rn.Pipponi COO

rn.Pipponi COO No. 2110001,04/1 141/2611 ill ............... Application for Export Certificate of Airworthiness Export Certificate No. Est 3 7_5(ge redonl Adak. Ailsoints. INSTRUCTIONS - This application is to be submitted to an authorized FM representative (one copy) when the aircraft to be exported is (are) presented for inspection. This application may be used, but is not required. for aircraft engines, propellers, and articles. Use Part I for products and Part II for articles. For complete aircraft, execute items 1 through 11, as applicable. For engines and propellers, omit item 5A. Part III is for FM use only. Part I - Application for Export Certificate of NrworthIness (Complete Mims 1.11) 1. Application is made n export certificate NEW hiness to cover the product(s) described below which (are): USED 2. Name and address of exporter Summit Aviation, Inc. 4200 Summit Bridge RD Middletown, DE 19709-9340 3 Name and address of foreign purchaser Greenwich Aerogroup Brazil Leasing Inc 4200 Summit Bridge RD Middletown, DE 19709-9340 4. Country of destination Brazil 5. Description of products) Type (a) Transport Helicopter Make and Model (b) Identification No. Serial Nos. (c) FAA T.C. or Spec. No. (d)Operating time (Hours) (e) Since Overhaul Tout A. AIRCRAFT Sikorsky S-76C N162AD 760472 Hi NE 1.3 49 c4. 03 B. ENGINES Turbomeca Arriel 2S1 P/N 02920053 10 #1 eng: 20040 #2 eng: 20533TEC E00054 EN #1:09g7 #2:2368.351.94.: zma. 3 C. PROPELLERS N/A N/A N/A N/A N/A N/A 8. Does the product I comply with all applicable Federal Aviation Regulations. Airworthiness Directives, and other FAA requirements? YES NO (Explain In "Remarks" 7. Nave ay.e.abliti special rWents of the importing country been complied with? LJYES 11.1.-INO (Explain In "Remarks") 8. Date title passed or is expected to pass to foreign purchaser: 10-Apr-2013 9. For overseas shipment, preservation and packaging methods used to protect product(s) against corrosion and damage (List Spec. No. or Tiffin: Effective duration of above methods: N/A 10. Remarks Reference attached ANAC Letter - Document No. Of.50/2013/GGAC/SAR-ANAC, dated 05 April 2013. Reference attached Summit Aviation, Inc. Exceptions Document SIKORSKY S-76C, SIN 760472, dated 8-April-2013. 11. EXPORTER'S CERTIFICATION — The undersigned certifies that the above statements are true and that the product(s) described herein is (are) airworthy and in a condition for operation except as may be noted under item 10 'Remarks' above. Signature of applicant or authorized represe TT Edward J. ScullyS on, Title VP Summit Aviation, Inc. Date 08-APR-2013 M1yr Ml SDNY_GM_02754682 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241604 EFTA01261493 SDNY_GM02754683 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241605 EFTA01261494 Pan li - Application for Approval of *Marrs (Complete Items 12-20) 12. Name and address of exporter 13 Name and address of foreign purchaser 14. Country of destination 15. Articles are eligible for installation on Make and model of product FAA Spec. No or T.C. Ear USED 16 The articles are (Check One) 17. ribq articles are described (Check One) l_lBelow by name, part number and quantity On the attached invoce or packing sheet by name. pan number and quantity Invacingroaclung sheet No Name (a) Part number (b) Quantity (C) 18. Have applicable special requirements of the importing country been complied with? YES ❑NO (Explain In item 10 "Remarks" 19 Preservation and packaging methods used to protect articles against corrosion and damage (List Spec. No. or TWO: Effective duration of above methods: 20. Exporters Certification - I certify that the foregoing statements are true and that the articles described herein are airworthy, conform to FAA approved design data. are in a condition for sale operation except as may be noted in item 10 'Remarks'. Signature of applicant or authorized representative Tide Date Part al - Approval (FOR FAA USE ONLY) 21. It is considered that the products) and articles described in Part I or Part II is (are) airworthy 7 Part i riPart u and conform a) to pertinent requirements except as noted in Item 10 Check One) • Signature Sazgreei Number 'Da Tee -sof Oate ni...Zei A * 1 I FAA In (Check one) ODA WAR DAR actor 22. Give quantity of approval tags, FAA From 8130-3, issued for the articles described in Part Quantity II.--* N/A 23. EXPORT FILE SPOT-CHECKED BY: FAJc-Get4r;isl;_i3kc6lr o WILICC41 4D.O. No. -Arafk-P'SDO -31 Oate„ LAY) \O _. _.._........_. /AA PwelYl Porton SDNY_Gtvl_02754684 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241606 EFTA01261495 SDNY_GM_027541385 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241607 EFTA01261496 The United States of America Department of Transportation Federal Aviation Administration Washington, D.C. No. £437518 Export Certificate of Airworthiness This certifies that the product identified below and particularly described in Specification(s) 1 of the Federal Aviation Administration, Numbered HINE; E00054EN has been examined as of the date of this certificate is considered airworthy in accordance with a comprehensive and detailed airworthiness code of the United States Government, and is in compliance with those special requirements of the importing country filed with the United States Government, except as noted below. The certificate in no way attests to compliance with any agreements or contracts between the vendor and purchaser, nor does it constitute authority to operate an aircraft. Product: Aircraft Total Time: 6906.8 Engine Manufacturer: Sikorsky Turbomeca S.A. Model: Arriel 2S1 Model: S-76C PI Serial No. 20040 Total Time: 5695.7 Hrs, TSO 5695.7 02 Serial No. 20533TEC Total Time: 2368.3 Hrs, TSO 2368.3 Serial No: 760472 New: Used: x Country to which exported: Brazil Exceptions: Reference Attachment dated 8 April 2013 listing exceptions and ANAC Exception acceptance letter 01.50/2013/CGAUSAR-ANAC dated 5 April 2013 Additional