either a. or b.):a. all aircraft operated by the air carrier in[domestic, international, or domestic and international]services; orb.[domestic, international, or domestic and international]services operated by the air carrier with the following aircraft:Registration MarkingType and Model5. The insurer undertakes to notify the Secretary <strong>of</strong> the Canadian Transportation Agency forthwithin writing when:a. the air carrier’s coverage has been cancelled or is intended to be cancelled;b. the air carrier’s coverage has been altered or is intended to be altered in a manner that results in thefailure by the air carrier to comply with section 7 <strong>of</strong> the Air Transportation Regulations; orc. the air carrier’s operations have been changed or are intended to be changed in a manner that resultsin the failure by the air carrier to comply with section 7 <strong>of</strong> the Air Transportation Regulations.6. The insurer (check one):is registered and/or licensed in Canada to issue aircraft insurance policies; oris licensed or approved by a foreign government to issue aircraft insurance policies.On behalf <strong>of</strong> the Insurer:[name <strong>of</strong> authorized person or agent][title][signature] [day] [month] [year]2 <strong>of</strong> 3 pages673/L4/12-1
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