Air Transportation Regulations

Insurance Covering Air Carrier Liability to Passengers and Public Liability

• 1 This is to certify that

(insurer)

(Name, address and participation percentages of insurer or insurers)

has/have issued the policies listed in this certificate covering risks of liability to passengers and public liability to

(air carrier)

(Name and address of air carrier)

effective from (day) (month) (year)

to (day) (month) (year).

• 2 The insurer has assumed, under the policies listed in this certificate, liability insurance covering risks of injury to or death of passengers and insurance covering risks of public liability in accordance with the requirements of section 7 of the Air Transportation Regulations.

• 3 The air carrier has been insured against the risks described in section 2 for each incident or accident related to the operation of a (a domestic, an international, or domestic and international) service in the following amounts:

  Type of Liability	Amount	Policy No.
  Passenger
  Public
  Single limit coverage

• 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; or

  • (b)  (domestic, international, or domestic and international) services operated by the air carrier with the following aircraft:

    Registration Marking		Type and Model

• 5 The Insurer undertakes to notify the Secretary of the Canadian Transportation Agency forthwith in 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 the failure by the air carrier to comply with section 7 of the Air Transportation Regulations; or

  • (c) the air carrier’s operations have been changed or are intended to be changed in a manner that results in the failure by the air carrier to comply with section 7 of the Air Transportation Regulations.

• 6 The insurer (check (a) or (b))

  • (a) is registered and/or licensed in Canada to issue aircraft insurance policies; or

  • (b) is licensed or approved by a foreign government to issue aircraft insurance policies.

    Date		On behalf of the insurer:
    		(Signature, name and title of authorized person or agent)

  FILING DIRECTIONS:

• (1) An original of this certificate and any notification made pursuant to section 5 are to be filed with the Secretary, Canadian Transportation Agency, Ottawa, Ontario, Canada K1A 0N9.

• (2) An air carrier may file a certificate that contains one or more of the three conditions and the table set out in the attachment hereto.

ATTACHMENT

NAME OF AIR CARRIER:

The Air Carrier has been insured against the risks described in section 2 under Policy no. , which is issued on one or more of the following conditions:

• (a) the aircraft are as described, and are insured for the amounts shown, in the table below;

• (b) the number of passengers carried does not exceed the number of passenger seats insured for each aircraft as shown in the table below; and

• (c) the aircraft will be used for the following purposes:

TABLE