Text extracted via OCR from the original document. May contain errors from the scanning process.
FedEx Ship Manager - Pnnt Your Labelts)
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11-101N2i3A0 AIRIORM
VOE.01. AVW OL - NOW
.1211321031.1
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830N3s 1118
After printing this label:
1. Use the 'Print' button on this page to print your label to your laser or inkjet printer.
2. Fold the printed page along the horizontal line.
3. Place label in shipping pouch and affix it to your shipment so that the barcode portion of the label can be read and scanned.
Warning: Use onhjr the printed anginal label for shipping. Using a photocopy of this label for shipping purposes is fraudulent and could result in
additional bang charges. along with the cancellation of your FedEx account number
Use of this system constitutes your agreement to the service conditions in the current FedEx Service Guide, available on fedex.com.FedEx will not
be responsible for any claim in excess of $100 per package, whether the result of loss. damage. delay, non-deliverymisdelivery,or misinformation.
unless you declare a higher value, pay an additional charge, document your actual loss and file a timely claim.Limitations found in the current FedEx
Service Guide apply. Your right to recover from FedEx for any loss. including intrinsic value of the package. loss of sales. income interest. profit,
attorneys fees, costs. and other forms of damage whether direct, incidentattOnSequential or special is limited to the greater of 8100 or the
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FedEx Service Guide.
https/vvww.fedex.com/shippingishipmentConfirmationAction.handle?method=doContinue
1/1
EFTA00085930
May 7, 2021
Melissa Koboldt
AIC Title Service
Re:
N722JE Purchase
Dear Melissa,
Enclosed you will find the Exemption of Aircraft Sold for Removal based upon our potential
acquisition of the helicopter N722JE.
Please let me know if you have any questions.
Sincerely,
....ie.-ter
Rich Munkvold
Chief Financial Officer
Industrial Integrity Solutions, LLC
EFTA00085931
Of PARfmf
Of MENU,
Suggested Format for Affidavit for Exemption of Aircraft Sold for
Removal from the State of Florida by a Nonresident Purchaser
GT-500002
The following is a suggested format of an affidavit to be completed by the purchaser and furnished to the
selling dealer. In order to satisfy the requirements for exemption, the affidavit must contain all of this
information and be completed in full.
Florida
Broward
STATE OF
COUNTY OF
N. 05/02
*** READ CAREFULLY BEFORE SIGNING '
Before me this day appeared the affiant named below, who being duly sworn, states that:
1. I have read Rule 12A-1.007(10), Florida Administrative Code, and § 212.05, Florida Statutes; and
2. I am not a resident of the State of Florida and did not make my permanent place of abode in Florida at the
time of taking delivery of the aircraft described below; and
3. I am not engaged in Florida in any employment, trade, business, or profession for which the described aircraft
will be used in Florida; and
4. I do not represent a corporation which has any officer or director who is a resident of Florida, or makes his
or her permanent place of abode in Florida; and
5. I do not represent an artificial entity other than a corporation which has any individual vested with authority to
participate in the management, direction, or control of the affairs of the entity who is a resident of Florida or
makes his or her permanent place of abode in Florida; and
6. I agree to furnish the Florida Department of Revenue (within 30 days of the date of departure) written proof
that this aircraft was licensed, titled, or registered outside Florida; and
7. I agree to furnish the Florida Department of Revenue (within 10 days of the date of departure) invoices for
fuel, tie-down or hangar charges, repairs, or other similar documentation issued by an out-of-state vendor or
supplier which identifies this aircraft and its timely removal (including the FAA registration number).
Industrial Integrity Solutions, LLC
Name of purchaser
SSN
If purchaser is a corporation or partnership, list officers or partners
Purchaser's permanent address (Street)
(City)
Purchaser's daytime telephone number
/Country)
(ZIP)
D.O.B.
Purchaser's driver's license number and state of issuance
Purchasers passport or visa number
Name of selling dealer or broker
Address of selling dealer (Street)
(City)
(State/Country)
(ZIP)
Selling dealer or broker's Florida certificate of registration number
Selling dealer or broker's telephone number (
Date of sale (Month)
MAY
(Day)
(Year)
2021
N/A
(continued on reverse side)
EFTA00085932
Description of Aircraft
Make
Serial number
760750
FAA registration number
N722JE
(Check one)
New
Used CB
Purchase
Net purchase
price S
1 .800,000.00
Trade-in $
price $
SIKORSKY
Model
S76C++
Year
2008
Primary location of aircraft while in Florida
KFXE AIRPORT
I claim exemption from Florida sales and use tax on the purchase price of the aircraft described herein under
s. 212.05(1)(a)2, Florida Statutes, for the following reason (check one):
U
The aircraft will be removed from Florida within 10 days of the date of purchase.
Ga
The aircraft requires repairs, additions, or alterations and it will immediately be taken to a repair facility and
will be removed from Florida within 20 days (excluding tolled days) after completion of the work.
Under penalty of perjury, I declare that I have read the foregoing and the facts alleged are true to the best of my
knowledge and belief. I understand that if I fail to comply with the requirements of this affidavit, I will be liable for
payment of the tax and a mandatory penalty equal to the tax.
Sworn to (or affirmed) and subscribed before me this day of
Signature of Notary
Print, type, or stamp name of Notary
D Personally known
U
Produced identification
Type of Identification:
Signs ure of affiantipurchaser
Distribution of Do
ments
The original affidavit and a copy of the sales invoice, bill of sale, or closing ocument must be sent to the Florida
Department of Revenue, Aircraft Enforcement Unit, P.O. Box 6417, Tallahass
FL 32314-6417 within five (5) days of the
date of sale.
A copy of the affidavit must be retained by the selling dealer and made a part of the de
The selling dealer or broker should provide the purchaser with a copy.
Notice To Dealers
r s records.
Affidavits not filed within five (5) days of the date of sale may not be accepted by the Department o
avenue and
the selling dealer or broker may be billed for tax, penalty, and interest due.
EFTA00085933
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
_validity of that document.
State of California
County of AN ,gett4At2.01N-0
On MAC
, 2-024
before me,a0Ahl. Citet.Dt G1)001AlKijklini
(insert name and title of the officer)
personally appeared 1;14 CAVV03
1•1 ..V OLD
who proved to me on the basis of satisfactory evidence to be the personffil whose name,(4) is/
subscribed to the within instrument and acknowledged to me that he/sPreitPey executed the same in
his/Depeir authorized capacity(jeg), and that by histetipt4ir signaturefg on the instrument the
persong or the entity upon behalf of which the persoracted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
S GONZALES z
Notify Public • California g
Ffreenkcle Canty
•••
Gam.
Mat 27.2025
EFTA00085934
This SECOND AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT
(this "Second Amendment") is made and entered into as of the 7th day of May, 2021 (the
"Effective Date"), by and between Hyperion Air, LLC ("Seller") and Industrial Integrity
Solution, LLC ("Purchaser"), and amends that certain Aircraft Purchase Agreeement by and
between Seller and Purchaser entered into as of April 16, 2021 (the "Original Agreement"), as
the same was previously amended by that certain First Amendment to Aircraft Purchase
Agreeement by and between Seller and Purchaser made and entered into as of April 20, 2021
(said Original Agreement, as so amended, the "Agreement"), governing the purchase and the
sale of that certain 2008 Keystone Helicopter (Sikorsky) model S-76C++ aircraft, bearing
manufacturer's serial number 760750, and currently registered with the United States Federal
Aviation Administration as N7221E. All capitalized terms used but not otherwise defined
herein shall have the meanings ascribed to those terms in the Agreement.
WHEREAS, Section 4(a) of the Agreement provides in relevant part that ". . .in no event
shall the Closing take place later than May 7, 2021 (the "Closing Date")";
WHEREAS, the Parties desire to extend the May 7, 2021 Closing deadline provided for
in Section 4(a) until May 13, 2021, so that May 13, 2021 is the absolute final and latest date
by which Purchaser must close under the Agreement; and
WHEREAS, Seller is willing to extend the May 7, 2021 Closing deadline until May 13,
2021, effective when and on the condition that immediately upon execution of this Second
Amendment Purchaser increases the Deposit by delivering to the Escrow Agent an additional
One Hundred Thousand Dollars (S100,000). and provided further that Purchaser agrees herein
that the full amount of the Deposit, as so increased, is non-refundable and immediately,
absolutely, and unconditionally due and payable to Seller regardless of whether or not the
Closing occurs, and immediately instructs Escrow Agent to disburse the Deposit, as so
increased, to Seller in accordance with Seller's disbursement instructions;
NOW, THEREFORE, in consideration of these premises and the mutual covenants
and agreements herein contained, the parties agree as follows:
1.
Subject to the provisions of Paragraph 2 of this Second Amendment and
effective if and only if Purchaser fully complies with such provisions, Section 4(a) of the
Agreement is hereby amended in its entirety to read as follows:
(a) The closing of this transaction ("the Closing") and delivery of the
Aircraft to Purchaser shall take place at Fort Lauderdale Executive Airport KFXE,
Florida ("the Closing Place") by not later than the Closing Date (as hereinafter defined),
EFTA00085935
unless the parties subsequently agree upon a later date in writing, in which case such
agreed upon date shall be deemed the "Closing Date". The Closing shall take place
promptly after: (i) Purchaser's delivery of the Certificate of Technical Acceptance
indicating Purchaser's Unconditional Acceptance of the Aircraft in accordance with
Sections 3(f) and (h) hereof; and (2) confirmation from the Escrow Agent that the
Escrow Agent has received the Purchase Price Balance from Purchaser and all Escrow
Documents (as defined below), but in no event shall the Closing take place later than
May 13, 2021 (the "Closing Date"). Seller and Purchaser hereby acknowledge that the
passing of title, possession and delivery of the Aircraft shall take place within the state
in which the Closing Place is located. The fuel costs and the expenses of Seller's flight
crew, if any, in flying the Aircraft from the Inspection Facility to the Closing Place
shall be the sole responsibility of and paid for by Purchaser.
2.
Immediately following Purchaser's and Seller's execution of this Second
Amendment, Purchaser shall increase the amount of the Deposit by delivering an additional
One Hundred Thousand Dollars ($100,000) to the Escrow Agent, whereupon the full amount
of the Deposit, as so increased (i.e., Two Hundred Thousand Dollars (S200,000), hereinafter
referred to as the "Increased Deposit"), shall be non-refundable and immediately, absolutely
and unconditionally due and payable to Seller, regardless of whether or not a Closing shall
thereafter occur. Concurrently with Purchaser's delivery of the additional amount of the
Deposit to the Escrow Agent, Purchaser shall deliver to the Escrow Agent (and send a copy of
the same to Seller) a signed written instruction directing the Escrow Agent to immediately
disburse the Increased Deposit to Seller in accordance with Seller's disbursement directions,
without any further writing or approval from Purchaser being required and without any
requirement that a Closing occur. If and only if Seller receives the full amount of the Increased
Deposit in accordance with Seller's disbursement instructions, the amount of the Purchase
Price Balance required to be paid by Purchaser under the Agreement shall decrease to One
Million Six Hundred Thousand Dollars ($1,600,000). The provisions of Paragraph I of this
Second Amendment will
t be effective unless and until Seller receives the full amount of
the Deposit in accorMic with Seller's disbursement instructions.