Information: The rotorcraft covered by this certificate has been examined and found to be in conformity with the Brazilian approved type design as defined by the Brazilian Type Cenificate No. 7906 and is in condition of safe operation. Sec Reverse side for listing of Supplemental Type Certificates (Sits) installed. Coyne Signature of Authorized Representative 8 April 2013 DART-801097-EA Date District Office or Designee Number 1 Forcomplete aircraft. AM applicable specification or type certificate data sheet for the aircraft. engine. and propeber. Applicable specification or type certificate data sheet, Knot attached to this export cettificare, ad have been fonyarded to the appropriate governmental Pike of the imparting country. FAA Fore 61304 (04-2011) Supersedes Previous Edition SDNY_GM_02754686 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241608 EFTA01261497 Export Certificate of Airworthiness E437518 Continued from front: Supplemental Type Certificates (Sits) Installed SR09355RC - Aero Seats and Systems, Inc. - 12 Place Passenger Seats - CHST No. 2008506-01 SR09211RC - Aero Seats and Systems, Inc. • External Mount Life Raft Deployment System - CHST No. 2004512-07 SR02822NY • Heli-One • Automatic Deployable ELT System - CHST No. 2009508-15 5R02603NY-D - Sikorsky Global Helicopters, Inc. - CVFDR-145 Cockpit Voice/Flight Recorder - CHST No. 2013501-06 SR01405NY • D & D Design, Inc. - Installation of Honeywell MK-XXll EGPWS - CHST No. 2011509-03 SR01616SE - FDC/Aerofiker WA LP - Engine Filter system with Wiring Modification per FAA DER approved Data SH5778SW -Meggitt (Addison), Inc. - Electrically Driven Vapor Cycle Air Conditioning system-CHST No. 2009507-09 SR00811NY - Technisonic Industries Limited - Installation of TFM-138B - CHST No. 2009511-07 5R01593NY-D - Sikorsky Global Helicopters, Inc. - Installation of Keystone Helicopter Utility Interior Panels - CHST No. 2003511-05 SR01113NY-D — Keystone Helicopter — S-76 Door Pin Kit — CHST No. 2009S09-06 SR01472NY — Eaton Aerospace — Zapper Pulsed Engine Chip Detector System 1K7707- CHST No. 2010505-06 5H241450 — Sikorsky - Installation of the Honeywell SRZ-850 Integrated Radio System. SH2413S0 — Sikorsky - Installation of the Honeywell AV-850 Digital Audio System. SH2361S0 — Sikorsky - Installation of a fixed landing light. SH2360S0 — Sikorsky - Installation of a search light switch on collective stick. 5H235850 — Sikorsky - Installation of gearbox inspection lights. SH235750 - Sikorsky - Installation of a power monitor panel (INSCO). 541236250 —Sikorsky - Installation of a dual static inverter AC power system. 541243050 — Sikorsky - Installation of a Precise Flight Pulselite System. 541243150 — Sikorsky - Installation of Recognition Lights. 541257050 — Sikorsky - Installation of an external power overvoltage monitor. 541290050 - Sikorsky - Installation of a Honeywell P-700 radar system. 5H294250 — Sikorsky • Installation of a Honeywell SPZ-760 digital automatic flight control system. SR00666AT —Sikorsky - Installation of a LITF dual LCR-925 attitude heading reference system (AHRS). SR00432AT — Sikorsky - Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFTS). SR00490AT — Sikorsky - Installation and operation of a Bendix CAS-66A traffic collision avoidance system TCAS). SR00531AT — Sikorsky - Installation of a lower anti-collision light. SR00508AT — Sikorsky - Installation of a Shadin 8800 ADC accessory unit. SR00902AT — Sikorsky - Installation of a Standby JET ADI.335D attitude indicator. SR00877AT-D— Sikorsky - Installation and operation of a Honeywell AA-300 radio altimeter system. 5R010118AT-D — Sikorsky - installation of a Universal Avionics UNS-1D flight management system. SR01407AT —Sikorsky - Installation and operation of a Baker M7950 Page/Chime Amplifier System. END SDNY_GM_02754687 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241609 EFTA01261498 ATTACHMENT TO EXPORT CERTIFICATE OF AIRWORTHINESS E437518 DATE: 8 APRIL 2013 LISTING OF EXCEPTIONS: UNS-1D System (Sikorsky STC SR01088AT-D) with software level SCN 601.X was modified to software level SCN 604. (FAA Form 337, dated 29-Mar-2001 and FAA Field Approval. The RFMS was approved by the New York Aircraft Certification Office). AeroFDC WA LP - STC SR01616SE — Installation of an engine air filter system. (ANAC validated by project number H.02-2619-0 and CHST 2007503-08 was issued). STC SR01616SE is approved & validated for S-76C helicopters with IIDS. This rotorcraft does not have LIDS, but has a Master Caution Annunciator System installed. The STC Holder, AeroFDC WA LP, has provided electrical drawing FDC/aerofilter "KIT, Wiring Modification — IBF System For 5-76C+ W/O IIDS", No. 1076K15 , wiring for the Master Caution, and Rotorcraft Flight Manual Supplement (RFMS) "Sikorsky 5-76C+ Helicopters (S-76C Helicopter Powered by Turbomeca Arriel 251 Engines) NOT Equipped With !IDS". Doc. No. 1076-1200-102, which was not approved under the STC. Both the electrical drawing and the RFMS are FAA DER Approved on FAA Form 8110-3 and on the FAA Form 337 when the installation has been completed. The following major alterations were installed per an STC and do not have ANAC validation; however, the basis for the FM SIC is Transport Canada's STC: 1. Heli-One SIC SR02822NY — Installation of the CPI.503 Automatic Deployable ELT. (Basis for STC is Transport Canada STC SHOE- S8 is ANAC validated by project number H.02-3080-0 and ANAC CHST 2009508-15 was issued). 2. Technisonic Industries Limited SIC SR00811NY - TIL Engineering - VHF Marine Radio. (Basis for STC is Transport Canada SIC SH94-10 is ANAC validated by project number H.02.3220.0 and ANAC CHST 2009511.07 was issued). The following major alterations were installed via an SIC and do not have ANAC validation per the special requirements. The STCs are manufacturer options, installed by Sikorsky during production and prior to the original Standard Airworthiness Certificate issuance. These systems have been incorporated into the Maintenance Manual and the IPC. Rotorcraft Flight Manual Supplements (RFMS) are incorporated in the Flight Manual as applicable. Additionally, all of the below listed Sikorsky STCs have been Installed for 6,906.8 hours, exceeding the referenced 6,000 hours, identified in Paragraph 5.6.1 of FM AC 21-21, Appendix 2, Federative Republic of Brazil — Special Requirements, dated August 2011. 