Quote No: Q752423 Page 1 

### Parsippany, NJ Quote No: Quote Date: Q752423 June 26, 2015
Quotation is valid for 30 days.



### Applicant: 

## VIZTOOLS **LLC**

396 WASHINGTON STREET SUITE 260 WELLESLEY, MA 02481

-6209 **Broker Name:**  

## AV**IA TION**  **MA RKETS**  **Contact Name:**  

## LORRETTA **STEFFETER**

307 N. MICHIGAN AVENUE SUITE 302 CHICAGO, IL 60601 Coverage Dates: From: June 26, 2015 To: June 26, 2016 

## This insurance shall commence and cease on the dates shown at 12:01 A.M. local time at the address of the Applicant **Insurance Quote**  

# Aviation Insurance Policy **Unmanned A ircraft Sy** **stems (UA S Policy**  **Form)** Insurance applies to the insured's declared use of aircraft described in the attached schedule. See the policy form and any accompanying endorsementsfor complete coverage details. The attached schedule also contains the rated exposures and premiums for each aircraft.
**PLEA SE NOTE:**  The following separate licensed insurers, whose liability is several and not joint, provide the insurance afforded by policies issuedthrough Global Aerospace, Inc. American Alternative Insurance Corporation Wilmington, Delaware American Commerce Insurance Company Columbus, Ohio Central States Indemnity Company of Omaha Omaha, Nebraska Mitsui Sumitomo Insurance Company ofAmerica New Y ork, New Y

ork T okio Marine America Insurance Company New Y ork, New Y

ork 44.96%

10.00%

23.39%

9.28%

12.37%Quote No: Q752423 Page 2 

## Coverage(s) and **Limit(s):**
**Part 1 -**  **Liability Coverage A**  **- Bodily Injury and Property Damage**  **Liability** 

### 1. Each **Occurrence** Limit: **See attached schedule for individual aircraft limits**  

### 2. Each **occurrence** sub

-limit and deductible applicable to damaged property: Damage to **Cargo** Limit: **NIL Cargo**  Deductible: **NIL** The sub

-limit described above is part of and not in addition to the Each **Occurrence** Limit. 

### 3. Supplementary payment limits for emergencies and search and rescue operations related to **scheduled aircraft** : (a) **NIL** is the most we will pay for expenses incurred under an emergency condition for: (1) Application of foam on a runway; (2) Fire and crash contro and rescue; or (b) The lesser of **NIL** or the **insured value** of the **scheduled aircraft** is the most we will pay for repositioning expenses incurred following a landing made under emergency conditions at a location where a safe takeoff cannot be made. (c) **NIL** is the most we will pay for expenses incurred for search and rescue operations. **Part 2 -**  **Physical Damage**  **Coverage B -**  **Physical Damage to Scheduled Ai** **rcraft** (a) Subject to Paragraph (b) below, the limit of insurance for a **scheduled aircraft** is its **insured value**, lessany applicable deductible. (b) The **insured value** of any **newly acquired aircraft** or any **scheduled aircraft** modified during the policy period is subject to the Maximum **Insured Value**  Limit: **See attached schedule for Highest Hull value of aircr** **aft** 

## Endorsements: A125 Amendment of Defined Terms C025 Electronic Date Recognition Exclusion Limited Coverage C064 Premises Coverage $1,000,000 Sub Limit 

### S023 Massachusetts Amendatory 

## Pay**ment Plan:**  100% of the Annual Premium Due on Inception 

## Ap**proved Pilots for Scheduled Ai** **rcraft:** The policy shall not apply while an **aircraft** is in **flight** unless the **pilot in command** is Roland J. Boucher Jr. :



## Underw**riter's Remarks:**  All other terms, conditions and exclusions per the Global Aerospace UAS policyform.Quote No: Q752423 Page 3



### Unique serial numbers required for unit prior to binding.



## Special **Notices:** ● State Amendatory Endorsement and Disclosure notice included as required. ● This quotation does not apply to the extent that trade or economic sanctions or other laws or regulations prohibits Global Aerospace from offering or providing insurance. Tothe extent any such prohibitions apply, this policy is void ab initio.
● The producer warrants that they are properly licensed to solicit or sell insurance, as applicable, in their state of domicile and in all other jurisdictions where they transact business.
● It is the producer's responsibility to comply with any applicable laws regarding disclosure to the policyholder of commission or other compensation we pay, if any, in connection with this policy or program.

keep with next



## Dated: June 26, 2015 

### Underwriter:Quote No: Q752423 Page 4 TotalAnnual Premium: **$981** 

### Ai**rcraft Schedule (Page 1 of 1)**  **viz @ 26 June** 

**F AA**  **Number Serial**  **Number Aircraft**  **Make Aircraft**  **Model Aircraft**  **Y**

**ear Seats**  **Crew +**  **Passenger Use**  YUNEEC YQ5004K 2015 0+0 UAS **Hull V**  **alue Hull**  **Rate** $1,450 7.000 **Hull Premium**  $102 **Hull W** **ar Rate**  0.250 **Hull W** **ar Premium**  $4 **Liability Limit**  **Passenger Liability**  $1,000,000 Excluded **Liability Premium**  $875 **Passenger W** 