1-2"scrase.ct
3.
In the etkni of any inconsistencies between the provisions of the Agreement and
the provisions of this Second Amendment, the provisions of this Second Amendment shall
control in all respects. Except as expressly amended hereby, the provisions of the Agreement
shall remain unchanged, valid and in full force and effect.
4.
This Second Amendment may be fully executed in separate counterparts by each
of the parties hereto. Any signatures on this Second Amendment may be transmitted via
facsimile or e-mail (in pdf format), which signatures shall be deemed originals for all purposes.
[Signatures on the following page]
2
EFTA00085936
IN WITNESS WHEREOF, the parties hereto have executed this SECOND
AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT as of the day and year first
written above.
Seller:
Hyperion Air, LLC
By: ---1-.)(2".EA.A._
Print: Darren Indyke
Title: Authorized Representative
Purchaser:
Industrial Integrity Solutions, LLC
By:
Print: Rich Munkvold
Tide: Chief Financial Officer
3
EFTA00085937
2008 KEYSTONE (SIKORSKY) S-76C++ HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Pursuant to provisions of that certain Aircraft Purchase Agreement dated April _, 2021 (the
"Agreement") by and between HYPERION AIR, LLC, a U.S. Virgin Islands limited liability
company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS, LLC, a New Mexico limited
liability company ("Purchaser"), Purchaser hereby acknowledges the delivery and acceptance of one
used 2008 Keystone (Sikorsky) model S-76C++ helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA")
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft").
Purchaser accepts the Aircraft at
p.m., on
, 2021 in an "As
Is, Where Is" condition and "With all Faults" at
, Florida and
subject to the waivers and disclaimers set forth in the Agreement.
hours
Engine No. 1 (MSN 42285TEC):
hours/cycles
Engine No. 2 (MSN 42286TEC):
hours/cycles
INDUSTRIAL INTE
By:
'cow /1/1p.uovoCia>
Name: e
Title:
C..0
S-
3- Z. I
Date:
TIONS, LLC
25
EFTA00085938
2008 KEYSTONE (SIKORSKY) S-76C++ HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Pursuant to provisions of that certain Aircraft Purchase Agreement dated April
2021 (the
"Agreement") by and between HYPERION AIR, LLC, a U.S. Virgin Islands limited liability
company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS, LLC, a New Mexico limited
liability company ("Purchaser"), Purchaser hereby acknowledges the delivery and acceptance of one
used 2008 Keystone (Sikorsky) model S-76C-i-F helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA")
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft").
Purchaser accepts the Aircraft at
p.m., on
2021 in an "As
Is, Where Is" condition and "With all Faults" at
Florida and
subject to the waivers and disclaimers set forth in the Agreement.
hours
a1
Engine No. 1 (MSN 42285TEC):
2641 9
Cycle: NI=3852.6 / N2.3188.2 hours/cycles
Engine No. 2 (MSN 42286TEC):
2641.9
Cycles: N I =3879.7 / N2=3197A hours/cycles
5472
INDUSTRIAL INTE
SOLjTdTIONS, LLC
By:
Name:
C.04.44D fr igev ornetn...0
Title:
0:0
Date:
S- 3- Z.. I
25
EFTA00085939
*** NO MATCHES FOUND ***
ARCOLP01
05/13/21
ARCOLM01
09:04
TYPE-COLL
SEARCH CRITERIA
1
2,3,9
4
5
Type-Coll
: 1
(Required)
N-Number
: 722JE
Mfr Name
•.
Model Name
•.
Serial Number:
Air Carrier :
Air Carr City:
Air Carr Loc :
Recording Nbr:
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EFTA00085940
ARNNIP03
05/13/21
ARNNIM03
09:04
DATES-STATUS
Reg-Number : 722JE
Cert Issue: 07/17/2019
Pending Chg:
Act Issue : 07/17/2019
Serial Num : 760750
Last Act : 07/17/2019
Year-Make : 2008 KEYSTONE HELICOPTER
Expir Date: 07/31/2022
Model
: S-76C
Type Reg : LLC
Mode-S-Code: 52325707
Uniq-id: 01014797
Status
: VALID
Reason
: FINST REJ
Street
City
Phase/Queue:
State-Zip
: ■
Pkt Status :
County
Stat Date
Country-Zip
: VIRGIN ISLANDS USA
Susp/D1r/IR: NO NO YES
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OPT
MAIN
PREV IMAGE
EFTA00085941
ARNNIP03
Additional Options
05/13/21
ARNNIM03
M
1. View Airworthiness Info
09:04
2. View Cross-Reference
AIRCRAFT DE
3. View Previous Registered Owners
Reg-Number : 722JE
9
Pending Chg:
9
Serial Num : 760750
9
Year-Make : 2008 KEYST
2
Model
: S-76C
Mode-S-Code: 52325707
REGISTERED OWN
Street
: 610
/NATION
City
: ST
State-Zip
: VI
OPTION:
County
Country-Zip
: VIR
NO YES
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EFTA00085942
GFGIIP03
GFGIIM09
N-Number
Serial Num
Mfr Name
Model Name
Page
1 of
4
722JE
760750
S-76C
DOCUMENTS
05/13/21
09:04
Document Description
Status
Doc ID
Doc Date
*Figs
1. APPLICATION FOR REGISTRATION
ACCEPTED
8485
06/13/2019
2
2. EVIDENCE OF OWNERSHIP
JD020475
8484
06/13/2019
2
3. REG RENEWAL APP (ONLINE)
ACCEPTED
9377
03/28/2017
4
4. RQST DUP/EXTENSION/TEMPORARY
ACCEPTED
9736
08/04/2014
2
5. TEMPORARY CERTIFICATE
ACCEPTED
9084
08/04/2014
2
6. REGISTRATION RENEWAL APP
ACCEPTED
4974
07/14/2014
2
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EFTA00085943
GFGIIP03
GFGIIM09
N-Number
Serial Num
Mfr Name
Model Name
Page
2 of
4
722JE
760750
S-76C
DOCUMENTS
05/13/21
09:04
Document Description
Status
Doc ID
Doc Date
liPgs
1. N-NUM CHANGE CANC. NOTICE
ACCEPTED
1736
12/11/2012
2
2. FORM 8050-64
ACCEPTED
5077
09/16/2011
2
3. N-NUMBER CHANGE REQUEST
ACCEPTED
3932
08/26/2011
2
4. N-NUM CHANGE EXP NOTICE
ACCEPTED
4012
10/12/2012
4
5. APPLICATION FOR REGISTRATION
ACCEPTED
7391
07/26/2011
2
6. EVIDENCE OF OWNERSHIP
DT007148
7390
07/26/2011
2
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EFTA00085944
GFGIIP03
GFGIIM09
N-Number
Serial Num
Mfr Name
Model Name
Page
3 of
4
722JE
760750
S-76C
DOCUMENTS
05/13/21
09:04
Document Description
Status
Doc ID
Doc Date
#Pgs
1. APPLICATION FOR REGISTRATION
ACCEPTED
6668
08/16/2010
2
2. N-NUMBER CHANGE REQUEST
ACCEPTED
0725
02/12/2010
2
3. N-NUMBER CHANGE REQUEST
ACCEPTED
3902
03/16/2010
2
4. NAME CHANGE TEMPLATE
ACCEPTED
4696
03/17/2010
2
5. APPLICATION FOR REGISTRATION
ACCEPTED
2985
02/17/2009
2
6. EVIDENCE OF OWNERSHIP
PH001657
0071
12/30/2008
2
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-DOC +DOC
EFTA00085945
GFGIIP03
GFGIIM09
N-Number
Serial Num
Mfr Name
Model Name
Page
4 of
4
722JE
760750
S-76C
DOCUMENTS
05/13/21
09:04
Document Description
Status
Doc ID
Doc Date
liPgs
1. EVIDENCE OF OWNERSHIP
PH001656
0069
12/30/2008
2
2. MISCELLANEOUS-SUPPORT
ACCEPTED
0752
12/23/2008
2
3. ASSIGNMENT LETTER
ACCEPTED
8161
09/09/2008
2
4. ASSIGNMENT OF N-NUMBER
ACCEPTED
5061
09/05/2008
2
5. ASSIGNMENT OF N-NUMBER
ACCEPTED
5060
09/05/2008
2
6. MEMO TO FILE
ACCEPTED
8211
09/09/2008
2
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EFTA00085946
*** NO ASG RECORDS EXIST FOR N-NUMBER 722JE ***
GEGIIP02
05/13/21
GFGIIM02
09:06
Doc Type : ASG
Required Search Criteria
N-Number
: 722JE
Serial Number
Name
Control Number
: 2021 -
F7
E-Number
Date
Billing Number
•
Recording Number
•
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EFTA00085947
*** NO NCG RECORDS EXIST FOR N-NUMBER 722JE ***
GEGIIP02
05/13/21
GFGIIM02
09:06
Doc Type : NCG
Required Search Criteria
N-Number
: 722JE
Serial Number
Name
Control Number
: 2021 -
F7
E-Number
Date
Billing Number
•
Recording Number
•
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085948
*** NO RECORDS ***
GFGIIP02
05/13/21
GFGIIM02
09:07
Doc Type : RSV
Required Search Criteria
N-Number
: 722JE
Serial Number
Name
Control Number
: 2021 -
F7
E-Number
Date
Billing Number
•
Recording Number
•
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085949
*** NO RECORDS ***
GFGIIP02
05/13/21
GFGIIM02
09:07
Doc Type : RSV
Required Search Criteria
N-Number
: 722JE
Serial Number
Name
Control Number
: 2021 -
F7
E-Number
Date
Billing Number
•
Recording Number
•
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
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PREV
GFGIIP07
05/13/21
GFGIIM43
09:07
IR Authorization Code :
OR
Name
OR
N-number
: 722JE
OR
Type
Serial Number:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
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EFTA00085950
GFGIINII
GFGIIM36
Page
1 of
1
05/13/21
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Doc Description: INTERNATIONAL REGISTRY
N-Number
: 722JE
IR Auth Code
N-Number
Date
Pgs
1. IRN20190613101517 722JE
06/14/2019
2
2. IRN20110726120229 722JE
07/27/2011
2
3.
4.
5.
6.
7.
8.
9.
10.
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+DOC
EFTA00085951
GFGIIP07
05/13/21
GFGIIM43
09:07
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 1
Serial Number: 760750
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
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EFTA00085952
GFGIIN12
GFGIIM36
Page
1 of
1
Doc Description: INTERNATIONAL REGISTRY
05/13/21
09:07
Collateral
:
1 760750
IR Auth Code
Collateral
Date
A Pgs
* 1. IRN20190613101517 722JE 760750 KEYSTONE HELICOPTER S-7 06/14/2019
2
2. IRN20110726120229 722JE 760750 SIKORSKY S-76
07/27/2011
2
3. IRN20081230154204 750A 760750 SIKORSKY S-76
12/31/2008
2
4.
