Henry Aviation Heliport Operations Kansas Speedway. 2. Liability insurance as additional insured for Henry Aviation;

Transcription

1 Heliport Operations Kansas Speedway Required Event Documentation: 1. Liability insurance as additional insured for Kansas Speedway; 2. Liability insurance as additional insured for ; 3. Signed Hold Harmless Agreement for Kansas Speedway; (Note: A Separate Hold Harmless Agreement Is Required By Each Pilot-In-Charge) 4. Signed Hold Harmless Agreement for ; 5. Copy of 135 Charter Certificate and Operations Specifications page D085 from Charter Company; 6. Prior Permission Request (PPR) to land; 7. TSA/TFR waiver; 8. Schedule of planned arrivals; 9. Landing fee payment. Please FAX all paper work to or to ajones@henrymgmt.com Please do not hesitate to contact us with any questions or concerns you may have Ofc Fax

2 Company Acknowledgment of Responsibility and Hold Harmless Agreement 2015 Please read and understand this Agreement before signing. Company: Event: Kansas Speedway: (All 2015 Events) In consideration of the Company being permitted to conduct business on or to land and take off helicopters on property known as Kansas Speedway and managed by during the period of 2015: The undersigned Company agrees to indemnify, defend and hold harmless, Henry Management, and their respective officers, directors and employees from any and all liabilities and expenses (including attorneys fees and court costs) that may sustain in any action or claim for property damage or personal injuries, including death, resulting from, or in any way connected with any business conducted on the property, and or any use of a helicopter in or around Kansas Speedway. The undersigned Company agrees that its request to conduct business or operate a helicopter on Kansas Speedway property presumes that such business or operation(s) are at the Company s own risk. The Company further certifies that the Company has in force an insurance policy with minimum liability limits of $10,000, for each occurrence, combined bodily injury and property damage, and that an original instrument documenting this coverage has been provided by Company s insurance underwriter to. The Company hereby certifies that the Company is aware of, and agrees with the responsibility legally transferred to the Company under the Federal Aviation Regulations as regards to the Company s decision to conduct business on or operate a helicopter in the vicinity of and on the Kansas Speedway property. Any damage resulting there from is solely the Company s responsibility and liability. It is further agreed that none of the proposed business or flights are mandatory, that the Company conducts all business and all fights at the Company s option. The Company understands that the Kansas Speedway landing site is unimproved. Further, in no way does this document supersede or otherwise abdicate the responsibility of the Company and/or pilot in-command as stated in the Federal Aviation Regulations. The term cleared to land, takeoff, etc. denotes ATC authority. The Company understands that is not responsible for, nor legally able to provide any type of Air Traffic Control or Separation Service for any aircraft operating on or near Kansas Speedway property. For safety purposes, communicates only in an advisory capacity for arrivals and departures. All instructions and guidance received, regardless of terminology used, are to be considered advisory in nature. Furthermore, the Company acknowledges that other aircraft in the area may be participating in air traffic management initiatives and may not be listening on any of the radio frequencies in use in the area of this event. The Company acknowledges that the pilot-in-command of each aircraft in the area is in full and complete charge and control of their aircraft. Further, the pilot-in-command of each aircraft is fully responsible for all decisions and the suitability and safety of the available landing area and any operations conducted in its vicinity. Officials and employees of may or may not supply printed, verbal or radio advisory information. The Company understands and

3 acknowledges that if any of the Company s actions rely on such provided information that this occurs at the Company s own risk and that and their employees assume no responsibility for the completeness or accuracy of such information. It is the Company s understanding that may determine whether the Company s proposed use complies with all rules of eligibility of Kansas Speedway. Permission for the Company to conduct business or operate a helicopter on Kansas Speedway property by Henry Aviation does not constitute a representation or warranty of any kind or character of the safety of the intended or proposed business or operation nor the suitability of the landing area. By signing below, the Company indicates a clear understanding that in exchange for permission for the Company conduct business on or to land on Kansas Speedway property, during 2015, the Company must have tendered proof of the Company s insurer s waiver of any subrogation rights as may exist against. Company Name: Date Authorized Representative Signature: Authorized Representative Name (printed): Authorized Representative Title: Helicopter Registration Number ( s) The Liability policy must be primary and evidenced by a certificate of insurance showing the entities listed below as additional insureds:, Henry Management, and their respective officers, directors and employees Evidence of insurance should be sent to the following: Certificate Holder Phone: Fax: ajones@henrymgmt.com

