AUA Application Form

Note: A license fee of $33.00 (incl. GST) and an Access Gate Card fee of $55.00 (incl. GST) apply. The AUA is valid for the financial year or part thereof and will be renewed at AAC’s discretion.

APPLICANT DETAILS

NAME

EMPLOYER/BUSINESS NAME

SITE NUMBER

HANGAR LOCATION

SITE / POSTAL ADDRESS

Phone

VEHICLE DETAILS

NEW OR SWAP

COMPANY OR PRIVATE

VEHICLE TYPE

MAKE

MODEL

YEAR

GVM (kg)

REGISTRATION NO.

(if not registered, give details of industry pecifications with which the vehicle complies)

REGISTRATION EXPIRY DATE

COMPANY LOGO DISPLAYED

YES

TYPE OF OPERATION

TYPE OF AUA

(tick appropriate – see Airside Vehicle Control Handbook for details)

GREEN

BLUE

RED

JUSTIFICATION

(type of work & areas of operation)

VEHICLE CALL SIGN

(If operating within the manoeuvring area)

COMMUNICATION EQUIPMENT

(If fitted - required for Red AUA’s)

THIRD PARTY INSURANCE (PROPERTY)

(Copy of insurance Certificate of Currency or Certificate Insurance showing at least $10 million cover must be attached, confirming that the policy does not exclude airside or on‐airport activities; confirming that the Airport Lessee is named as an Additional Insured; and the policy includes a Cross Liability or similar clause)

INSURER

AMOUNT

APPLICATION ACKNOWLEDGEMENT AND CERTIFICATION

I acknowledge that in making this application, I undertake that the vehicle will be maintained, insured and operated in conformity with the conditions promulgated by Archerfield Airport Corporation (AAC) in the Airside Vehicle Control Handbook. I further confirm that I have read, understood and accepted the Airport Conditions of Use and Airside Vehicle Indemnity and Release. I acknowledge also that AAC may cancel or suspend the Authority without refund at any time.

SIGNATURE

Date

ATTACHED DOCUMENTS

Copy of Third-Party Insurance Certificate of Currency showing amount of cover

Signed Airside Vehicle Indemnity & Release form

DOCUMENTS FILES

Drop files here or

Max. file size: 256 MB, Max. files: 5.

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