5.
6.
7.
8.
9.
10.
WINDOW 1 :
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
WIN 1 FB
MAIN
COLL
PREV
+DOC
EFTA00085953
ARC0LP01
05/13/21
ARC0LMO1
09:07
TYPE-COLL
SEARCH CRITERIA
Type-Coll
: 2
(Required)
1
N-Number
2,3,9
Mfr Name
•
Model Name
•
Serial Number: 42285
4
Air Carrier
Air Carr City:
Air Carr Loc :
5
Recording Nbr:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
PREV
EFTA00085954
*** NO MATCHES FOUND ***
ARCOLP01
05/13/21
ARCOLM01
09:08
TYPE-COLL
SEARCH CRITERIA
Type-Coll
: 2
(Required)
1
N-Number
2,3,9
Mfr Name
•
Model Name
•
Serial Number: 42285
4
Air Carrier
Air Carr City:
Air Carr Loc :
5
Recording Nbr:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
PREV
EFTA00085955
GFGIIP07
05/13/21
GFGIIM43
09:08
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 2
Serial Number: 42285TE
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085956
*** NO RECORDS FOUND ***
GFGIIP07
GFGIIM43
05/13/21
09:08
IR Authorization Code :
Name
N -number
OR
OR
OR
Type
Serial Number:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085957
GFGIIP07
05/13/21
GFGIIM43
09:08
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 2
Serial Number: 42285
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085958
GFGIIN12
GFGIIM36
Page
1 of
1
Doc Description: INTERNATIONAL REGISTRY
05/13/21
09:08
Collateral
: 2 42285
IR Auth Code
Collateral
Date
Pgs
1. IRN20190613101517 42285 TURBO ARRIEL 2S2
06/14/2019
2
2. IRN20110726120229 42285 TURBO ARRIEL 2S2
07/27/2011
2
3.
4.
5.
6.
7.
8.
9.
10.
WINDOW 1 :
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WIN 1 FB
MAIN
COLL
PREV
+DOC
EFTA00085959
*** NO MATCHES FOUND ***
ARCOLP01
05/13/21
ARCOLM01
09:08
TYPE-COLL
SEARCH CRITERIA
Type-Coll
: 2
(Required)
1
N-Number
2,3,9
Mfr Name
•
Model Name
•
Serial Number: 42286
4
Air Carrier
Air Carr City:
Air Carr Loc :
5
Recording Nbr:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
PREV
EFTA00085960
GFGIIP07
05/13/21
GFGIIM43
09:09
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 2
Serial Number: 42286TEC
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085961
*** NO RECORDS FOUND ***
GFGIIP07
GFGIIM43
05/13/21
09:09
IR Authorization Code :
Name
N -number
OR
OR
OR
Type
Serial Number:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085962
GFGIIP07
05/13/21
GFGIIM43
09:09
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 2
Serial Number: 42286TEC
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085963
*** NO RECORDS FOUND ***
GFGIIP07
GFGIIM43
05/13/21
09:09
IR Authorization Code :
Name
N -number
OR
OR
OR
Type
Serial Number:
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085964
GFGIIP07
05/13/21
GFGIIM43
09:09
IR Authorization Code :
OR
Name
OR
N -number
OR
Type
: 2
Serial Number: 42286
Enter-PF1---PF2---PF3---PF4---PF5---PF6---PF7---PF8---PF9---PF10--PF11--PF12---
CONT
MAIN
PREV
EFTA00085965
GFGIIN12
GFGIIM36
Page
1 of
1
Doc Description: INTERNATIONAL REGISTRY
05/13/21
09:09
Collateral
: 2 42286
IR Auth Code
Collateral
Date
Pgs
1. IRN20190613101517 42286 TURBO ARRIEL 2S2
06/14/2019
2
2. IRN20110726120229 42286 TURBO ARRIEL 2S2
07/27/2011
2
3.
4.
5.
6.
7.
8.
9.
10.
WINDOW 1 :
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+DOC
EFTA00085966
U.S. DEPARTMENT OF TRANSPORTATION FEDERAL AVIATION Aokonsna-noN
FOR AND IN CONSIDERATION OF $ 1.00 + OVC THE
LEGAL
UNITED STATES
N 722J E
KEYSTONE HELICOPTER S-76C
AIRCRAFT SERIAL No.
760750
DOES THIS
)
DAY OF May
, 2021
OMB Control No. 2120-0042
Exp. 04/30/2017
Do Not Mitt In This Block
FOR FM USE ONLY
PURCHASER
(IF INDIVIDUAL(S). GIVE LAST NAME. FIRST NAME. AND MIDDLE
Industrial Integrity Solutions , LLC
re—wit ,s,s0---ni-ToPs AND ASSIGNS TO HAVE MC TO HOLD
tu
co
HAVE SET
MY
(TYPED OR PRINTED)
Hyperion Air LLC
2)44>
DAY OF May, 2021
SIGNATURE(S)
(IN INK) (IF EXECUTED FOR
DKIKOlatt pd by LARRY VISOSKI
of Vlb TNT
ZIA194StAtt
TITLE
(TYPED OR PRINTED)
Manager
AC Form 8050-2 (01/12) (NSN 0052-00-629-0003)
EFTA00085967
FEDERAL AVIATION ADMINISTRATION — MIKE MONRONEY AERONAUTICAL CENTER
1) UNTIED STATES
REGISTRATION
N 722JE
NUMBER
0
I Inooctual
4) TYPE 04 REGISTRATION
0
2 prbwrip
0
3 Corporator,
0
4 Co-Caver
(dace one bee I
0
5 Goestivnent
07
On*, L.C.Vti Canonry (LLC)
0
e Non-Obion Capcoseco
0
9 Non-Gni:on Cctoceator Co-OAnor
2)
AIRCRAFT
MANUPFACTURER
KEYSTONE HELICOPTER S-76C
AND ACCEL
3) AIRCRAFT
SERIAL
760760
NUMBER
I) KAMM OF AmetiCANT(S)(AIMONs) shown on onsdonce of owners's, rf oo9o49 pis last !re first rens as mom. tribal I
Industrial Integrity Solutions. LLC
I) TELEPHONE NUMBER ( ■
)
7) MAILING
NUMBER
RURAL
CITY
for test
Lm
ACORESS (Penniman (refry Elcress
socicant On
i
ANDS1REET
ROUTE
P 0 KO(
STATE
l
l
ZIP
I) PHYSICAL
ROOMER
DESCRIPTION
LOCATION
CITY
ADORESS/LOCATION EF PO BOX MAIL Halo OR RI RAL ROI IT E ROx ,Cn fl FOR MA i L NG ArfORFRA
ARO STREET
OF
STATE
ZIP
I) •
CHECK HERE F YOU ARE Ma REPORTING A CHANGE OFADORESS
ME CERTIFY:
41)
Ms
10)
CERTIFICATION
rte or 0)
re ems aro* a mood Of Me oxientiarea ecipscart tan is (MIST Coif mk Asin/OR COMPLETE&
tgl a A Mein el Ma UMW SUS as °Mood 0749 LOC 40102m)(I3).
o
0 A maws elesmath len reparson (Form 1.551) No
•
C A riOrsoNsio Oncation agand ant sang OLONINIS urv3Or fillIIM/SOI (enrol
Orld sae *roan
is teal SAS reersites timidness Orme Sulu Rama et ape roars are eviestes br nspeiacts at (provide cotroste Physical eclikass)
.
0 A McKean:a uwe• soling a at Kilaiellty DS (WM Cl Maas
(2)
If
Seek
(3)
That
(4)
This
the
knorrecge
uoiersland
wry
Oct
0:1300S
registration
[acts 0 Slow is ~col I Os Oslow wed only twists aunceres by me
moan reipstratien on sew Ply entity end teal I mil avec* sal same aftv:OZ•tOn
ire mat is not retsfored soder ne less c4 ars !o'er carte), 5, 0
if
nuance cii onnerstno is •41:4100 a has DO44, 440 vent,* lion Anton
ANY AND ALL SIGNATORIES OF TH5 APPLICATION MUST READ
hereby ceith ma: me intrinaron worded' . and in any allannenD 10 his appicaton
and beet the under:slain:I tat he FAA airrInaaCr MI rely on the rthrnaton
that Another. .n any nailer whin he unsdocn 0 any department Cr agency
XXX scheme Cr *We any man* tacfts) statemenfts) reveseniaton(s) or enty(*)
(18 U.S .G. gg 1001 and 3571) hie understand Mat )o krovegly and will* a)
or tauluent stacerrentlenty or c) Mete any Decorah Eke steerrentintanaton
or the svhecl amore may be delayed. 08909 and* resoled
NOTE: ll executed Tor cimaivnership. all appkatts trust
appease sown, above to spn woofs* Occurrents and to
II reoussesa
Atnniurason
Id Imre regSnlOn IS :tit WC/gate and crxrect in me best of mytur
1St prOYGErCelermarg (nyOur puanca:on br motel recastratco tae
of the United Sates AnCroong/y are *Ably galsies conceals or covers up by
may be 'red up to S500.000 Or (Whored br rot more than Int (5) yews or
lardy or comeat a maknal lact orb) use a clocurrent I:nosing ii ccelains a false.
can B.,htect me 33 Dental prosecubh (49 USC g46336). and he
Use
il
sign.
next pr
o
be and add pageS) necessary.
ii)
SIGNATURE
DigitallySiled by RICHARD MUNKVOLD
id liwsunt
nEwspseetiS474sW
DATE 5- i 3 apt 1
TYPED/PRINTED
NAME
Richard Munkvold
CFO of Frontier Finance Co its Member
TITLE:
12)
SIGNATURE
DATE:
TYPEWPRINTED
NAME
TITLE
NOTE: Laced wten the most recent reirstration 44 the subject *craft 6 hares or cancelie4, 14 CI
31(c) provides In an wrivoriny
US. nut to be operated In up to 90 days wink the United States when a copy of the signed math reorstratetn application is carried
in the *craft while heading issuance and receipt 04 the new registration certificate.
AC Form IOWA t02/20)
Page I
EFTA00085968
Complete name of the Applicant:
State in which LLC is organized:
Statement in Support of Registration of a United States Civil Aircraft
in the Name of a Limited Liability Company
Industrial Intregrity Solutions. LLC
New Mexico
Effective date of formation of the LLC: October 7.2016
Name of each member of the LLC:
Name of Member:
James L Previti
Frontier Finance Co
Type of Entity
(ie: individual, corporation,
partnership, etc.)
Individual
California Corp.
(Please use additional sheets if additional space is required)
LLC is managed by:
If LLC is managed by
Name of Manageffs)
Officer(s)
0 Manager(s)
ember(s)
Manager(s)/Officer(s)
Intairaditt
(ie: individual, corporation,
partnership, etc.)
