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<br />,," SH <br /> <br />e <br /> <br />e <br /> <br />. <br /> <br />POLICY PART B. <br />RETURN TO <br />COMPANY <br />IF CANCELLED. <br />GLA 11746G <br /> <br />PART B GENERAL LIABILITY AIRPORT POLICY <br />DECLARATIONS <br /> <br />ISSUED THROUGH <br /> <br />RENEWAL OF NUMBER <br /> <br />A VIA TION OFFICE OF AMERICA <br />INCDRPDRA TED <br /> <br />0799711-0100 <br /> <br />Aviation Insurance Managers <br />LOVE RELD TERMINAL BUILDING/DALLAS. TEXAS 75235 <br /> <br />No. <br /> <br />GLA - 13019G <br /> <br />I'm I. <br /> <br />Named Insured and Address: (NO.. STREET. TOWN OR CITV. COUNTY STATE) <br /> <br />Item 2. <br />From <br /> <br />KENNETH MEDCALF DBA GAFFORD AERO <br />P. O. BOX 1354 <br />SAN MARCOS, TEXAS 78666 <br />Policy Period: ("to DAV VR.) <br />JANUARY 2, 1980 to JANUARY 2, 1981 <br />12:01 A.M., standard time at the address of the named insured as stated herein. <br /> <br />[] <br />D <br /> <br />UNITED STATES FIRE INSURANCE COMPANY <br />INTERNATIONAL INSURANCE COMPANY <br /> <br />The named insured is: <br /> <br />CXI Individual D Partnership <br />Business of the named insured is: (ENTER BELOW) <br /> <br />D Joint Venture D Other: <br /> <br />Audit Period: Annual, unless otherwise stated, (ENTER BELOW) <br />SRMT _ A NNTTAJ, <br /> <br />The insurance afforded is only with respect to the following Coverage Part(sl indicated by specific premium charge(s). <br /> <br />D Corporation <br /> <br />Item 3. <br /> <br />COVERAGE PARTS <br /> <br />COVERAGE <br />PART NOS. <br /> <br />ADVANCE <br />PREMIUMS <br /> <br />~ <br /> <br />Owners', Landlords' and Tenants' Liability Insurance. <br /> <br />L 6416 <br /> <br />250.00 <br /> <br />Comprehensive General Liability Insurance . <br /> <br />L 6395a <br /> <br />Completed Operations and Products Liability Insurance <br /> <br />L 6391 <br /> <br />424.00 <br /> <br />Contractual Liability Insurance . <br /> <br />Personal Injury Liability Insurance <br /> <br />L 6400 <br />L 9288 <br /> <br /> <br />Premises Medical Payments Insurance <br /> <br />L 6426 <br /> <br />Owners' and Contractors' Protective Liability Insurance <br />HANGERKEEPERS LIABILITY . . . . . . . <br /> <br />L 64 14 <br />15023 <br /> <br />560.00 <br /> <br />Form numbers of endorsements other than those <br />entered on Coverage Part(s) attached at issue L9175b, AOA 1505 (4) <br /> <br />Total Advance Premium for this Policy <br /> <br />*If the Policy Period is more than one year and the premium is to be paid in installments, premium is payable on: <br /> <br />Effective Date 1st Anniversary 2nd Anniversary <br /> <br />1,234.00 <br /> <br />$ <br /> <br />$ <br /> <br />$ <br /> <br />Item 4. During the past three years no insurer has cancelled insurance, issued to the named insured, similar to that afforded hereunder, unless otherwise <br />stated herein: <br /> <br />Countersigned: <br /> <br />~ fl, l~ <br /> <br />By <br /> <br />,I <br /> <br />~ Ij~r <_/,/ <br /> <br />JANUARY 28, 1980 <br /> <br />*NOT APPLICABLE IN TEXAS <br /> <br />AUTHORIZED REPRESENTATIVE <br /> <br />THIS PART B, WITH "POLICY PROVISIONS-PART A", AND COVERAGE PART(S) AND ENDORSEMENT(S), llF ANY), ISSUED TO FORM A PART <br />THEREOF, COMPLETE (S) THE ABOVE NUMBERED POLICY <br /> <br />~D'X-F 4-79 <br /> <br />RETURN THIS DECLARATION TO COMPANY IF CANCELLED-SPOILED-OR NOT USED. <br />