AUA Application ASA

Authority to Use Airside (AUA) Application

For Operations at Alice Springs Airport (ASA)

This form is to be used when applying for a new Authority to Use Airside Permit (AUA) or when renewing a current AUA Permit due to its forthcoming expiry.

Prior to applying for an AUA as a new operator at Alice Springs Airport (ASA), applicants are required to complete and submit an Airside Vehicle Indemnity and Release Form and provide evidence of Public Liability Insurance for an amount not less than AUD $20 million.

In this application you must demonstrate an operational need to drive a vehicle airside on a frequent and unescorted basis. You must further show that the operational task(s) cannot be otherwise undertaken landside.

All vehicles driven airside of Alice Springs Airport (ASA) must display a current AUA Permit.

APPLICANT DETAILS

AUA TYPE *

NEWRENEWAL

Existing AUA Label #

Company Name *

ABN/ACN

Business Address *

Contact Name *

ASIC# *

Job Title

Contact Number

Email Address

PAYMENT

Payment for AUA applications must be made at the time of submission, no applications will be accepted without payment.

AUA cost: $50 (Inc. GST)

ASA accepts the following methods of payment:

Cash
Credit
EFTPOS
Cheques made payable to Alice Springs Airport

Your company has the option of providing ASA with an Ongoing Credit Card Authority Form that will be securely retained by us and used for payment each time the company submits an application.

Alternatively, you can attach a Single Payment Credit Card Authority Form that we will use for once off payment. Both of these forms are available on our website at www.alicespringsairport.com.au.

How Many AUAs *

Total Cost

GST

Credit Card Processing Fees

Payment Amount *

Email address for Tax Receipt *

*Credit Card details will be asked at the bottom of this form.

N/A Reason *

Online Receipt Number *

VEHICLE DETAILS

Section A - Vehicle Specification

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)

Registration *

Registration Expiry / GSE Inspection Due Date *

Make *

Model *

Year

Serial/Chassis # (if not registered)

Reason for AUA - What will you use this vehicle for on the Airside? *

Special Features

Upload Current Registration/Mechanic Report Copy

Browse

Add Vehicle 2

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)

Registration *

Registration Expiry *

Make *

Model *

Year

Serial/Chassis # (if not registered)

Reason for AUA - What will you use this vehicle for on the Airside? *

Special Features

Upload Current Registration/Mechanic Report Copy

Browse

Add Vehicle 3

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)

Registration *

Registration Expiry *

Make *

Model *

Year

Serial/Chassis # (if not registered)

Reason for AUA - What will you use this vehicle for on the Airside? *

Special Features

Upload Current Registration/Mechanic Report Copy

Browse

Add Vehicle 4

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)

Registration *

Registration Expiry *

Make *

Model *

Year

Serial/Chassis # (if not registered)

Reason for AUA - What will you use this vehicle for on the Airside? *

Special Features

Upload Current Registration/Mechanic Report Copy

Browse

Add Vehicle 5

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)

Vehicle Type

Vehicle (MVR Qualified)GSE (Ground Service Equipment)Private Vehicle (Staff)

Registration Expiry *

Make *

Model *

Year

Serial/Chassis # (if not registered)

Reason for AUA - What will you use this vehicle for on the Airside? *

Special Features

Upload Current Registration/Mechanic Report Copy

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Section B - Criteria For Use

This Application Form must meet one or more of the following criteria for the issue of an AUA Permit to be approved.This vehicle will:

Please check as required *

Be directly involved with the operations or servicing of aircraftBe directly involved with the servicing of Ground Servicing Equipment (GSE)Be directly involved with the servicing, maintenance or construction of airside infrastructure, equipment, buildings or other airside facilities, and that these areas cannot be reached via the landsideHave a need or authority to carry out regulatory or law enforcement activities airsideRequire access to an operational facility located airside for the purpose of conducting duties (EG: APAS Facility)

Section C - Vehicle Markings & Beacon

All vehicles which are intended to be used on the airside must have a beacon and company signage displayed as described below. Upon application, proof of these must be supplied to ASA for the issue of an AUA permit to be approved (e.g. photos – these can be emailed to asa-administration@adgnt.com.au or attached to this application).

Confirm Markings & Beacon *

A Rotating amber beacon displayed on top of the vehicle or highest point which is visible from all angles (360°)Signage – Operator/Company Name and/or Logo displayed clearly on the vehicle

Upload proof of signage and beacon

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Section D: Communication Equipment

Is this vehicle required to operate on the maneuvering area and communicate with ATC? *

NoYes - please provide details of radio communication equipment. If a call sign is already issued, please advise current call sign below

Radio Fitted

Call Sign

Upload proof of radio fitting

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INSURANCE DETAILS

Please Note: Copies of Insurance Certificates must be attached to this Application Form. Insurance MUST cover the use of this vehicle airside.

Vehicle Insurance

Insurer *

Expiry Date *

Amount of Cover *

Upload Current Vehicle Insurance Copy

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Public Liability Insurance

PL Insurer *

PL Insurance Expiry *

PL Insurance Cover Amount *

Upload Current Public Liability Insurance Copy

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Airside Vehicle Indemnity & Release Deed Poll

Organisations operating vehicles airside must have a current Airside Vehicle Indemnity & Release Deed Poll signed and on file. Click to view the Deed Poll

To confirm if a current copy is held on file, please contact the Airport Management Centre on 08 8951 1211 or email asa-administration@adgnt.com.au

Upload Airside Indemnity & Release Copy

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AUTHORISING APPLICANT DETAILS

To be completed by Company Authorised Signatory only. To confirm the authorizing signatories, please contact the Airport Management Centre – 08 8951 1211 | asa-administration@adgnt.com.au

I *

Of (company) *

Acknowledge that:

(i) I have read and understood the Airside Vehicle Control Handbook in relation to vehicle/equipment requirements

(ii) It is a condition of an AUA that the Vehicle comply with the Handbook and the Airports (Control of On-Airport Activities) Regulations 1997;

(iii) Failure to comply with the Handbook and/or the Regulations may result in the AUA being suspended or withdrawn;

(iv) Public Liability Insurance for an amount not less than AUD $20 million will be maintained;

(v) It is the Vehicle operator’s responsibility to ensure the vehicle/equipment meets the applicable industry standards and is maintained in safe working condition at all times;

(vi) Consent to ASA collecting, using and disclosing any personal information contained in this application form in accordance with the Privacy Act 1988 and the ASA Privacy Policy as detailed on our website.

Signed *

Draw signature|Type signatureClear

Date *

ADMINISTRATION - OFFICE USE ONLY

Additional Checks

Current Indemnity & Release on fileCorrect display of operator logo & beaconProof of Radio Installation (if applicable)

Application Processed

Application Processed By (name)

Payment Receipt #

Receipt Number (Online Payment) *

Payment Receipt Date

Payment Processed By (name)

AUA Label

AUA Label 2

AUA Label 3

AUA Label 4

AUA Label 5

AUA Expiry Date

Database Updated

Database Updated By (name)

CAPTCHA *

Credit Card Payment *

Pay

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