(Please use additional sheets if additional space is required)
Can the managers, members or officers of this LLC act independently?
Citizenship Verification
Y
YI:1
Officer(s)
NE
tin
U.S. Citizenship Verification
The undersigned certifies that the Applicant is a citizen of the United States since, to the best knowledge and
belief of the undersigned, at least 2/3rds of the managers, officers or managing members qualify as citizens of
the United States as defined in 49 U.S.C. 40101(aXI5) and at least 75% of the voting interest or units is owned
or controlled by persons who qualify as citizens of the United States as defined in 49 U.S.C. 40102(aXI5).
49 U.S.C. Section (aXI5): Citizen of the United States means: (I) An individual who is a citizen of the United
States or one of its possessions; or (2) A partnership of which each member is such an individual; or (3) A
corporation or association created or organized under the laws of the United States or of any State, Territory,
or possession of the United States, of which the president and 2/3 or more of the board of directors and other
managing officers thereof are such individuals and in which at least 75% of the voting interest is owned or
controlled by persons who are citizens of the United States or of one of its possessions.
If any member, officer or manager of the LLC is not a citizen of the United States as defined in U.S.C.
40102(aXI5) please attach an additional sheet for explanation to substantiate that the LLC qualifies as a citizen
of the United States.
RV
COW, FMnevral-
(title)
Dated.
5 -(2-a• I
EFTA00085969
Pursuant to that certain Aircraft Purchase Agreement, dated April 16
2021 (the
"Agreement"), by and between HYPERION AIR, LLC, a U.S. Virgin Islands limited liability
company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS, LLC, a New Mexico limited
liability company ("Purchaser"), for and in consideration of the sum of Ten Dollars ($10.00) and
other good and valuable consideration, the receipt and sufficiency of which are hereby
acknowledged by Seller, and being the owner of the full legal and beneficial title in and to that
certain used 2008 Keystone (Sikorsky) model S-76C++ helicopter, bearing manufacturer's serial
number 760750, and currently registered with the United States Federal Aviation Administration
(the "FAA") as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2
engines bearing Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics,
equipment systems, furnishings and accessories installed on, contained in or attached to said aircraft
and engines, all as is more particularly described on Exhibit A, and also including all airframe, engine
and accessory logbooks, flight and operation manuals, maintenance and overhaul records, and all
other records and paperwork relating to the above-described aircraft and engines in Seller's
possession (collectively, the "Aircraft"),
Seller does hereby grant, bargain, sell, convey, transfer and deliver unto Purchaser,
its successors and assigns, all of Seller's right, title and interest in and to the Aircraft.
Seller hereby warrants to Purchaser, its successors and assigns, that Seller is the
lawful full legal, record and beneficial owner of 100% of the Aircraft and that there is hereby
conveyed to Purchaser good and marketable title to the Aircraft, free and clear of any and all leases,
liens, claims, encumbrances and rights of third parties whatsoever, and Seller will warrant and
defend such title forever, at the sole expense of Seller, against all claims and demands whatsoever.
PRECEDING PARAGRAPH (THE "EXPRESS WARRANTIES"), THE AIRCRAFT AND
EACH PART THEREOF IS BEING SOLD TO PURCHASER HEREUNDER IN ITS "AS IS,
WHERE IS" CONDITION AND "WITH ALL FAULTS" EFFECTIVE AT THE CLOSING.
LIMITING
THE
GENERALITY
OF
THE
FOREGOING
DISCLAIMER
OF
[Signature on following page]
22
EFTA00085970
IN WITNESS WHEREOF, Seller has caused this Warranty Bill of Sale to be
executed by its duly authorized representative, this T' day of 01, 2021.
!Dig
by LARRY VISOSKI
By:
Name:
Lawrence Visoski
Title:
Manager
Date:
23
EFTA00085971
. -DEPA Vv.! Al
01 Rf‘fnbf
Suggested Format for Affidavit for Exemption of Aircraft Sold for
Removal from the State of Florida by a Nonresident Purchaser
GT-500002
The following is a suggested format of an affidavit to be completed by the purchaser and furnished to the
selling dealer. In order to satisfy the requirements for exemption, the affidavit must contain all of this
information and be completed in full.
Florida
Broward
STATE OF
COUNTY OF
N. 05/02
*** READ CAREFULLY BEFORE SIGNING '
Before me this day appeared the affiant named below, who being duly sworn, states that:
1. I have read Rule 12A-1.007(10), Florida Administrative Code, and § 212.05, Florida Statutes; and
2. I am not a resident of the State of Florida and did not make my permanent place of abode in Florida at the
time of taking delivery of the aircraft described below; and
3. I am not engaged in Florida in any employment, trade, business, or profession for which the described aircraft
will be used in Florida; and
4. I do not represent a corporation which has any officer or director who is a resident of Florida, or makes his
or her permanent place of abode in Florida; and
5. I do not represent an artificial entity other than a corporation which has any individual vested with authority to
participate in the management, direction, or control of the affairs of the entity who is a resident of Florida or
makes his or her permanent place of abode in Florida; and
6. I agree to furnish the Florida Department of Revenue (within 30 days of the date of departure) written proof
that this aircraft was licensed, titled, or registered outside Florida; and
7. I agree to furnish the Florida Department of Revenue (within 10 days of the date of departure) invoices for
fuel, tie-down or hangar charges, repairs, or other similar documentation issued by an out-of-state vendor or
supplier which identifies this aircraft and its timely removal (including the FAA registration number).
Industrial Integrity Solutions, LLC
Name of purchaser
SSN
If purchaser is a corporation or partnership, list officers or partners
Purchaser's permanent address (Street)
(City)
(State/Country)
(ZIP)
Purchaser's daytime telephone number (
)
D.O.B.
Purchaser's driver's license number and state of issuance
Purchaser's passport or visa number
Name of selling dealer or broker
Address of selling dealer (Street)
(City)
(State/Country)
(ZIP)
Selling dealer or broker's Florida certificate of registration number
Selling dealer or broker's telephone number (
Date of sale (Month)
MAY
(Day) 1
(Year)
2021
N/A
(continued on reverse side)
EFTA00085972
Description of Aircraft
Make
Serial number
760750
FAA registration number
N722JE
(Check one)
New 0
Used ill)
Purchase
Net purchase
price $
1 .800.000.00
Trade-in $
price $
Primary location of aircraft while in Florida
KFXE AIRPORT
SIKORSKY
Model
S76C++
Year
2008
I claim exemption from Florida sales and use tax on the purchase price of the aircraft described herein under
s. 212.05(1)(a)2, Florida Statutes. for the following reason (check one):
U
The aircraft will be removed from Florida within 10 days of the date of purchase.
(21
The aircraft requires repairs, additions, or alterations and it will immediately be taken to a repair facility and
will be removed from Florida within 20 days (excluding tolled days) after completion of the work.
Under penalty of perjury, I declare that I have read the foregoing and the facts alleged are true to the best of my
knowledge and belief. I understand that if I fail to comply with the requirements of this affidavit, I will be liable for
payment of the tax and a mandatory penalty equal to the tax.
Sworn to (or affirmed) and subscribed before me this day of
Signature of Notary
Print, type, or stamp name of Notary
Personally known
U
Produced identification
Type of Identification:
Sii>
i'
laure of affiant/purchaser
Distribution of Do• monts
69
(mil'
rek
cec
The original affidavit and a copy of the sales invoice, bill of sale, or closin
ocument must be sent to the Florida
Department of Revenue. Aircraft Enforcement Unit, P.O. Box 6417, Tallahass
FL 32314-6417 within five (5) days of the
date of sale.
A copy of the affidavit must be retained by the selling dealer and made a part of the de
The selling dealer or broker should provide the purchaser with a copy.
Notice To Dealers
s records.
Affidavits not filed within five (5) days of the date of sale may not be accepted by the Department o
evenue and
the selling dealer or broker may be billed for tax, penalty, and interest due.
EFTA00085973
ACKNOWLEDGMENT
A notary public or other officer completing this
certificate verifies only the identity of the individual
who signed the document to which this certificate is
attached, and not the truthfulness, accuracy, or
vafiditatof that document.
State of California
County of aNIk ek4AIWintsn)
on mAti 1 1 imni
before meausw GatuA. Gotnagt,nliniPti•ut.
(insert name and title of the officer)
personally appeared 1?---1CA4Al2X> AUK' --t/ our)
who proved to me on the basis of satisfactory evidence to be the personforlwhose nameAel is/0
subscribed to the within instrument and acknowledged to me that he/sire/34y executed the same in
his/Defipeir authorized capacity(jfl), and that by his/0146r signaturecier on the instrument the
personf,sor or the entity upon behalf of which the persoracted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct.
WITNESS my hand and official seal.
Signature
COMM. #2353114
z
Notary Public • California 43
INvorstde County
—
Ca
Mat. V 202S
".••••
•.
EFTA00085974
2008 KEYSTONE (SIKORSKY) S-76Ot-f HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Pursuant to provisions of that certain Aircraft Purchase Agreement dated April 11,9,2021 (the
"Agreement") by and between HYPERION AIR, LLC, a U.S. Virgin Islands limited liability
company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS, LLC, a New Mexico limited
liability company ("Purchaser"), Purchaser hereby acknowledges the delivery and acceptance of one
used 2008 Keystone (Sikorsky) model S-76C-H- helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA")
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft").
(Or
Purchaser accepts the Aircraft at I •
ArA
Pa., on Int..
i3, 2021 in an "As
Is, Where Is" condition and "With all Faults" at FortLauderdale Executive airport KFXE , Florida and
subject to the waivers and disclaimers set forth in the Agreement.
2641.9
hours
TOTAL TIME ON ENGINES AT DELIVERythal
Engine No. 1 (MSN 42285TEC):
2641.9
Cycle N1.3652 6 / N2.3188 2 hours/cycles
Engine No. 2 (MSN 42286TEC):
2641.9 Cycles N I 4879 7 N2.3197 4 hours/cycles
5472
INDUSTRIAL INTE
TIONS, LLC
By:
Name:
ecia.4.5 MP. ar4412"
)
Title:
eco
Date:
5-i 3- Z. 1
25
EFTA00085975
Phone:
Outside the US:
Fax:
DATE MCIM
I Wit
Re: Keystone Helicopter S-76C, N722JE, SN: 760750
O
Or
'coy'
r7-
Do
=Ft
%
ve
so.
-se
--
1/4..,
xs
—n
n-i
7:::
irn
cn Tv cr,
—ipci
"7:10_
•,, -CA
--ip.=
T
Ladies and Gentlemen:
C.)
=
•-•-I -It
=
),
3>
OP
1:3.
We are enclosing the following documents for your review and recordation:
--4
•-<
ci
-0
7a
Bill of sale
Seller: Hyperion Air LLC
Purchaser: Industrial Integrity Solutions, LLC
Aircraft registration application by Industrial Integrity Solutions, LLC
LLC support statement by Industrial Integrity Solutions, LLC
Please record the certified copies of the documents and return recorded originals and/or digitally signed
recorded documents and ORIGINAL REGISTRATION CERTIFICATE to AIC Title Service in the Public
Documents Room. If for any reason you find any of these documents to be unacceptable for recordation
or not needed for FAA records, please return them to AIC Title Service, LLC in the Public Documents
Room.