1. Sikorsky STC 5H241450 — Installation of the Honeywell SRZ-850 Integrated Radio System. 2. Sikorsky STC 5112413SO — Installation of the Honeywell AV-850 Digital Audio System. 3. Sikorsky STC 511236150 — Installation of a fixed landing light. 4. Sikorsky STC SH236050 — Installation of a search light switch on collective stick. S. Sikorsky STC 511235850 — Installation of gearbox inspection lights. 6. Sikorsky STC SH235750 — Installation of a power monitor panel (INSCO). 7. Sikorsky STC 5H236250 — Installation of a dual static inverter AC power system. 8. Sikorsky STC 5H243050 — Installation of a Precise Flight Pulselite System. 9. Sikorsky STC SH2431S0 — Installation of Recognition Lights. 10. Sikorsky SIC 5H257050 — Installation of an external power overvoltage monitor. 11. Sikorsky STC SH2900S0 — Installation of a Honeywell P-700 radar system. 3 12. Sikorsky STC SH2942S0 — Installation of a Honeywell SPZ-760 digital automatic Right control system. 13. Sikorsky SIC SR00666AT — Installation of a UTF dual LCR-925 attitude heading reference system (AHRS). 14. Sikorsky STC SR00432AT — Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFIS). 15. Sikorsky STC SR00490AT — Installation and operation of a Bendix CAS-66A traffic collision avoidance system (TCAS). 16. Sikorsky STC SR00531AT — Installation of a lower anti-collision light. 17. Sikorsky STC SR00508AT — Installation of a Shadin 8800 ADC accessory unit. 18. Sikorsky SIC SR00902AT — Installation of a Standby JET ADI-335D attitude indicator. 19. Sikorsky STC SR00877AT-D — Installation and operation of a Honeywell AA-300 radio altimeter system. 20. Sikorsky STC SR1088AT — Installation of a Universal Avionics UNS-1D flight management system. 21. Sikorsky STC SR01407AT — Installation and operation of a Baker M7950 Page/Chime Amplifier System. END SDNY_GM_02754688 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 16 10 EFTA01261499 SDNY_GM_02754689 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0024 16 I I EFTA01261500 reANAC Of 50/2013/GGAC/SAR-ANAC AGeNCIA NACIONAL OE AVIACAO CIVIL Rio de Janeiro. 05 April 2013. Daryl K. Former Principal Maintenance Inspector FAA FSDO-17 2 International Plaza Suite 110 Philadelphia, PA 19113, USA Subject: Exceptions for Sikorsky S-76C S/N 760472. Ref.: 1- FAA letter dated 04 April 2013. Dear Mr. Former, We hereby inform that ANAC will accept the Export Certificate of Airworthiness for the Sikorsky S-76C, serial number 760472 rotorcraft with the following exceptions: a. UNS-ID System (Sikorsky STC SR01088AT-D) with software level SCN 601.X was modified to software level SCN 604.3 (predicated on FAA approved STC SA00876LA, dated 23-Nov-1999, for Raytheon Aircraft Company B-300 KingAir aircraft). (FAA Form 337, dated 29-Mar-2011 and FAA Field Approval. The RFMS was approved by the New York Aircraft Certification Office); b. LSZ-850 Lightning Sensor (Sikorsky STC SI-12416SO) Honeywell model sensor LP- 850. returned to manufacturer for modification & re-installed as Honeywell model sensor LP-860. (FAA Form 337, dated 23 Mar 1999, FAA Field Approval. The RFMS was approved by Boston Aircraft Certification Office); c. Keystone Helicopters-STC SR00919NY- Installed S76, Split Tail Rotor Gear Box Cover. Two piece Tail Rotor Cowling (FAA Form 337, dated 27-Dec-2001); d. STC SR01616SE is approved & validated for S-76C helicopters with 11DS. This rotorcraft does not have 'IDS, but has a Master Caution Annunciator System installed. The STC Holder, AeroFDC WA LP, has provided electrical drawing FDC/aerofilter "KIT, Wiring Modification — IBF System For S-76C+ W/O IIDS", No. 1076KI5, wiring for the Master Caution, and Rotorcraft Flight Manual Supplement (RFMS)"Sikorsky S-76C+ Helicopters (S-76C Helicopter Powered by Turbomeca Arriel 251 Engines) NOT Equipped With IUDS". Doc. No. 1076-1200- 102, which was not approved under the STC. Both the electrical drawing and the SDNY_GM_02754690 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241612 EFTA01261501 SDNY_GM_02754691 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241613 EFTA01261502 ANACAGENCIA NACIONAL DE AYIACAO CIVIL RFMS will be FAA DER Approved on FAA Form 8110-3 and on the FAA Form 337 when the installation has been completed; e. Heli-One STC SR02822NV — Installation of the CPI-503 Automatic Deployable ELT (Basis for STC is Transport Canada STC SH08-58 is ANAC validated by project number H.02.3080.0 and ANAC CHST 2009508-15 was issued); f. Technisonic Industries Limited STC SR00811NY — T1L Engineering —VHF Marine Radio. (Basis for SIC is Transport Canada STC SH94-I 0 is ANAC validated by project number H.02-3220.0 and ANAC CHST 2009S11-07 was issued) ; Sikorsky STC SH24145O - Installation of the Honeywell SRZ-850 Integrated Radio System; h. Sikorsky STC 5112413SO - Installation of the Honeywell AV-850 Digital Audio System; i. Sikorsky STC SH2416SO — Installation of the Honeywell LSZ-850 Lightning Sensor System; j. Sikorsky STC SH23615O - Installation of a fixed landing light; k. Sikorsky STC 5112360SO — Installation of a search light switch on collective stick; I. Sikorsky STC SH2358SO — Installation of gearbox inspection lights; m. Sikorsky STC 5H23575O — Installation of a power monitor panel (INSCO); n. Sikorsky STC SI-12362SO — Installation of a dual static inverter AC power system; o. Sikorsky STC SH2430SO — Installation of a Precise Flight Pulselite System; p. Sikorsky STC SH243I SO - Installation of Recognition Lights; q. Sikorsky STC SH2570SO — Installation of an external power overvoltage