SIPJ Insurance Order

Last name:

First name:

E-Mail:

Street and Number:

City:

Zip-Code:

Country:

Nationality:

Passport Nr:

Destination City and Country:

Date of arrival:

Duration of stay in days:

Date of departure:

Premium:

Evacuation country:

Conditional Title of Transport Agreement

between

SIPJ Sonnig International Privat Jets Fujairah P.O. Box 7441 Fujairah, United Arab Emirates
Hereafter indicated as "SIPJ"

And

Last Name	Last Name
First Name	First Name
Address	Street City Zip Country
Nationality	Nationality
Passport Nr	Passport Nr

Hereafter indicated as "The Subscriber"

Whereas SIPJ and partners operate private aircrafts suitable for emergency medical evacuation missions.
Whereas The Subscriber plans to travel to and/or reside in destination for a period of duarion days days entering the country on date arrival and departing on date departure
Whereas in case of life threatening accident or sickness occurring during his stay in destination, The Subscriber is entitled for emergency evacuation by SIPJ aircraft to one of the countries listed in annex I or in the country agreed with SIPJ.
Whereas conditions for emergency air evacuation to any country other than those listed in Annex I are subject to the SIPJ previous assessment and approval
Whereas this Conditional Title of Transport is valid from date arrival till date departure and is registered under a ID number
Whereas this Conditional Title of Transport is valid ONLY for the person listed on this document (The Subscriber) and SIPJ has no obligation to carry any other person on board the aircraft except The Subscriber
Whereas emergency air evacuation of The Subscriber under this Conditional Title of Transport is considered necessary and is launched only upon confirmation, by the team of appointed doctors, that condition of The Subscriber is life threatening and requires medical evacuation. "Evacuation launch time" is the point in time when appointed doctor declares that medical evacuation is required and this information is recived by SIPJ.

Parties (SIPJ and The Subscriber) have agreed that:

The Subscriber hereby declares that, in case of medical evacuation under this Conditional Title of Transport, he shall be transported to evacuationCountry
SIPJ guarantees emergency transport to the destination indicated in the article 1 providing that conditions for commencement of transport stipulated in recitals vii are met
SIPJ guarantees departure from destination, or closest suitable airport within maximum of 48 hours from the evacuation launch time (defined in recitals VII)
Flight schedule is subject to availability of overflight and landing permissions, airport opening hours and other authorisations or conditions/parameters beyond the control of the SIPJ. SIPJ will however do all possible to operate the emergency evacuation flight as expedite as possible.
During the validity period of the Conditional Title of Transport, The Subscriber agrees to pay a premium of EUR 40.- (forty-euros) for every 7-day period, or fraction of the 7-day period thereof.
The payment indicated in art. 5 has to be effected before declared arrival date in destination in order to make this Conditional Title of Transport Agreement valid.
Agreement renewal or extension of the coverage period can be requested and agreed upon once The Subscriber is in destination. In such case, The Subscriber shall contact SIPJ to agree conditions and start date of the subsequent Conditional Title of Transport.
The payment method for issuance of Conditional Title of Transport is via Paypal service in favour of SIPJ. Once payment is effected, The Subscriber shall receive this Agreement and invoice for the payment.
This Conditional Title of Transport Agreement is the sole proof of the contractual obligation between SIPJ and The Subscriber and shall be presented prior emergency medical evacuation. This Agreement is valid only if medical condition/accident that requires medical evacuation has occurred during the validity period of this Title.
Any legal proceedings or disputes related to this Conditional Title of Transport Agreement are under the jurisdiction of the Court and Laws of Fujairah, UAE.

Annex I

Destination countries which may be selected as destinations in case of necessity to evacuate The Subscriber by air as per this Conditional Title of Transport:

Malta, Spain, Portugal, France, Italy, Switzerland, Germany, United Kingdom, Austria, Slovenia, Croatia, Bosnia and Herzegovina, Serbia, Montenegro, FYR Macedonia, Greece, Turkey, Morocco, Algeria, Egypt.

If The Subscriber desired destination country is not listed above, please contact SIPJ for assessment and approval of your intended evacuation destination.

AGREEMENT

I HAVE READ AND UNDERSTAND THIS AGREEMENT, AND I ACCEPT AND AGREE TO ALL OF ITS TERMS AND CONDITIONS. I ENTER INTO THIS AGREEMENT VOLUNTARILY, WITH FULL KNOWLEDGE OF ITS EFFECT.
CONTRACT IS ONLY VALID UPON WRITTEN CONFIRMATION FROM SIPJ, RECEIPT OF THE CTOT ID NUMBER AND SIGNED CONDITIONAL TITLE OF TRANSPORT DOCUMENT.

PREMIUM