Sincerely,
Melidsou Kabala-
Melissa Koboldt
AIC Title Service, LLC Staff
FAA FEE: $5.00
Filing time
EFTA00085976
DEPARTMENT OF TFtAhtSPORTATION - FEDERAL AVIATION AltrateST RADON
This cerbficate
must be in the al/-
craft wnen operated.
NATIONALITY AND
REGISTRATION MARKS N 722JE
7607$0
S- 76C
ICAO Aircraft AddresS Cade
52325707
I
S
S
U
E
D
T
0
S LLC
ill
LLC
This onto:MP
"sued for
registrabon potholes
only and is not e
ceitillcate of bee.
The Federal Awation
Admubstration does
not detemNne noMs
of parsnip as
between covets
persons.
U S Department
of Transportation
Federal Aviation
A 4 certified that the above descnbed aircraft has been entered on the register of the Federal
Anton AdmatiStrabOn, Undid States of America. if 1 accordance with the Convention on
Intemalmnal CM Aviation dated December 7. 1944. and with Tale 49. United States Code,
and regulations issued thereunder.
DATE OF ISSUE
July 30. 2021
EXPIRATION DATE July 31, 2024
itt l'
Administration
:/
I d
ADMINISTRATOR
V
pr..w ear'
S
a
U.S. Department
of Transportation
Federal Aviation
Administration
CM Amber, Regstry
P.O. 80x 25504
Odshonts Cot OK Tat 25450A
audal OusIness
Pauly lee Rivets UN WO
AC Fans e00341101010)Supenedire erratum edition
722JE
TO:
S LLC
EFTA00085977
Title 49 U. S. C. 44103(cK2) provides *A certificate of registrabon issued under this isogon is not ew0ence of
ownership of aircraft in a proceeding in which ownership is or may be in Issue? THIS CERTIFICATE MUST BE
SIGNED AND RETURNED BY THE REGISTERED OWNER WITHIN 21 DAYS WHEN IT IS NO LONGER IN
EFFECT FOR ANY REASON UNDER 14 C.F.R. 47.41(aX1) through (7). Registration is canceled HIM
request of the owner for one of the following reasons (Must check and/or compete Blocs a b c. d of e).
a. O The aircraft is totally destroyed
or scrapped.
b. O United States citizenship has
been lost. or the owners status as
a resident alien has changed
(unless changed to Mat ci a U.S. Man).
c K Thirty days have elapsed VACS the
death of the registered owner
(estate representative should sign)
d.
The aircraft is to be registered
under the laws of a foreign country
(NAME OF FOREIGN COUNTRY)
(SIGNATURE)
e. O The ownership of the aircraft is
transferred to
(NAME)
(ADDRESS)
(CITY. STATE. ZIP)
(TITLE)
(DATE)
This certificate must be returned to
NRORAFT REGISTRATION BRANCH. P.O. BOX 25504. OKLAHOMA CITY. OKLAHOMA 73125-0504
Federal AyillbOn Regulations require that the registered owner of the
aircraft shall report in writing within 30 day* any change in permanent
mailing address. A revised Certificate of Registration will be issued
without charge. The APoicaten for Registration AC Form 8050-1 may
be used to report a change of address.
If this certificate is lost destroyed or mutilated, a replacement may
be obtained al the written request of the NOlder. Send your request
and 32.00 replacement fee (check or money order made payable to tbe
Federal Aviation Administration) to
Aircraft Registration Branch
P O 8ox 25504
Oklahoma City. Oidahorne 73125-0504
NOTE Al correspondence should include the registration NiNumber.
manufacturer, model and serial number of the aircraft
To offer your feedback regarding the aircraft registration profess.
please visit our websse at http /'registry faa govarcert/
EFTA00085978
SIKORSKY
SIKORSKY COMMERCIAL INC*
USA
Page 1 of 1
Invoice Number: 8117788
Invoice Date: February 04, 2021
Customer No.
301290
Sales Order
Sales Order Date Customer Contract or P/O No.
22278585
February 04, 2021 S76D12297PAP
Remit To: SIKORSKY COMMERCIAL INC
EFT/ACH/WIRE
Ultimate
End User:
USA
Ship Tu;
payment a lit HYPERION AIR. LLC
Be made by:
Amer.Virgin Is.
Terms: Net 30 days
Shipped from: • on: Via: CAU Bill of Lading: ITA:,eller. place
AMER.VIRGIN IS.
Airway Bill Number:
Items Stock/Parts
Description
Condition
76C_MAIN_GEAR_BOX
76C_Main
_Gear Box
Ct
SN 760750
- r
t.
76C_INTER_GEAR_BOX 76C_Inte
r Gear Box
AIRCRAFT SN 760750
Reporting Date: December 31. 2020
76C_TAIL_GEAR_DOX
76C_Tail
Gear Box
AIRCRAFT SN 760750
Reporting Date: December 31, 2020
sgi m
t
itit •
Init UnitPrice0USDI
NetAmountalSDI
8.30
EA
137.49
1,141.17
8.30
EA
9.24
76.69
8.30
EA
18.48
153.38
SUBTOTAL:
1,371.24
TAXES:
0.00
NET TOTAL:
1,371.24
1,371.24
'Sikorsky Commercial. Inc. is a registered trade name of Helicopter suppon. inc. (also referred to as "t St") in the Connecticut 'ovens of Shelton. North Haven. Stratford
and Trumbull. and a registered fictitious name of Helicopter Support. Inc. in the State of Maryland and the Commonwealth of Pennsylvania
EFTA00085979
This FIRST AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT (this
"Amendment") is made and entered into as of the 20111 day of April, 2021 (the "Effective Date"),
by and between Hyperion Air, LLC ("Seller") and Industrial Integrity Solutions, LLC
("Purchaser"), and amends that certain Aircraft Purchase Agreeement by and between Seller and
Purchaser entered into as of April 16, 2021 (the "Agreeement") governing the purchase and the
sale of that certain 2008 Keystone Helicopter (Sikorsky) model S-76C++ aircraft, bearing
manufacturer's serial number 760750. and currently registered with the United States Federal
Aviation Administration as N722JE (the "Aircraft"). All capitalized terms used but not otherwise
defined herein shall have the meanings ascribed to those terms in the Agreement.
WHEREAS, Section 4(a) of the Agreement provides in relevant part that ". . .in no event
shall the Closing take place later than April 20, 2021 (the "Closing Date")";
WHEREAS, the Parties desire to extend the April 20, 2021 Closing deadline provided for in
Section 4(a) until May 7, 2021, so that May 7, 2021 is the absolute latest date by which Purchaser
must close under the Agreement;
NOW, THEREFORE, in consideration of these premises and the mutual covenants and
agreements herein contained, the parties agree as follows:
1.
Section 4(a) of the Agreement is hereby amended in its entirety to read as follows:
(a) The closing of this transaction ("the Closing") and delivery of the
Aircraft to Purchaser shall take place at Fort Lauderdale Executive Airport KFXE, Florida
("the Closing Place") by not later than the Closing Date (as hereinafter defined), unless the
parties subsequently agree upon a later date in writing, in which case such agreed upon
date shall be deemed the "Closing Date". The Closing shall take place promptly after: (i)
Purchaser's delivery of the Certificate of Technical Acceptance indicating Purchaser's
Unconditional Acceptance of the Aircraft in accordance with Sections 3(f) and (h) hereof;
and (2) confirmation from the Escrow Agent that the Escrow Agent has received the
Purchase Price Balance from Purchaser and all Escrow Documents (as defined below), but
in no event shall the Closing take place later than May 7, 2021 (the "Closing Date"). Seller
and Purchaser hereby acknowledge that the passing of title, possession and delivery of the
Aircraft shall take place within the state in which the Closing Place is located. The fuel
costs and the expenses of Seller's flight crew, if any, in flying the Aircraft from the
Inspection Facility to the Closing Place shall be the sole responsibility of and paid for by
Purchaser.
2.
In the event of any inconsistencies between the provisions of the Agreement and
the provisions of this Amendment, the provisions of this Amendment shall control in all respects.
Except as expressly amended hereby, the provisions of the Agreeement shall remain unchanged,
valid and in full force and effect.
EFTA00085980
3.
This Amendment may be fully executed in separate counterparts by each of the
parties hereto. Any signatures on this Amendment may be transmitted via facsimile or e-mail (in
pdf format), which signatures shall be deemed originals for all purposes.
IN WITNESS WHEREOF, the parties hereto have executed this FIRST
AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT as of the day and year first
written above.
Seller:
Hyperion Air, LLC
By:
XILAM/.4.A...
Print: Darren Indyke
Title: Authorized Representative
Purchaser:
Industrial Integrity Solutions, LLC
By:
Print: Rick Munkvold
Title: Chief Financial Officer
2
EFTA00085981
This FIRST AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT (this
"Amendment") is made and entered into as of the 20111 day of April, 2021 (the "Effective Date"),
by and between Hyperion Air, LLC ("Seller") and Industrial Integrity Solutions, LLC
("Purchaser"), and amends that certain Aircraft Purchase Agreeement by and between Seller and
Purchaser entered into as of April 16, 2021 (the "Agreeement") governing the purchase and the
sale of that certain 2008 Keystone Helicopter (Sikorsky) model S-76C++ aircraft, bearing
manufacturer's serial number 760750. and currently registered with the United States Federal
Aviation Administration as N722JE (the "Aircraft"). All capitalized terms used but not otherwise
defined herein shall have the meanings ascribed to those terms in the Agreement.
WHEREAS, Section 4(a) of the Agreement provides in relevant part that ". . .in no event
shall the Closing take place later than April 20, 2021 (the "Closing Date")";
WHEREAS, the Parties desire to extend the April 20, 2021 Closing deadline provided for in
Section 4(a) until May 7, 2021, so that May 7, 2021 is the absolute latest date by which Purchaser
must close under the Agreement;
NOW, THEREFORE, in consideration of these premises and the mutual covenants and
agreements herein contained, the parties agree as follows:
1.
Section 4(a) of the Agreement is hereby amended in its entirety to read as follows:
(a) The closing of this transaction ("the Closing") and delivery of the
Aircraft to Purchaser shall take place at Fort Lauderdale Executive Airport KFXE, Florida
("the Closing Place") by not later than the Closing Date (as hereinafter defined), unless the
parties subsequently agree upon a later date in writing, in which case such agreed upon
date shall be deemed the "Closing Date". The Closing shall take place promptly after: (i)
Purchaser's delivery of the Certificate of Technical Acceptance indicating Purchaser's
Unconditional Acceptance of the Aircraft in accordance with Sections 3(f) and (h) hereof;
and (2) confirmation from the Escrow Agent that the Escrow Agent has received the
Purchase Price Balance from Purchaser and all Escrow Documents (as defined below), but
in no event shall the Closing take place later than May 7, 2021 (the "Closing Date"). Seller
and Purchaser hereby acknowledge that the passing of title, possession and delivery of the
Aircraft shall take place within the state in which the Closing Place is located. The fuel
costs and the expenses of Seller's flight crew, if any, in flying the Aircraft from the
Inspection Facility to the Closing Place shall be the sole responsibility of and paid for by
Purchaser.