monitor; r. Sikorsky STC SH2900SO — Installation of Honeywell P-700 radar system; s. Sikorsky STC 5H29425O - Installation of Honeywell SPZ-760 digital automatic flight control system; t. Sikorsky STC SR00666AT - Installation of a LITF dual LCR-92S attitude heading reference system (AHRS); u. Sikorsky STC SR00432AT — Installation of a Honeywell EDZ-7565x6 Electronic Flight Instrument System (EFIS); v. Sikorsky STC SR00490AT — Installation and operation of a Bendix CAS-66A traffic collision avoidance system (TCAS); Lunoniendtrciademn,avtgebIMAck Sins. As •• SDNY_GM_02754692 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241614 EFTA01261503 SDNY_GM_02754693 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241615 EFTA01261504 ANAC AGENCIA NACIONAL DE AVLACAO CIVIL w. Sikorsky STC SR00531AT — Installation of a lower anti-collision light; x. Sikorsky STC SR00508AT — Installation of a Shadin 8800 ADC accessory unit; y. Sikorsky STC SR00902AT - Installation of a Standby JET ADI-335D attitude indicator; 2. Sikorsky STC SR00877AT-D - Installation and operation of a Honeywell AA-300 radio altimeter system; aa. Sikorsky STC SR1088AT - Installation of a Universal Avionics UNS-ID flight management system; bb. Sikorsky STC SR01407AT - Installation and operation of a Baker M7950 Page/Chime Amplifier System. 2. The non conformities listed above are major alterations and will be eligible for acceptance by ANAC during the aircraft initial inspection, if they meet the criteria of IS 21.010A (httyliwww2.anac.Rov.br/bibliotecanS/IS%202 I -010A.odt), item 5.6. and MPR-900.04 (http://www2.anac.e.ov.bricertificacao/MPR/Textos/N4PR-900.04-004-P.pdf). 3. Please make reference to this letter on the Export Certificate of Airworthiness. %line re Alm,. a• Yours sincerely, • Eduaril Americo Campos Filho Manager, Continued Surveillance Coordination PROTOCOLO ANAC 00065.045227/2013.52 SDNY_GM_02754694 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241616 EFTA01261505 SDNY_GM_027.695 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241617 EFTA01261506 Greenwich AEROGROUP January 28, 2013 To Whom it May Concern This letter is to confirm that Edward J. Scully is a duty elected Vice president of Summit Aviation, Inc. and is authorized to execute and deliver in the name and on behalf of Greenwich AeroGroup Brazil Leasing, Inc. (the "Corporation") all documents and forms required by the Federal Aviation Administration in connection with the registration and deregistration of aircraft owned by the Corporation. erely, F. Kohler President & Secretary State of Connecticut County of Fairfield On this the 28th day of January, 2013, before me, Linda Appelbaum, the undersigned officer, personally appeared John F. Kohler, known to me to be the person whose name is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. In witness whereof I hereunto set my hand. Signature of 146tary Public Date Commission Expires: LINDA APPRIAUM Man Pa Sam al Onioltut kti Camodstion Eggs Oman 31.2018 Greenwich AeroGroup, Inc. 975 Steamboat Rood www.areenwichaeroarouo.com Greenwich, Cr 06830 SDNY_GM_02754696 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_002416 IS EFTA01261507 SDNY GM 02754697 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241619 EFTA01261508 V•11OVUMS 00 11.001 DEPNITLEN1 OF TRANSPORTATION-RODIN. AMIN AMItizSTRAION STANDARD AIRWORTHINESS CERTIFICATE ulreaehAV SAVACTO.000.1006. I KNOAII Walt I CATIICA• NI62AD I Satorsky S-76C • ovIriartrot Mid 444..“ ._salve. erns • rerun ea 5: •POPIIttiNg rOISPitintillf••••••••1•00tte. ••••••••••.0.01•••• •••••••0••••• Cosise•I••••••”•• swan rasa me wee bases i /01•1,A6COIWOrett • enn• eft • to non ain't= • now• holt 41 al 4i. tr. Ras seauroppe0n • •••••• 10/21/1997 IALSCIATOO Walt .FS120-25 _pot oii ee.....4 /Mon PI NA fin......a........ Area.. nay ;)•••••••••••••••4anna viti:retili WS, IRMA= • nt • ccop.:t ...waintetiowroomurera *1.4 Pon n»!3.• MONS rm.. WAN 760472 763660.24 O SDNYSA4_02 754698 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00241620 EFTA01261509 •(.26 iSScf6,1 ocV/G/20t I SUFI GM 02754699 T TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, EFTA_00241621 EFTA01261510 on Downer Of ( AViATC*4 ACIMISTWON STANDARD AIRWORTHINESS CERTIFICATE • ••••••ankin II162AL I Pular. AWO•yeFOR 01.0.110.41/4004 MGM/ fa ste.amil Saadi .**. &can 0•110, SWAG, R-10-21-1997 -It - • es n's "swot+ %tn. t* (4.01A Ava,c0,CGAAtONS FAA Fenn 610:1•2 04n .0.•••••••••••••••••• ON ••• ••••••••••• Oa r•Wee••••••••••••••+re. CSSOIMOniallt• EA 3 .nrwrowearseinst • I 61, ACCONOMitt mt. *Main 1.Oy. SDNY_GM ":0757707 " F TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15 EFTA_00241622 EFTA01261511 SDNY_GAl_02754701 1 TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15 EFTA 00241623 EFTA01261512 UNITED STATES OF AMERICA DEPARTMENT OF TRANSPORTATION -FEDERAL AVIATION ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE 3 AIRCRAFT SERIAL I NATIONALITY AND A CATEGORY REGISTRATION RAMS N162AD S AUTHORITY ARO BASS FOR ISSUANCE Pis smenNesu anima 'mei mesa • ti U SC VOW AU artin AA bdll dav cliparce.dy siva? /3 Ala mot Ns tan HAHool ib %c€ embn he two an hi tab. TT bi Meant' la us al Ton tow Arm inetaeloinutTli Oro pia* anpren:tirodesail "Ss tybalbN Cosorlocntreanstul0614166 acect as — rem 1.410000 Sikorsky S-76C NUMBER 760472 Transport NONE 6 TERMS AND COMYT.OHS Lau wow steam( fesitffit *en s Tantace600 remise WSW* TIN FAA. NT ~fees. Milks asnl knj is re antoura 6.36. AM argots n h KAMM .66 Pao 2I. al. al II d hirFAHTO atiSad Sus OATS OF ISSUANCE R-10/2111997 MraWska. v.:awe.