**ar Liability**  Included **Third Party**  **W**

**ar Limit**  **Third Party**  **W**

**ar Basis**  $1,000,000 Aggregate **Third Party**  **W**

**ar Premium**  Included **Medical Limit**  $5,000 **Medical Premium**  Included **Deductible In**  **Motion Deductible**  **Not In**  **Motion** 5% 5%
**T otal**  **Annual Premium**  **$981**Quote No: Q752423 Page 5 

### Ad**dendum 1 to Quote viz @ 26 June**  **TERRORISM RISK INSURANCE ACT OF 2002**  

### (A**s amended and extended by**  **The Terrorism**  **Risk Insurance**  **Extension Act**  **of 2005**  **and The**  **Terrorism Risk**  **Insurance Program**  **Reauthorization Acts**  **of 2007**  **and 2015)**  **NOTICE TO PRODUCER:** The applicant must be made aware of the opportunity to purchase the coverage contained in the Applicant Disclosure described below. Any request from you to bind the coverage offered in this quote must include advice to us regarding the applicant’s choice for terrorism insurance coverage. The premium stated in the disclosure is for terrorism insurance coverage only. **APPLICANT DISCLOSURE: NOTICE AND OFFER OF TERRORISM INSURANCE COVERAGE**  You are hereby notified that under the Terrorism Risk Insurance Act of 2002, as amended, hereinafter referred to as ‘the Act,’ you have a right to purchase insurance coverage for losses arising out of acts of terrorism, as defined in Section 102(1) of the Act: “The term “act of terrorism” means any act that is certified by the Secretary of the Treasury

— in consultation with the Secretary of Homeland Security, and the Attorney General of the United States

— to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property; or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion.” PURCHASE OF THE INSURANCE OFFERED IN THIS DISCLOSURE HAS THE EFFECT OF **NULLIFYING** TERRORISM **EXCLUSIONS** CONTAINED IN NEW OR RENEWAL POLICIES FOR ACTS OF TERRORISM, AS DEFINED IN THEACT. HOWEVER, ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED, AND YOUR POLICY MA Y CONTAIN OTHER EXCLUSIONS THAT MIGHT AFFECT YOUR COVERAGE. IF THIS COVERAGE IS NOT PURCHASED, THE COVERAGE AFFORDED BY THE POLICY WILL BE THAT WHICH WOULD APPLY IN THE ABSENCE OF THE ACT. IF PURCHASED, COVERAGE AFFORDED FOR LOSSES CAUSED BY CERTIFIED ACTS OF TERRORISM MA Y BE PARTIALLY REIMBURSED BY THE U.S. GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LA W. UNDER THIS FORMULA, IF THE AGGREGATE INSURED LOSSES EXCEED A TRIGGER AMOUNT ($100,000,000 THROUGH 2015; $120,000,000 BEGINNING ON JANUARY 1, 2016; $140,000,000 BEGINNING ON JANUARY 1, 2017; $160,000,000 BEGINNING ON JANUARY 1, 2018; $180,000,000 BEGINNING ON JANUARY 1, 2019; AND $200,000,000 BEGINNING ON JANUARY 1, 2020), THE U.S. GOVERNMENT GENERALLY PAYSA PERCENTAGE (85% THROUGH 2015; 84% BEGINNING ON JANUARY 1, 2016; 83% BEGINNING ON JANUARY 1, 2017; 82% BEGINNING ON JANUARY 1, 2018; 81% BEGINNING ON JANUARY 1, 2019; AND 80% BEGINNING ON JANUARY 1, 2020) OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE PREMIUM CHARGE FOR THIS COVERAGE DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE U.S. GOVERNMENT UNDER THE ACT. YOU SHOULD ALSO KNOW THATTHE ACT, CONTAINS A PROGRAM CAP OF $100,000,000,000 THAT LIMITS U.S. GOVERNMENT REIMBURSEMENTAS WELL AS INSURERS’ LIABILITY FOR LOSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ONE CALENDAR YEAR EXCEEDS THE PROGRAM CAP. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEEDS THE PROGRAM CAP, YOUR COVERAGE MA Y BE REDUCED. PREMIUM FOR TERRORISM INSURANCE COVERAGE (which is in addition to the ”Total Premium”, and is subject to any applicable state taxes and surcharges)

Liability $88 Hull $4 Total $92
In accordance with the provisions of the Act, the Terrorism Risk Insurance Program shall terminate on December 31, 2020. Unless the program is renewed, extended or otherwise continued by the federal government, insurance coverage purchased for losses arising out of acts of terrorism shall terminate as of the date when any one or more of the following first occurs: (a)the policy period ends; (b) the federal Terrorism Risk Insurance Program, established by the Act, has terminated either in its entirety or as respects the type of insurance afforded by this policy; or (c) renewal, extension or continuation of the Terrorism Risk Insurance Program has become effective without a requirement to make terrorism coverage available as respects the type of insurance afforded by this policy. If the insurance is not terminated upon the occurrence of b. or c. above, insurance will remain in force without change for the remainder of the policy period, unless the company notifies you of any such change in response to any change in the federal law. If the insurance is terminated upon the occurrence of b. or c. above, pro rata unearned premium will be returned toyou. **PLEASE ADVISE IF YOU WISH TO PURCHASE THIS COVERAGE.**