2.
In the event of any inconsistencies between the provisions of the Agreement and
the provisions of this Amendment, the provisions of this Amendment shall control in all respects.
Except as expressly amended hereby, the provisions of the Agreeement shall remain unchanged,
valid and in full force and effect.
EFTA00085982
3.
This Amendment may be fully executed in separate counterparts by each of the
parties hereto. Any signatures on this Amendment may be transmitted via facsimile or e-mail (in
pdf format), which signatures shall be deemed originals for all purposes.
IN WITNESS WHEREOF, the parties hereto have executed this FIRST
AMENDMENT TO AIRCRAFT PURCHASE AGREEMENT as of the day and year first
written above.
Seller:
Hyperion Air, LLC
By:
XILAM/.4.A...
Print: Darren Indyke
Title: Authorized Representative
Purchaser:
Industrial Integrity Solutions, LLC
By:
Print: Rick Munkvold
Title: Chief Financial Officer
2
EFTA00085983
It is required by law to provide you with certain disclosures and information about the
products, services or accounts you may receive or access in connection with your relationship
with us ('Required Information'). With your consent, we can deliver Required Information to
you by a) displaying or delivering the Required Information electronically; and b) requesting
that you print or download the Required Information and retain it for your records.
This notice contains important information that you are entitled to receive before you
consent to electronic delivery of Required Information. Your consent also permits the general
use of electronic records and electronic signatures in connection with the Required
Information.
After you have read this information, if you agree to receive Required Information from us
electronically, and if you agree to the general use of electronic records and
electronic signatures in connection with our relationship, please click the 'ACCEPT' button.
Statement of electronic disclosures:
You may request to receive Required Information on paper, but if you do not consent
to electronic delivery of Required Information, we cannot proceed with the acceptance
and processing to create a relationship with you in connection to the products,
services or account.
If you consent to electronic delivery of Required Information, you may withdraw that
consent at any time. However, if you withdraw your consent we will not be able to
continue processing to create a relationship with you in connection to the products,
services or account.
If you consent to electronic disclosures, that consent applies to all Required Information
we give you or receive from you in connection with our relationship and the associated
notices, disclosures, and other documents.
You agree to print out or download Required Information when we advise you to do so
and keep it for your records. If you are unable to print or download any Required
Information, you may call us and request paper copies. If you need to update your e-mail
address or other contact information with us, you may do so by calling us and
requesting the necessary updates.
If you wish to withdraw your consent to electronic disclosures, you may do so by calling
us and requesting withdrawal of consent. After consenting to receive and deliver
Required Information electronically, you may request a paper copy of the Required
Information by calling us.
EFTA00085984
If you do not have the required software and/or hardware, or if you do not wish to use
electronic records and signatures for any other reason, you can request paper copies of the
Required Information to be sent to you by calling us.
Your consent does not mean that we must provide the Required Information electronically.
We may, at our option, deliver Required Information on paper. We may also require that
certain communications from you be delivered to us on paper at a specified address.
I have read the information about the use of electronic records, disclosures,
notices, and e-mail, and consent to the use of electronic records for the
delivery of Required Information in connection with our relationship. I have
been able to view this information using my computer and software. I have
an account with an internet service provider, and I am able to send e-mail and
receive e-mail with hyperlinks to websites and attached files. I also consent to
the use of electronic records and electronic signatures in place of written
documents and handwritten signatures.
EFTA00085985
It is required by law to provide you with certain disclosures and information about the
products, services or accounts you may receive or access in connection with your relationship
with us ('Required Information'). With your consent, we can deliver Required Information to
you by a) displaying or delivering the Required Information electronically; and b) requesting
that you print or download the Required Information and retain it for your records.
This notice contains important information that you are entitled to receive before you
consent to electronic delivery of Required Information. Your consent also permits the general
use of electronic records and electronic signatures in connection with the Required
Information.
After you have read this information, if you agree to receive Required Information from us
electronically, and if you agree to the general use of electronic records and
electronic signatures in connection with our relationship, please click the 'ACCEPT' button.
Statement of electronic disclosures:
You may request to receive Required Information on paper, but if you do not consent
to electronic delivery of Required Information, we cannot proceed with the acceptance
and processing to create a relationship with you in connection to the products,
services or account.
If you consent to electronic delivery of Required Information, you may withdraw that
consent at any time. However, if you withdraw your consent we will not be able to
continue processing to create a relationship with you in connection to the products,
services or account.
If you consent to electronic disclosures, that consent applies to all Required Information
we give you or receive from you in connection with our relationship and the associated
notices, disclosures, and other documents.
You agree to print out or download Required Information when we advise you to do so
and keep it for your records. If you are unable to print or download any Required
Information, you may call us and request paper copies. If you need to update your e-mail
address or other contact information with us, you may do so by calling us and
requesting the necessary updates.
If you wish to withdraw your consent to electronic disclosures, you may do so by calling
us and requesting withdrawal of consent. After consenting to receive and deliver
Required Information electronically, you may request a paper copy of the Required
Information by calling us.
EFTA00085986
If you do not have the required software and/or hardware, or if you do not wish to use
electronic records and signatures for any other reason, you can request paper copies of the
Required Information to be sent to you by calling us.
Your consent does not mean that we must provide the Required Information electronically.
We may, at our option, deliver Required Information on paper. We may also require that
certain communications from you be delivered to us on paper at a specified address.
I have read the information about the use of electronic records, disclosures,
notices, and e-mail, and consent to the use of electronic records for the
delivery of Required Information in connection with our relationship. I have
been able to view this information using my computer and software. I have
an account with an internet service provider, and I am able to send e-mail and
receive e-mail with hyperlinks to websites and attached files. I also consent to
the use of electronic records and electronic signatures in place of written
documents and handwritten signatures.
EFTA00085987
(TOTAL BUSINESS CHECKING)
P MORGAN CHASE
WIRE ACCOUNT #:
ROUTING#:
SWIFT CODE:
EFTA00085988
OneSpanocr-
OneSpan Sign Electronic Evidence Summary
Signing Ceremony ID:
ID:
Name:
Created:
Completed:
Summary document generated:
Sender:
Name:
Documents:
Electronic Disclosures and Signatures Consent
N722JE N722JE BOS (FInWSCn)
N722JE WBOS
OneSpan Sign Electronic Evidence Summary
Recipients:
Name:
Email:
Role:
ID:
Name:
Email:
Role:
ID:
Electronic Disclosures and Signatures Consent
N722JE N722JE BOS (FInWSCn)
N722JE WBOS
Name:
Email:
Role:
ID:
Audit Trail:
fcb4Y4hMWofiPY2i5Tjg62n-P38=
N722JE N722JE BOS (FInWSCn)
2021-May-0617:14:44 (GMTZ) GMT
2021-May-06 19:51:34 (GMTZ) GMT
2021-May-06 19:51:36 (GMTZ) GMT
Melissa Koboldt
2 pages
1 page
2 pages
2 pages
Melissa Koboldt
Owner
42EC2utgPCID
LARRY VISOSKI
Larry_Visoski
Larry_Visoski
1 accept
1 signature
1 signature
DARREN INDYKE
Darren_Indyke_FcipTcON
Darren_Indyke_FqpRON
Copyright 2021, OneSpan. All Rights Reserved.
EFTA00085989
Date and Time
Recipient
Action
Document
IP
Other
2021-May-06 17:40:01 (GMTZ) GMT
LARRY VISOSKI
Signing Session
For Recipient
N/A
174.194.139.168
Signing session
for recipient:
LARRY VISOSKI)
2021-May-06 17:40:11 (GMTZ) GMT
LARRY VISOSKI
View
Electronic
Disclosures and
Signatures
Consent
174.194.139.168
2021-May.06 17:42:36 (GMTZ) GMT
LARRY VISOSKI
Accept
Electronic
Disclosures and
Signatures
Consent
174.194.139.168
Approval:
8e8k72a-d851-
47ec-bf2a-
f81d7ac10f67
2021-May-06 17:42:37 (GMTZ) GMT
LARRY VISOSKI
Confirm
Electronic
Disclosures and
Signatures
Consent
174.194.139.168
2021-May-0617:42:47(GMTZ)GMT
LARRY VISOSKI
View
N722JEN722JE
BOS (FInWSCn)
174.194.139.168
2021-May-0617:44:04 (GMTZ) GMT
LARRY VISOSKI
Click To Sign
N722JE N722JE
BOS (FInWSCn)
174.194.139.168
Approval:
XiW1KrixDUP8U
2021-May-06 19:47:50 (GMTZ) GMT
LARRY VISOSKI
Signing Session
For Recipient
N/A
174.195.144.56
Signing session
for recipient:
LARRY VISOSKI)
2021-May.06 19:47:53 (GMTZ) GMT
LARRY VISOSKI
View
N722JEN722JE
BOS (FInWSCn)
174.195.144.56
2021-May-06 19:50:49 (GMTZ) GMT
LARRY VISOSKI
Signing Session
For Recipient
N/A
64.183.118.170
Signing session
for recipient:
LARRY VISOSKI)
2021-May-06 19:50:55 (GMTZ) GMT
LARRY VISOSKI
View
N722JEN722JE
BOS (FInWSCn)
64.183.118.170
2021-May-06 19:51:17 (GMTZ) GMT
LARRY VISOSKI
Confirm
N722JE N722JE
BOS (FInWSCn)
64.183.118.170
2021-May-0619:51:22 (GMTZ) GMT
LARRY VISOSKI
View
N722JE WOOS
64.183.118.170
2021-May-0619:51:30 (GMTZ) GMT
LARRY VISOSKI
Click To Sign
N722JE WBOS
64.183.118.170
Approval:
vDOPyjwicisUO
2021-May-0619:51:34 (GMTZ) GMT
LARRY VISOSKI
Confirm
N722JE WOOS
64.183.118.170
Copyright 2021. OneSpan. All Rights Reserved.
EFTA00085990
EXHIBIT C
TO
Certificate of Technical Accentance
2008 KEYSTONE (SIKORSKY) S-76014 HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Reference is made to the provisions of Sections 3(f) and (h) of the Aircraft Purchase
Agreement dated April /4,, 2021 (the "Agreement") by and between HYPERION AIR, LLC, a U.S.