* nut.. al morn- OAS* Ty • sHadal Wew Rstiesi Te NOS S Stwna 346 mts CEA/SCAN MT BE DISGUYED tit ME WACCORSDICE M APFUCAHA FEDERAL AWASCII REGULATORS MOUTON MOUSER AEA-FSDO-25 FM fin SIMI (04.11) Scant:eat Prevoa Edllon SDNY_GM_02754702 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241624 2 MAHAFACTURERANO MODEL EFTA01261513 SDNY_GM02754703 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241625 EFTA01261514 DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION ADMINISTRATION ROUTE SLIP DATE: September 16, 2011 TO: NAME ROUTING SYMBOL Aircraft Registry AFS-750 • ❑ Per your request ❑ For your information ❑ Per our conversation ❑ Note and return ❑ Discuss with me ❑ For your approval ❑ For your signature 0 Take appropriate action ❑ Comment ❑ Please answer ❑ Prepare reply for signature of REMARKS: Issued replacement airworthiness certificate for Sikorsky Model S-76C, S/N 760472, N I 62AD. Certificate issued due to Registration Number change from N162AE to N162AD accomplished 09/14/2011 per AC Form 8050-64 issued 08/17/2011. Attached are copy of replacement FAA Form 8100-2 dated R-10/21/1997 and original superseded Form FAA 8100-2 dated R-I0/21/1997. ROUTING SYMBOL AEA-FSDO-25 SDNY_GM_02754704 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241626 EFTA01261515 SDNY_GM_02754705 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 0024I627 EFTA01261516 IMITCOSTAWSOF Millerya DEPARTMENT OF TRANSPORTATION —FEDERAL AVIATION ADMINISTRATION STANDARD AIRWORTHINESS CERTIFICATE MaTIOPIALITY ARO FIGORTRAIXT4 BMWS N162AE SIKOR AUTHOROYM40 6094 ton THeywoOnrimoil malt I* rene• Woad 00OraliOn.•04/Watean IHOMad by Amer IV Emablant .t% 6 lailMSAROCCROilsONS UnOSS SeOrei M ersOnNwnii tenoca 6,6r1: 4 6H6 OCCOrtteralisitsPans2I y riaMeamm Yaw NQ DAM OF PPINIPE R-10-21-1997 P RHO alNralgn. rawoduatr.o• Hisysaogirmaen• Man 0.0011 litE CER114CAlt WET BE CoSPCATIO IN AVIATION REMOTIONS FM Form 8100-2 MCI STANDARD AIRWORTHINESS CERTIFICATE 000.31 SWUM • eitnr). A Vita 2CATEGORY `RANSP0RT im mat Oa IM /MO of Mora TM ihreka 6 be on twos*, lot WM and MOW amertHema COMM as latis646 eV 136 AdnumityIor and Orylari an polo/nod in Ltlwaya rafe.pnI.ednw Ualed DESIONATICW IMMOLP 'EA—TOO-61 not Weed.' SI101c. unpmemnim Hareamelon03 ANLMFT IM 6O3O41O.Oia WITH APPLICABLE MEAN Y.S. arosool • 0044611 VNITCO TTTTTT OF AMINRCA DEPARTMENT OF TRANSPORTATION —FEDERAL AVIATION ADMINISTRATION I. WATENUAITT 6•4 NARKS •N152AE I. MMof ACtUSC It MID MOOCI. Sikorsky S76C 3 RMISMI SCatat twit MR 760472 4 CATT6OMV ransport S. AUTHOMIT AM, /HMS ISM siSSIIANCE einoolthinint wHifitere it isyMd pommel ie l e Ndocel AyPsion AO el 1930 end wig.. Me. Os N My dole of iis9oN. th• e;iroall le wIth lisped boo bees loomed end bond se colony to the typo wer.icom o Mottles. to b. comb Imn Ica woe otTembon, and bet boo down la pro lti •••yopmsb N Me applicable con.preboni... and aimmlod eimortkinass tecie at OPTION by Abp. E to the Corpus, M Int.4441.941 Gni AsHatiya. wimp• os noted Immis loceries. None E. PI In WO CORP 1065 WHIR, seem. endoNd. staspipelod. rpobed. or o iltrairation dole is ethemtior •nobliMed by IN Ad...; T ; TTT 0,..... I INs eirwoothloos, triiEspo ; i olloctly• en kw. as the meintmenty. istvonlelim meinlononct end elIerobom my I patlenowill in octodemy HMI Pens V. 43, end 91 of IN Iodate, Ayierbio 17.1oboss. oi oporoymioio, end the 1 PrinalI is noWsiwyd is IM POO Pesos. I DATE Pt IMAM( SiCal•II011MusleCII 10-21 -97 DAR NE200001AC Any yahHelien. memcbott6n. r inisys• el this 4 y bo 'thyblo by • by Nye ozysod49. II.000. 0. iw. • Prisoneoai nN 494voilkii 3 yaws. y• bet% I KAT St BE DIOTATIO IN TNT AIIKRATT IN ACED'S. MKT WITH APPLICMItt IEDIRM AWATI (01./IATI . FAA Fern 1100-2 ,7-47. FORM FAA FORM .36.3 m2754706 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10,soNy_ 15,_0 and 17 EFTA_00241628 EFTA01261517 SDNY_GM_02754707 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241629 EFTA01261518 0 MAJOR REPAIR AND ALTERATION US Dmrsonol ot Trampolaorn (Airframe, Powerplant, Propeller, or Appliance) fades Minim AIIIMISSO Form raftrAd OMB Ns 21204020 For FAA Ow Oak, rico klenikobov INSTRUCTIONS: Print a type all entries. See FAR 43.9. FAR 43 Appendix 8. and AC 43 9.1 (Or subsequent revision thereof) for instructions and disposition of this form. This report is mated by Wm (49 U.S.C. 142t) Fakes to report can result in a civil penalty not to exceed $1,000 for each such violation (Section 901 Federal Aviation Act 1958) 1. Aircraft Mn Sikorsky moss S.76C 34viai NO. 760472 PalioNaly MP ROcreralto WO U.S.A. N152AE 2. Owner NOVO all Vail on orgrantron conks* Aetna Life insurance 151 Farmington Ave. Hartford, Connecticut 06156-0001 3 For FAA L,, n), a IAN ideraleekin 5 Typo lint Mae YDS WY MO REL.., 'dowry, AIRFRAME X -Ms dnafbed in lam 1 ebdw) POWERPLANT PROPELLER APPLIANCE Tr:* lArvoracTior a Conforney summon A. Agency's Mine rd Addend a Ant of /rotor C. Osnecal• NO Keystone Helicopter Services 1420 PhoenIxWIle Pike West Chester, PA 19380 U.S. Candid miasmic Airframe Class 3 Radio Class I e 2 CRS EGRRS26D Limited Accessory reeenc.nired mochank Candied Repair Paton Hstawlscharm D. I certify that the repair and/or alteration made to the unit(s) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requkoments of Pad 43 of the U.S. Federal Aviation Regulations and that the information liimi,thed herein is true and correct to the best of my knOvidedbe. Date December 29. 2006 $9540000t rorostan Intimdual Jerry Smedley rYl....2.(1.121.4 / T. Approval for Return DO Seneca Pursuant to the authority given persons specified below, the unit Identified in item 4 was inspected in the manner prescribed by re Administrator of the Federal Aviation Administration and is 0 APPROVED O REJECTED BY • FAA Fx Standards AIWA lOr O Ilanufaceser O Inspection Authorization Der Mow o FAA Designee Er/ Repair Sutton O Person Approved by Transport Canada kmorthiness Grow OM al ApprovalCr Roma+ DMCOMber 29,2006 *mikes, a Cimeneton No. CRS EGRR526D waive or ilitiontod Is3vddai Edward H. Waterland 4-24-9-7 ( -... J FAA Fine YR (1246) SDNY_GM_02754708 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241630 EFTA01261519 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. 