BROKER OF RECORD LETTER

TO: All Aviation Insurance Companies

This is to certify that Travers & Associates is my authorized representative for the purpose of arranging aviation insurance on my behalf.

By signing this letter, I am eliminating the ability of any other broker to obtain a quotation or to
bind aviation insurance with your company. Please waive the normal five day waiting period.

This letter will remain valid until I formally rescind the authorization in writing.

Signed: ____________________________________________

Printed Name:_______________________________________

Company Name: ____________________________________

Date:_________________________

N#: ______________

Travers & Associates
P.O. Box 220519
St. Louis, MO 63122

Print and Fax to: 314-963-9105