Virgin Islands limited liability company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS,
LLC, a New Mexico limited liability company ("Purchaser"), relating to the purchase and sale of one
used 2008 Keystone (Sikorsky) model S-76C++ helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA')
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft"). Capitalized terms used but not otherwise defined in this Certificate shall have the meanings
ascribed to such terms in the Agreement. This is to Certify as follows:
Unconditional Acceptance:
Purchaser hereby certifies that Purchaser has completed its Pre-Purchase Inspection of the
Aircraft in accordance with the provisions of the Agreement on the date written below, and Purchaser
has Technically Accepted the Aircraft in its "as is", "where-is" and "with all faults" condition. The
Deposit has become non-refundable and may be disbursed only as and when provided in the
Agreement. This confirmation constitutes Purchaser's Unconditional Acceptance as provided in
Sections 3(f) and (h) of the Agreement;
Dated:
LUTIONS, LLC
B
Name: tomee insaglielea
Title: ea
19
EFTA00085991
EXHIBIT C
TO
Certificate of Technical Accentance
2008 KEYSTONE (SIKORSKY) S-76014 HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Reference is made to the provisions of Sections 3(f) and (h) of the Aircraft Purchase
Agreement dated April /4,, 2021 (the "Agreement") by and between HYPERION AIR, LLC, a U.S.
Virgin Islands limited liability company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS,
LLC, a New Mexico limited liability company ("Purchaser"), relating to the purchase and sale of one
used 2008 Keystone (Sikorsky) model S-76C++ helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA')
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft"). Capitalized terms used but not otherwise defined in this Certificate shall have the meanings
ascribed to such terms in the Agreement. This is to Certify as follows:
Unconditional Acceptance:
Purchaser hereby certifies that Purchaser has completed its Pre-Purchase Inspection of the
Aircraft in accordance with the provisions of the Agreement on the date written below, and Purchaser
has Technically Accepted the Aircraft in its "as is", "where-is" and "with all faults" condition. The
Deposit has become non-refundable and may be disbursed only as and when provided in the
Agreement. This confirmation constitutes Purchaser's Unconditional Acceptance as provided in
Sections 3(f) and (h) of the Agreement;
Dated:
LUTIONS, LLC
B
Name: tomee insaglielea
Title: ea
19
EFTA00085992
EXHIBIT C
TO
Certificate of Technical Accentance
2008 KEYSTONE (SIKORSKY) S-76014 HELICOPTER
Manufacturer's Serial No. 760750
U.S. Registration No. N722JE
Reference is made to the provisions of Sections 3(f) and (h) of the Aircraft Purchase
Agreement dated April /4,, 2021 (the "Agreement") by and between HYPERION AIR, LLC, a U.S.
Virgin Islands limited liability company ("Seller"), and INDUSTRIAL INTEGRITY SOLUTIONS,
LLC, a New Mexico limited liability company ("Purchaser"), relating to the purchase and sale of one
used 2008 Keystone (Sikorsky) model S-76C++ helicopter, bearing manufacturer's serial number
760750, and currently registered with the United States Federal Aviation Administration (the "FAA')
as N722JE, together with said aircraft's two (2) Turbomeca S.A. model Arriel 2S2 engines bearing
Manufacturer's Serial Nos. 42285TE and 42286TEC, and with all avionics, equipment systems,
furnishings and accessories installed on, contained in or attached to said aircraft and engines, all as is
more particularly described on Exhibit A, and also including all airframe, engine and accessory
logbooks, flight and operation manuals, maintenance and overhaul records, and all other records and
paperwork relating to the above-described aircraft and engines in Seller's possession (collectively, the
"Aircraft"). Capitalized terms used but not otherwise defined in this Certificate shall have the meanings
ascribed to such terms in the Agreement. This is to Certify as follows:
Unconditional Acceptance:
Purchaser hereby certifies that Purchaser has completed its Pre-Purchase Inspection of the
Aircraft in accordance with the provisions of the Agreement on the date written below, and Purchaser
has Technically Accepted the Aircraft in its "as is", "where-is" and "with all faults" condition. The
Deposit has become non-refundable and may be disbursed only as and when provided in the
Agreement. This confirmation constitutes Purchaser's Unconditional Acceptance as provided in
Sections 3(f) and (h) of the Agreement;
Dated:
LUTIONS, LLC
B
Name: tomee insaglielea
Title: ea
19
EFTA00085993
tYr.PARTMENT
Of RIVENUf
Suggested Format for Affidavit for Exemption of Aircraft Sold for
Removal from the State of Florida by a Nonresident Purchaser
GT500002
The following is a suggested format of an affidavit to be completed by the purchaser and furnished to the
selling dealer. In order to satisfy the requirements for exemption, the affidavit must contain all of this
information and be completed in full.
Florida
STATE OF
COUNTY OF
Broward
*** READ CAREFULLY BEFORE SIGNING
Before me this day appeared the affiant named below, who being duly sworn, states that:
1. I have read Rule 12A-1.007(10), Florida Administrative Code, and § 212.05, Florida Statutes; and
2. I am not a resident of the State of Florida and did not make my permanent place of abode in Florida at the
time of taking delivery of the aircraft described below; and
-3. I am not engaged in Florida in any employment, trade, business, or profession for which the described aircraft
will be used in Florida; and
4. I do not represent a corporation which has any officer or director who is a resident of Florida, or makes his
or her permanent place of abode in Florida; and
5. I do not represent an artificial entity other than a corporation which has any individual vested with authority to
participate in the management, direction, or control of the affairs of the entity who is a resident of Florida or
makes his or her permanent place of abode in Florida; and
6. I agree to furnish the Florida Department of Revenue (within 30 days of the date of departure) written proof
that this aircraft was licensed, titled, or registered outside Florida; and
7. I agree to furnish the Florida Department of Revenue (within 10 days of the date of departure) invoices for
fuel, tie-down or hangar charges, repairs, or other similar documentation issued by an out-of-state vendor or
supplier which identifies this aircraft and its timely removal (including the FAA registration number).
N. 05/02
Name of purchaser
Industrial Integrity Solutions, LLC
SSN
***
If purchaser is a corporation or partnership, list officers or partners
T.I.N.
Purchaserssint address (Street)
(City)
(State/Country)
U
(ZIP)
Purchaser's daytime telephone number (W
)
D.O.B.
Purchaser's driver's license number and state of issuance
Purchaser's passport or visa number
Name of selling dealer or broker
Address of selling dealer (Street)
(City)
(State/Country)
(ZIP)
Selling dealer or broker's Florida certificate of registration number
Selling dealer or brokers telephone number (
Date of sale (Month)
MAY
(Day)
(Year)
2021
N/A
(continued on reverse side)
EFTA00085994
Description of Aircraft
SIKORSKY
S76C++
Make
Model
Year
2008
Serial number
760750
FAA registration number
N722JE
(Check one)
New C:l
Used 51
Purchase
Net purchase
price S
1,800,000.00
Trade-in $
price $
Primary location of aircraft while in Florida
KFXE AIRPORT
I claim exemption from Florida sales and use tax on the purchase price of the aircraft described herein under
s. 212.05(1)(a)2, Florida Statutes, for the following reason (check one):
O
The aircraft will be removed from Florida within 10 days of the date of purchase.
i
The aircraft requires repairs, additions, or alterations and it will immediately be taken to a repair facility and
will be removed from Florida within 20 days (excluding tolled days) after completion of the work.
Under penalty of perjury, I declare that I have read the foregoing and the facts alleged are true to the best of my
knowledge and belief. I understand that if I fail to comply with the requirements of this affidavit, I will be liable for
payment of the tax and a mandatory penalty equal to the tax.
Signature of affiant/purchaser
Sworn to (or affirmed) and subscribed before me this day of
Signature of Notary
Print, type, or stamp name of Notary
O Personally known
O Produced identification
Type of Identification:
Distribution of Documents
The original affidavit and a copy of the sales invoice, bill of sale, or closing document must be sent to the Florida
Department of Revenue, Aircraft Enforcement Unit, P.O. Box 6417, Tallahassee FL 32314-6417 within five (5) days of the
date of sale.
A copy of the affidavit must be retained by the selling dealer and made a part of the dealer's records.
The selling dealer or broker should provide the purchaser with a copy.
Notice To Dealers
Affidavits not filed within five (5) days of the date of sale may not be accepted by the Department of Revenue and
the selling dealer or broker may be billed for tax, penalty, and interest due.
EFTA00085995
Si.
BANYAN
WE THANK YOU FOR YOUR BUSINESS!
34211
I
HYPERION AIR
L
L
T
O
ACCOUNT SUMMARY
PAGE NUMBER
DATE
05/06/21 19:05
Department
Date
I Invoice #
I Aircraft
I
Document I Reference
I Invoice Amount
I Amount Paid I
Balance Due
21 - FXE NORTH SIDE
3/01/21
1872671
N722JE
572704
LT 572704
2,675.00
.0D
2,675.00
21 - FXE NORTH SIDE
4/01/21
1879381
N722JE
S76361
LT 576361
2,675.00
.03
2,675.00
21 - FXE NORTH SIDE
5/01/21
1886068
N722JE
579934
LT 579934
2,675.00
.0D
2,675.00
21 - FXE NORTH SIDE
5/06/21
1887298
N722JE
580645
LT 580645
2,675.00CR
.03
2,675.00CR
20 - CUSTOMER SUPPORT
5/06/21
1887299
N722JE
580646
LT 580646
1,551.50
.03
1,551.50
21 - FXE NORTH SIDE
5/06/21
1887302
N722JE
580003
LT 580003
75.00
.00
75.00
Total:
6,976.50
Mail To: 5360 NW 20th Terrace • Ship To: 5323 NV,' 23th Terrace • Fort Lc:Joey:ale Execcit ve Airport • Florida 33309 • 954 4913
• 954
C281
• 'my, banyartar coo,
EFTA00085996
B
34211
I HYPERION AIR
L
L
0
s
34211
x --LPERION AIR
I
P
0
*ilk
BANIAIN
LINE TICKET:
020/580646
PAGE NUMBER
3.
DOCUMENT NUMBER
1887299
DATE
5/06/21
Registration
: N722JE
Make
: S76
Model
: S-76
Serial Number : TBD
Flight Recorder:
.00
F.R. Changed
:
.00
FDESK3
A/C Total Time :
.00
TERMS
REF. NUMBER
SHIP VIA
ORDER NO.
ORDERED
REQUESTED
SNIPPED
:MD
580646
5/06/21
5,06/21
R..7>nlyy KleSZ
ITEM NUMBER
ITEM REFERENCE
B.
0.
TA x
QTY
PER
PRICE
PER
DATE ISSUED
QUANTITY
PRICE
UOM
EXTENDED
HGR145
HANGAR
:Mount Subject To Sales Tax
Customer's Account
-
Signature:
Vote for
Thank
-ID DAYS IN MAY
1,450.00
FLORIDA: 7.04
51551.50
13.:0
:45.05C
State Saes
EACH
iubtotal:
Tax:
Total:
1,450.00
1,450.00
101.50
1,551.50
Banyan in 2021 PRASE Survey!
you for your support.