6. Description of Work Accomplish ad Of more space Is rewired. attach &Owned sheets. Identify with aircraft nationality and registration mark and date work completed.) Model : S-76C Date : December 22, 2006 Serial No. : 760472 Keystone Helicopter Services performed Modification of Tail Pylon Aft Spar in accordance with Sikorsky Customer Service Notice 76-220A, Part 3, cold work fastener kit part number 76070-20564-011. Replaced the tail boom vertical fin aft spar web upper section with new part number 76070-20562-122. Replaced vertical fin aft spar left hand side strap angle part number 76080-20046-101 with new part number 76201-25002-111. Replaced vertical fin aft spar right hand side strap angle part number 76080-20046-102 with new part number 76201- 25002-110. Keystone Helicopter Services repaired the Ft/H pylon forward fairing in accordance with Alert Service Bulletin 76-55- 16A. The aircraft weight and balance has been updated. Refer to Keystone Helicopter Services work orders H01194-2 for details of work performed. 0 Additional Sheets are attached SDNY_GM_02754709 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241631 EFTA01261520 U.S. Department ii) Tronzoonazon MAJOR REPAIR AND ALTERATION For FAA Use Only Firearm Aviation (Airframe, Powerplant, Propeller, or Appliance) Acninisustion Office Wentif.cation INSTRUCTIONS: Print or type al entries. See FAR 43.9, FAR 43 Appendix B, and AC43.9-1 (or subsequent revision thereof) for instructions and disposition of this form. This is regured by law (49 U.S.C. 14211. Failure to report can result in a civil penalty not to exceed $1.000 for each such violation (Section 901 Federal Aviation Act of 19581. 1. Aircraft Make SIKORSKY Model S-76C Serial No. 760472 Nationality and Registration Mark NIS2AE . 2 Owner Name lAs shown on registration certificate) Aetna Life Insurance Co. Address (As shown on registration certificate/ 151 Farmington Ave. Hartford, CT 06156-0001 3. For FAA Use Only ma ../ A ABLE A1RWO NESS REOur-----1B62iffrirkiEwrsAND FII3ED HEREINscED °CON!: UFO9SR THWIMIE ABOTIVIT DESCRIBED AIRCRAFT SUBJECT TO A CONFO AUTHORIZED IN FAR SECTION 43-7 INSPECTION BY A PERSON N /-O 6. Type 4. Un ant Unit Make Model I ‘. Serial No. Repair Atieration AIRFRAME (As dactilaid In hem I above 3OOC POWERPLANT PROPELLER APPLIANCE Type Manufacturer 8. Can Ginty Statement A. Agency's Name and Address B. Kind of Agency C. Certificate No. VIP AERO INSTRUMENTS AND AVIONICS 68 LINDBERGH DRIVE HA ciTFORD, CT 06114 U.S. Certified Mechanic 7715R223N Foreign Certified Mechanic x Certified Repair Station Manufacturer D. I certify that the repair and/or alteration made to the uni (a) identified in item 4 above and described on the reverse or attachments hereto have been made in accordance with the requirements of Part 43 of the U.S. Federal Aviation Regulations and that the information furnished herein is true and correct to the best of my knowledge. Date 0/y0% al°wS-4 7. Signature of Authorized individual 111 Approval for Return To Service Pursuant to the authority given persons specified below, the ure'identified in item 4 wa* Inwood in the manner prescribed by the Administrator of the Federal Aviation Administration and is A,PPROVED 0 REJECTED FAA Flt.Standerds Inspector Manufacturer M Inspection Authorization Other ISPecify) BY FAA Designee X Repair Station Person Approved by Transport Canada Airworthiness Group Date of App al or ' ction Certificate or ignature of Allhorized Individual /O/ Pi Designation No. TH5R223N 14.--A---- -/ FAA Fo 337 SDNY_GM_02754710 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241632 EFTA01261521 NOTICE e Weight and balance or operating limitation changes shall be entered In the appropriate adorer record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. • • 8. Oestaiption of Work Accomplished (f/more space is required, attach additional sheets. Identify with Aircraft nationality and registration math and dare work completed., 1- Removed the following equipment: Global Wolfsberg Flight Phone VI system consiting of RT-18D receiver transmitter, FF VI antenna, C-118 cockpit dialer and WH-I0 cabin handset. Removed Sikorsky Rotor Craft Flight Manual Supplement NO. 102 for operations of FLIGHTFONE VI System. 2- The equipment identified in the following steps was installed and tested in accordance with AC43.13-1B, chapter 4, para. 50 thru 62, chapter 10, para. 14, 16, 19, 20 & 21, chapters 11 para. 7, 8, 30, 31, 32, 37, 38, 47 thru 263, Chapter 12 para 1 thru 38 and AC43.13.2A, chapters 2 pan 21 thru 28, chapter 3 para. 37 thru 44, chapter 11 para. 211 thru 214, and chapter 13 para. 261 thru 263 when applicable. 3- Installed an Iridum Satellite Communication System consisting of the following: - International Communications Group ICS 100 p/n: 500616-2 Iridium Transceiver providing cabin and cockpit station intercom and phone operation. The ICS 100 transceiver is located on the aft avioincs bay equipment shelf at station: 265.0 - ICG Iridium Antenna p/n: 500644-1 installed on tail boom at station: 519.0 in accordance with Sikorsky antenna installation drawing number 33776-64681 sheets 1,6 and 14. - ICG Sigma 7 handset p/n: 500905-20-02-1 installed in cabin at same location as removed WHIO handset in aft center cabnet at station 204. The Sigma 7 handset is wired as SAT Phone station 13. - Northern Airborne Technologies FTAI2-100 cabin dialer with Bose Series X noise cancelling headset The PTA12-100 cabin dialer with Bose Series X noise cancelling handset is wired as SAT Phone station 12. The PTA12-100 Cabin Dialer is located in the cabin RH forward facing arm rest at station 198. - Northern Airborne Technologies PTA12 cockpit dialer for crew operation. The PTA12 cockpit dialer is wired as SAT Phone station II. The PTA12 Cockpit Dialer is located in the center pedestal at station 103. All wiring was accomplished in accordance with VIP Avionics, Inc. wire drawing ft: 2006W0001 Rev - dated 10/17/06 Sheets I thru 3. The drawing was DER approved on FAA form 8110-3 dated 10/20/06. Installed placard on both sides