4 Hold Harmless Agreement Kansas Speedway Corporation d/b/a Kansas Speedway [May 8-9, 2015 October 17-18, 2015 Please read and understand this agreement before signing. In consideration of the undersigned Operator being permitted to land and take off on property owned by Kansas Speedway Corporation d/b/a Kansas Speedway ( KSC ) during the period of May 8, 2015 thru October 18, 2015: The Operator agrees that its request to operate a helicopter on KSC Property presumes that such operation(s) will be at the Operator s own risk. Each pilot must sign this Hold Harmless Agreement. The Operator hereby certifies that the Operator is aware of, and agrees with the responsibility legally transferred to the Operator under the Federal Aviation Regulations as regards Operator s personal decision to operate a helicopter in the vicinity of and on the KSC Property. Any damage resulting there from is solely the Operator s responsibility and liability. It is further agreed that none of the proposed flights are mandatory, that the Operator makes all flights at the Operator s option. The Operator s proposed operation at KSC is at the Operator s request and at the Operator s own risk. The Operator further certifies that Operator has in force aircraft liability insurance policy with limits of not less than $10,000, per occurrence naming as additional insureds on a primary basis: Kansas Speedway Corporation d/b/a Kansas Speedway, its parent, subsidiaries, limited liability and affiliated companies and their respective shareholders, officers, directors, members and employees; Henry Aviation and their related officers, directors, agents, and employees; and any Sanctioning Body involved with the event ( Indemnified Parties ); and that a Certificate of Insurance documenting this coverage has been provided by Operator s insurance underwriter to KSC prior to being allowed to operate any aircraft on KSC Property. Such certificate of insurance shall specifically state that the insurance is primary and non-contributory over any other insurance that may be available to an Indemnified Party, and that a waiver of subrogation shall apply in favor of the Indemnified Parties. By signing below, each Operator indicates a clear understanding that in exchange for permission for the Operator to land on KSC Property, the Operator must have tendered proof of the Operator s insurer s waiver of any subrogation rights as may exist against the KSC, its parent and The Operator understands that the KSC landing site is unimproved. Further, in no way does this document supersede or otherwise abdicate the responsibility of the pilot-in-command as stated in the Federal Aviation Regulations to see and avoid other air traffic. The Operator understands that KSC, Its parent and are not responsible for, nor legally able to provide any type of Air Traffic Control or separation service for aircraft operating on or near KSC Property. Furthermore, the Operator acknowledges that other aircraft in the area may not be participating in any FAA sponsored air traffic management initiatives and may not be listening on any of the radio frequencies in use in the area of this event. The Operator acknowledges that the pilot-in-command of each helicopter and airplane in the area is in full and complete charge and control of the aircraft they are flying in. Further, the pilot-in-command of Page 1 of 2

5 each helicopter and airplane in the area is fully responsible for all decisions and operations made concerning operations connected with said helicopter or airplane on the ground or in the air. Officials and employees of KSC, Its parent, and may or may not supply printed, verbal or radio advisory information. The Operator understands and acknowledges that if any of the Operator s actions rely on such provided information, this occurs at the Operator s own risk, and the KSC, Its parent and and their employees assume no responsibility for the completeness or accuracy of such information. The Operator operates on and in the vicinity of KSC Property at the Operator s own risk. In furtherance of the foregoing, the Operator hereby releases and waives any and all claims against the Indemnified Parties in connection with the Operator s operation of a helicopter on KSC Property; provided that the foregoing release and waiver shall not be applicable to any claim arising out of the gross negligence or willful misconduct of any of such parties. In addition, the Operator hereby agrees to indemnify and hold harmless the Indemnified Parties from and against all claims, losses, damages, liability and expenses (including reasonable attorneys fees) arising out of or related to the Operator s operation of a helicopter on KSC Property, except to the extent such claims, losses, damages, liability or expenses result from the gross negligence or willful misconduct of the person or entity seeking indemnification. Please read and understand this Agreement before signing - Each Pilot Must Sign This Agreement Operator Name: Date: Company Name: Authorized Representative Signature: Printed Name/Title of Authorized Representative: Insurance Carrier: Aircraft Registration Number(s): Pilot(s) signature: a. b. c. d. Page 2 of 2