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: AVIATION MARKETS

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 Aircraft Systems (UAS Policy Form)

Insurance applies to the insured's declared use of aircraft described in the attached schedule. See the policy form and any accompanying endorsements for

complete coverage details. The attached schedule also contains the rated exposures and premiums for each aircraft.

PLEASE 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 of America 

New York, New York

Tokio Marine America Insurance Company 

New York, New York

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 Aircraft

(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 aircraft

Endorsements:

A125 Amendment of Defined Terms

C025 Electronic Date Recognition Exclusion Limited Coverage

C064 Premises Coverage $1,000,000 Sub Limit

S023 Massachusetts Amendatory

Payment Plan:

100% of the Annual Premium Due on Inception

Approved Pilots for Scheduled Aircraft:

The policy shall not apply while an aircraft is in flight unless the pilot in command is Roland J. Boucher Jr.:

Underwriter's Remarks:

All other terms, conditions and exclusions per the Global Aerospace UAS policy form.
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. To the 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

Total Annual Premium: $981

Aircraft Schedule (Page 1 of 1) viz @ 26 June

FAA Number 

Serial Number 

Aircraft Make 

Aircraft Model 

Aircraft Year

Seats Crew + Passenger 

Use

YUNEEC 

YQ5004K 

2015

0+0

UAS

Hull Value 

Hull Rate

$1,450 

7.000

Hull Premium $102

Hull War Rate 0.250

Hull War Premium $4

Liability Limit 

Passenger Liability

$1,000,000

Excluded

Liability Premium $875

Passenger War Liability Included

Third Party War Limit 

Third Party War Basis

$1,000,000

Aggregate

Third Party War Premium Included

Medical Limit $5,000

Medical Premium Included

Deductible In Motion 

Deductible Not In Motion

5%

5%

Total Annual Premium $981
Quote No: Q752423 Page 5

Addendum 1 to Quote viz @ 26 June

TERRORISM RISK INSURANCE ACT OF 2002

(As 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 THE ACT. HOWEVER, ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED, AND YOUR POLICY MAY 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 MAY BE PARTIALLY REIMBURSED BY THE U.S. GOVERNMENT UNDER

A FORMULA ESTABLISHED BY FEDERAL LAW. 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 PAYS A 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 THAT THE ACT, CONTAINS A PROGRAM CAP OF $100,000,000,000 THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS 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 MAY 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 to you.

PLEASE ADVISE IF YOU WISH TO PURCHASE THIS COVERAGE.