of aft cabin cabnet near Sigma 7 handset " TO CONTACT PILOT REMOVE HANDSET FROM CRADLE PRESS ON THEN DIAL 1!" VIP Avionics, Inc. Iridium Sat Phone Rotorcraft rators Guide dated 10/30/06, ICS 100 Users Guide p/n: 501330-UG, igma 7 Handset Users guide p/n: 500114 Rev F, PTA12 Operators Manual Rev. 1.10, PTA12-100 Operators Manual Rev. 1.0 and Seat Back Card p/n: 500024 rev. A were placed in the rotorcraft. INSTRUCTIONS FOR CONTINUED AIRWORTHINESS: Annually or every 100 hours end of page 1/3 - continued on next page... do Additional Sheets are Attached SDNY_GM_02754711 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241633 EFTA01261522 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. a. Descdption of Work Accomplished (II more space is required, attach additional sheets. Identify with Aircraft nationality and registration mark and date work completed.) inspect for insecure mounting. The ICS 100 system maintenance is on the condition of failure. There is no required maintenance. Suggested maintenance and troubleshooting proceedures are covered in the Installation manual number 501330 rev I or later in the manual section, Testing. 4- Installed a I I5V AC 60 HZ cabin power system consisting of the following equipment: - KGS Electronics HS-50 SOOVA 115V 60 HZ static inverter provideing 115V AC 60 HZ power to the system. The HS-50 static inverter is located on the aft avioincs bay equipment shelf at station: 263.0 - Levitron 8590-W Ground fault Isolater to provide ground fault isolation to the two cabin 110V AC recepticles. The 8590-W GFI is located on a fabricated mounting bracket next to the HS-50 static inverter on the aft avioincs bay equipment shelf at station: 256.0 - Two Hubbell HBL5258 AC Outlets to provide up to 4 amps of AC power for portable accesory utilization. The HBL5258 AC Outlets are located on the right and left side forward facing cabnets at station: 184.0. The outlets are placarded "110VAC 60 HZ 4 A MAX". - A MS24658-23D Lever Lock SPDT Switch connected to a M83536/6-025 remote relay to interupt power input to the HS-50 Static Inverter. The MS24658-23D switch is located at station 101 on the RH side of the pedestal and labeled "CABIN 110VAC 60HZ / OFF". The M8356/6.025 relay is located on a fabricated bracket just forward of the Aft AC junction box at station 272. All wiring was accomplished in accordance with VIP Avionics, Inc. wire drawing ft: 2006W0002 rev - dated 10/17/06 Sheets 1 thru 2. The drawing was DER approved on FAA form 8110-3 dated 10/20/06. INSTRUCTIONS FOR CONTINUED AIRWORTHINESS: Annually or every 100 hours inspect for insecure mounting. Annually or every 100 hours the Ground Fault Isolater (GPI) should be tested. With the aircraft running on the ground test the GFI by pressing the button labled TEST. The RESET button should pop out indicating a succesful test. Pressing the RESET button re-arms GFI for use. If the GFI reset button fails to pop out when the TEST button is pressed the GFI should be replaced. The SS-50 system maintenance is on the condition of failure. There is no required maintenance. See KGS Electronics Removal/Installation manual DWG No. 112106 rev. F dated AUG 03 2003 paragraph 2 E for ICA and removal and installation instructions. 5- Systems are protected by circuit breakers whose value are listed in the approved wiring drawings and labeled accordingly. All wiring was done IAW AC 43:13-la, ch. 11, sec. 3 thru 7. An Electrical Load Analysis was accomplished and recorded on VIP Avionics, Inc. Document Number 2006R0001 Rev - dated 10/18/06. The Electrical Load Ahalysis Addendum meets the requirement of I4CFR part 29.1351(a)(1). 6- All systems were tested per manufacturer's detailed check out procedures and all systems checked out satisfactorily. EMI/RFI tests were succesfully end of page 2/3 - continued on next page... ty Additionil sheets are Attached SDNY_GM_02754712 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241634 EFTA01261523 SDNY_GM_02754713 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241635 EFTA01261524 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be 'Compatible with all previous alterations to assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished 0/ more space is required, attach additional sheets. Identify with Aircraft nationality end registration mark and date work completed.1 completed per VIP Avionics, Inc. EMI/RFI Test Proceedure document number 2006R0002 dated 10/26/06. 7- Equipment list and weight and balance revisions have been entered into the aircraft POH. Aircraft log entries have been made. ❑ Additional Sheets are Attached SDNY_GM_02754714 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241636 EFTA01261525 SDNY_GM_02754715 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241637 EFTA01261526 r A 0 MAJOR REPAIR AND ALTERATION .., S Conan,. ti •,...,........ (Airframe, Powerplant, Propeller, or Appliance) ran ... Adaird'enik. Form Arosnoved 0148 No 1I10CC20 For FAA tht• Ont., AltliilIDO-17 81R INSTRUCTIONS: Print or type al entries. See FAR 43.9. FM 43 Appendix B. and AC 43.91 (or subsequent revision thereof) for instructions and disposition or this form. TNs report is required by law (4gu S.C. 1421) Failure to report can result in a civil penalty rot to exceed $1.030 for each such violation (Section 901 Federal Aviation Act 1958) I. Alityaft UAW Sikorsky MoStl S-76C UN. No. 760472 N•taNatY AM APPAPAPP0 Mani U.S.A. N152AE 2. Owner ewe (As Plow, an wand= cerate.PV Aetna Life Insurance Co. Metes Pao WYPPI an reparscon celAcAM 151 Farmington Ave. Hartford, CT 06156-0001 3., For FAA Us. No, 4. Unit kIentescatIon S. Typo Unit UNA Model Wu, No. Artue.co AIRFRAME described X (As In Item f above) POWERPLANT PROPELLER APPLIANCE 'hos MarvIscanr I. Conionnity Sisheraet A. AO.PCys Name 460 Address a tow a Agency c. cent NO Keystone Helicopter Services 1420 Phoenixville Pike West Chester, PA 19380 (! — at coarse mousinit Airframe Class 3 Radio Class 182 CRS EGRRS281) limited Accessory Foreign Craned Mechanic ewe's, Repair Melon ..