Gyroplane Form

By Ian Wilson from London, England (Gliding at Dunstable) [CC-BY-2.0 (http://creativecommons.org/licenses/by/2.0)], via Wikimedia Commons

Gyroplane Form

Name: Gyroplane Form
SKU: 6289
Availability: InStock

R0.00

Third Party Legal Liability Proposal Form (for Aeroclub members only)

Type Of Proposal *

Membership number *

Inception date *

Aircraft *

Registration No *

Inception *

1 January 2020 – 31 December 2020

1 April 2020 – 31 December 2020

1 July 2020 – 31 December 2020

These premiums include a R 70 policy fee. Note : Cover will only be in place once receipt of proposal form and premium have been confirmed by our office. Administration fee agreement between DJA Aviation Pty Ltd and Client The Client agrees that DJA Aviation can levy an administration fee of R70 per annum, which administration fee will be added to the premium. This administration fee includes the following services, which are additional to the intermediary services for which DJA Aviation receives remuneration in the form of commission from your insurer:
- policy holder risk profiling and insurance needs analysis, including providing risk management advice;
- managing and advising you on level of self-insurance and risk financing options;
- handling premium payments and queries,
- general advice outside of product specific advice;
- assisting you with the formulation of claims;
- negotiating claims with insurers;
- facilitating of non-insurance value-add products;
- managing uninsured losses; and
- managing aggregate deductibles.
You as the Client may cancel this fee at any stage should you feel that you do not require these services. You acknowledge the nature of the services above, for which the administration fee is being charged. DECLARATION I/We declare that the aforementioned Aircraft is/are my/our property, and particulars are true and that no information has been withheld that might influence acceptance of the Insurance and I/we agree that this Proposal, signed by or caused to be signed by me/us shall form the basis of and form part of the contract between me/us and Insurers and to accept a policy subject to the terms, conditions and exceptions described therein.
Signature*
Date*
Comments
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Category: E-Forms

Please note that due to the COVID-19 outbreak our offices will be closed from 27 March 2020 until 16 April 2020.

The company is still operational and all staff are still contactable telephonically and on email.

Please contact your broker on the below number: (if you do not know your broker, please contact Joanne Herman)

DJA EXTENSION LIST
Ashney Chetty	011	840	8352
Bernice Van Zyl	011	840	8379
Carol Kirstein	011	840	8377
Corina Andrews	011	840	8345
Darryl Fisher	011	840	8305
Derek Clark	011	840	8338
Graham Speller	011	840	8331
Ilze Strijdom	011	840	8361
Jackie Nieuwoudt	011	840	8357
Joanne Herman	011	840	8306
Judy Scandling	011	840	8308
Leigh-Ann Taylor	011	840	8378
Louise Pieterson	011	840	8330
Mandy Ramogayane	011	840	8373
Marlene Gill	011	840	8333
Natasha Sivak	011	840	8353
Selvan Govender	011	840	8350
Werner Kruger	011	840	8360
Cape-Town
Chris Readman 082-808-4114	011	840	8381
Suzanne Clark 072-425-4645	011	840	8382
Vickie Skinner 021 813 9589	011	840	8380

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