„ 1444444Clurer 0. !certify that the repair and/or alteration made to the units) have been made in accordance with the requirements furnished herein is true and correct to the best of my k identified in item 4 above and described on the reverse or attachments hereto of Part 43 of the U.S. Federal Aviation Regulations and that the information creamily. Darn 2 June 2004 Slin•lie• a matrixes 054.4444 Christopher A. Macario e0,42Tsthe- 4.-, .20Ar.ar, _.) 7. APProval kw Rheum 10 Service Pursuant to the authority given persons speofie4 below. The unit identified in Bern 4 was Inspected in the mamer prescnbed by the Administrator of (2)e Federal Aviation Administration and is C8) APPROVED 0 REJECTED ev MI FM RI Standards inspector O Manulactwer O Irmectica Aul/exitatan EXhat (Sper.41 O FM Designee 0 Repay Susan O Person Append by Transport Canada Airworthiness Group Dino pl span' it it R*aen 2 June 2004 Genital* or Clesierutdon No. CRS EGRR526DSpume al Atasewed intilwerat David Druce -ala4.4,,) Citi.t.,“,......._ FAA Form 337 (12418) SDNY_GM_02754716 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_0O241638 EFTA01261527 NOTICE Weight and balance or operating limitation changes shall be entered in the appropriate aircraft record. An alteration must be compaitftriatE tcrvious alterations to assure continued conformity with the applicable airworthiness requirements. 8. Description of Work Accomplished (If mom space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date work completed.) Model : 5-76C Date : 6-2-2004 Serial No. : 760472 Acft Total Time :4226.3 hrs. Keystone Helicopter Services installed inspection panels on the left and right hand side of tailboom vertical fin in accordance with Sikorsky Customer Service Notice 76-207C. An aircraft actual weighing has been performed and equipment list updated. Refer to Keystone Helicopter Services work order G03972 for details of work performed. — END 0 Additional Sheets we attached SDNY_Ghl_02754717 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241639 EFTA01261528 3«S- iii, MAJOR REPAIR AND ALTERATION .._ ., MAY us OCOVIIIN 01 (Airframe, Powerplant, Propeller, or Appliance) lansixibUn hderMAAmbn • L--- Maditsimbn , ntriseano020, - ilf kni For FAR US4 0414 1 n . , _ , ry 3 INSTRUCTIONS: PAM nth,* all "Pries. See FAR 43.9. FAR 43 Appendix B. and AC 4341 eSimiecrice15 -41ei ixacijlounstructiOdr — and disposition of tis Joon Pis rant it regained by Inv (40 U.S.C. 14213 Failure b MOW Can main a eke Franey not to mooed $ 1.000 • ter oath such violation (Seceon 901 Federe0M44401 AD 1958) • • 1. aJrctah Wks SIKORSKY Model S76C Serial No. 760472 Nationality and Ftegetration beam N152AE 2. Owner Name (As Moaner, reeislialicocertnicale) AETNA LIFE INSURANCE COMPANY Address Old thOW/1 on regismion ceetittcale) 151 FARMINGTON AVE HARTFORD, CT 06156.0001 3. for FAA Use Only 4. Untl Idantiecation 6. Type unit Make Modet Serial No. Repair Aderalion AIRFRAME X (As described in item 1 above)------ POWERPtANT PROPELLER APPLIANCE T)po Manufacturer 6 Conformity Statarent A Agencys Name end Address B. Kind of Arpricy C Cartificate No JOHN KEATING 168 EAST HILL ROAD CANTON. CT 06019 GI U.S. Corned methsne AP46641737IA O Foreign Garbled Mechanic O tamed Repair Stabon O Manufacbser D. I cents that to repair sober alteration made to the en(s) dentine:lin hoe bean made in accordance with the requirements of Part 43 of In, Is eta and Maga 10 Ma best of my knowledge. nom 4 above and described on the reverse or ettactreete$ here* the US. 4000* AviattOn Rogreations end that the information Nmished Data 05125/2003 Signature of Authorded Incavidgai ) 7. for Return to Service Punuant to the authority given persons wedded below. the unit kknelle2 In item 4 was inspected In the manner presorted by the ACInsmilralge a to Federal Asiabon Admnistraton and is El APPROVED 0 REJECTED FAA Fit Standards Inspector PAsnulacturer X 141401:60n AUth047.4:01 Coat (Spec BY FAA Designee Repair Station Person Approved by Tramped Canada Ainver1tmen Group Data tat Approval or Rejecton 05/25/2003 Cakficate of Oismanalitm No AP46641737IA Signature :[4Zatred Individual 94444 1 FAA Form 337 (1244) SDNY_GiA_02/5.4718 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241640 EFTA01261529 NOTICE weight and balance a operating limitation changes shall be entered in the appropnate aircraft record. An alteration must be. compatible with aft previous alterations to assure continued conformity with the applicable airworthiness requirements. 8. I/ascription of Work Accomplished (If more space is required, attach additional sheets. Identify with aircraft nationality and registration mark and date MOM completed) 0326/2803 SIKORSKY NI52AE SIN 760472 TOTAL TIME 3722.9 HOURS Installed Eaton Aerospace Zapper Pulsed Engine Chip Detection System I K7707 in accordance waft STC ISR01472NY dated 03/08/2002. Modified existing engine chip detection system to allow non-cntical slivers of wear fuzz to be pulsed away. Instated two channel power module. Chip Pulse switch, and Chip Detector test switch. Wired system and performed functional test. All work done IAW instuctions of STC. See attached for Instructions for Continued Airworthiness. FM Approved Rotoraaft Flight Manual Supplement a FM00508 inserted in Flight Manual Airaaft Weight and Balance change is negligible. ilialltadilShileb .An Altietild U.S.C.F43:1989-0-663-P7I SDNY_GM_02754719 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA_00241641 EFTA01261530 INSTRUCTIONS FOR CONTINUED AIRWORTHINESS FOR THE EATON AEROSPACE, ENGINEERED SENSORS/TEDECO PRODUCTS ZAPPER® PULSED ELECTRIC CHIP DETECTOR SYSTEM 1 K7707 ON SIKORSKY HELICOPTER MODEL S-76 EATON/TEDECO ZAPPER'' SYSTEM 1 K7707 DOCUMENT 1 K7707 I.C.A. SONY GM 02754720 SUBJECT TO PROTECTIVE ORDER PARAGRAPHS 7, 8, 9, 10, 15, and 17 EFTA 00241642 EFTA01261531 SDNY_GM_02754721 SUBJECT TO PROTE