Mail To: 5360 NW 20m Terrace •
Ship To: 5320 NW 20'n Terrace •
Ft Lauderdale Executive Airport •
Florida 33309 •
954.491.3170 p •
954.771.0281 f •
ithvw.banyanair.com
EFTA00085997
8
34211
I
D
L
L
0
8
34211
H
X
P
0
*ilk
BANIAIN
EXE NORTH SIDE
LINE TICKET:
021/576361
PAGE NUMBER
3.
DOCUMENT NUMBER
1879381
DATE
4/01/21
Registration
: N722JE
Make
: S76
Model
: S-76
Serial Number : TBD
Flight Recorder:
.00
F.R. Changed
:
.00
FDESK3
A/C Total Time :
.00
TERMS
REF. NUMBER
SHIP VIA
ORDER NO.
ORDERED
REQUESTED
SHIPPED
:MD
576361
4/01/21
4 C1/21
CS:OMER. SUPPORT'
ITEM NUMBER
ITEM REFERENCE
B.
O.
TA
x
QTY
PER
PRKE
PER
DATE ISSUED
QUANTITY
PRICE
UOM
EXTENDED
lonthly Charges For The Period: 04/01/21 to 04/30/21
HANGAR
HANGAR-MONTHLY N722JE
Amount Subject To Sales Tax
2,500.00
FLORIDA: 7.06
:uStOmer'S Account
-
52675.00
Invoice billed to Customer's Account.
Vote for Banyan in 2021 PRASE Survey!
Thank you for your support.
1
.117.C .:011
1.00
2,500.000
State Sales
EACH
Subtotal:
Tax:
Total:
2,500.00
2,500.00
175.00
2,675.00
Mail To: 5360 NW 20m Terrace •
Ship To: 5320 NW 20n Terrace •
Ft. Lauderdale Executive Airport •
Florida 33309 •
954.491.3170 p •
954.771.0281 f •
ithvw.banyanair.com
EFTA00085998
B
34211
I
t,
L
L
0
8
34211
8
P
I
P
0
*ilk
SERVICE INVOICE
•
LINE
BAINIAIN
FXE NORTH SIDE
LINE TICKET:
021/572704
PAGE NUMBER
1
DOCUMENT NUMBER
1872671
DATE
3/01/21
Registration
: N722JE
Make
: S76
Model
: S-76
Serial Number : TBD
Flight Recorder:
.00
F.R. Changed
:
.00
FDESK3
A/C Total Time :
.00
TERMS
REF. NUMBER
SHIP VIA
ORDER NO.
ORDERED
REQUESTED
SHIPPED
TOD
572704
3/07.121
3, C1/21
ITEM NUMBER
ITEM REFERENCE
B.
O.
TA
x
QTY
PER
PRKE
PER
DATE ISSUED
QUANTITY
PRICE
UOM
EXTENDED
lonthly Charges For The Period: 03/01/21 to 03/31/21
HANGAR
HANGAR-MONTHLY N722JE
Amount Subject To Sales Tax
2,500.00
FLORIDA: 7.06
:uStOmer'S ACCOunt
-
52675.00
Invoice billed to Customer's Account.
Vote for Banyan in 2021 PRASE Survey!
Thank you for your support.
1
3/Ol'TCT:
1.00
2,500.030
State Sales
EACH
Subtotal:
Tax:
Total:
2,500.00
2,500.00
175.00
2,675.00
Mail To: 5360 NW 20m Terrace •
Ship To: 5320 NW 20'n Terrace •
Ft Lauderdale Executive Airport •
Florida 33309 •
954.491.3170 p •
954.771.0281 f •
Ithvw.banyanair.com
EFTA00085999
Callie Meier
From:
Darzhane Gresham <
Sent:
Thursday, May 13, 2021 9:54 AM
To:
Melissa Koboldt
Subject:
N722JE
Amount
Account
Bank Reference
Customer Reference
Text
50.000 00 USD
0513236386
> on behalf of Darzhane Gresham
1
EFTA00086000
Callie Meier
From:
Abby Jones <->
on behalf of Abby Jones
Sent:
Wednesday, August 4, 2021 11:57 AM
To:
Melissa Koboldt
Subject:
Scans
Attachments:
N4848L Temp Registration.pdf; N707GY Registration.pdf; N460CM Registration.pdf;
N345RP Registration.pdf; N731AT Registration.pdf; N315TA Registration.pdt N722JE
Registration.pdf; N3165T Registration.pdf; N56JP Registration.pdf; N2590U
Registration.pdf; N98FP Registration.pdf; N215RP Registration.pdf; N262WH
Registration.pdf
Abby Jones
Receptionist
AIC Title Service
Tel:
or
www.aictitle.com
Fax:
alp
TITLE SERVICE
0 0 0
1
EFTA00086001
Callie Meier
From:
Darren Indyke <
Sent:
Thursday, May 6, 2021 3:47 PM
To:
Melissa Koboldt
Cc:
Darren Indyke; Richard Kahn;
Jonathan Williams
Subject:
Re: N7221E Escrow - AIC Title Service
I am working to get an answer for you.
Telephone:
Telecopier:
Mobile:
email:
> on behalf of Darren Indyke
The information contained in this communication is confidential, may be attorney-client
privileged, and is intended only for the use of the addressee. It is the property of
Darren K. Indyke. Unauthorized use, disclosure or copying of this communication
or any part thereof is strictly prohibited and may be unlawful. If you have received this
communication in error, please notify us immediately by return e-mail, and destroy this
communication and all copies thereof, including all attachments.
Copyright of Darren K. Indyke - © 2019 Darren K. Indyke — All rights reserved.
On May 6, 2021, at 4:31 PM, Melissa Koboldt
> wrote:
Darren, can you please reply? I'm trying to get this ready for closing tomorrow for another agent. Jon
Williams is copied here and will assist in my absence.
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
Skype
Cc: 'Richard Kahn'
Fax
<image001.jpg>
'Larry Visoski' <->;
'Gary Anzalone'
Darren, is there anything else to pay out of escrow other than the broker fee and %the escrow fee?
EFTA00086002
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: 'Richard Kahn'
Fax:
<image001.jpg>
'Larry Visoski' <
>; 'Gary Anzalone'
You were only on copy, they were sent to Larry for his signature.
The PUE requests for the IR will be going out this afternoon, you'll need to advise IATS (the IR
administrator) to approve AIC's request.
Please send me closing/disbursement instructions.
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: Richard Kahn
<image001.jpg>
; Larry Visoski <->;
Gary Anzalone
Larry C should sign as manager. You sent the docs to me to sign?
Sent from my iPhone. Please excuse the typos.
On May 6, 2021, at 1:16 PM, Darren Indyke
> wrote:
What about getting Larry closing docs? Also do we need to do anything Re the intl
registry?
Sent from my iPhone. Please excuse the typos.
On May 6, 2021, at 1:12 PM, Melissa Koboldt
wrote:
2
EFTA00086003
I haven't been able to find anyone who can take it yet, will keep you
posted.
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: Richard Kahn <
Larry Visoski
<
I>; Gary Anzalone
Fax:
<image001.jpg>
No to change FAA but yes to change warranty bos. Please See how
difficult Friday would be and we can decide after you let us
know. Thanks.
Sent from my iPhone. Please excuse the typos.
On May 5, 2021, at 6:41 PM, Melissa Koboldt
wrote:
The FAA has is registered with no comma-
<image001.png>
Do you still want it added?
Yes I can change the WBOS.
Everyone is booked in closings, I can see if it can be
squeezed in but Monday would be preferable.
Thanks,
Melissa Koboldt
Escrow agent
<image002.jpg>
AIC Title Service
Tel:
or
Fax:
Skype: melissa.koboldt www.aictitle.com
[mailto:
3
EFTA00086004
Cc: Richard Kahn <
k Larry
Visoski <
>.; Gary Anzalone
Thank you for the docs. A couple of revisions Can you
make seller Hyperion Air, LLC on FAA bos (you forgot
the comma after "Air"). Can you change date to May on
warranty bos. And re moving closing, is there no one in
your office who can do it on Friday? Please advise.
Thank you again.
Sent from my iPhone. Please excuse the typos.
On May 5, 2021, at 5:11 PM, Melissa
Koboldt
wrote:
Hi Darren,
Please review the FAA BOS and WBOS
and advise if everything is in order and I
will have them sent to Larry for digital
signatures.
It is my understanding closing was
targeted for 5-7-2021 however I will be
out of the office, do you have any issue
with closing to occur on 5-10-2021?
Thanks,
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Fax:
Skype:
<N722.1EBOS.pdf>
<N722.1E. WBOS.pdf>
<image00 1 jpg>
EFTA00086005
Callie Meier
From:
Darren Indyke <
Sent:
Thursday, May 6, 2021 3:49 PM
To:
Melissa Koboldt
Cc:
Darren Indyke; Richard Kahn;
Jonathan Williams
Subject:
Re: N7221E Escrow - AIC Title Service
> on behalf of Darren Indyke
If we want to demonstrate that the delivery was done in Florida, we will need a notarized delivery receipt, I believe.
Telephone:
Telecopier:
Mobile:
email:
The information contained in this communication is confidential, may be attorney-client
privileged, and is intended only for the use of the addressee. It is the property of
Darren K. Indyke. Unauthorized use, disclosure or copying of this communication
or any part thereof is strictly prohibited and may be unlawful. If you have received this
communication in error, please notify us immediately by return e-mail, and destroy this
communication and all copies thereof, including all attachments.
Copyright of Darren K. Indyke - © 2019 Darren K. Indyke — All rights reserved.
On May 6, 2021, at 4:47 PM, Melissa Koboldt
wrote:
Also, is it necessary for the delivery receipt to be notarized or can you accept a digital signature?
Melissa Koboldt
<image001.jpg>
Escrow agent
AIC Title Service
Tel:
or
Fax:
Skype:
Cc: 'Richard Kahn' <
>; Jonathan Williams <
>; 'Larry Visoski' <
>; 'Gary Anzalone'
Darren, can you please reply? I'm trying to get this ready for closing tomorrow for another agent. Jon
Williams is copied here and will assist in my absence.
1
EFTA00086006
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: 'Richard Kahn'
Fax:
<image001.jpg>
'Larry Visoski' <->;
'Gary Anzalone'
Darren, is there anything else to pay out of escrow other than the broker fee and !/: the escrow fee?
Melissa Koboldt
<image001.jpg>
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Fax:
Cc: 'Richard Kahn' <
> 'Larry Visoski' <
>; 'Gary Anzalone'
You were only on copy, they were sent to Larry for his signature.
The PUE requests for the IR will be going out this afternoon, you'll need to advise IATS (the IR
administrator) to approve AIC's request.
Please send me closing/disbursement instructions.
Melissa Koboldt
<image001.jpg>
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: Richard Kahn <
>
Fax:
; Larry Visoski <->;
Gary Anzalone
2
EFTA00086007
Larry C should sign as manager. You sent the docs to me to sign?
Sent from my iPhone. Please excuse the typos.
On May 6, 2021, at 1:16 PM, Darren Indyke
> wrote:
What about getting Larry closing docs? Also do we need to do anything Re the intl
registry?
Sent from my iPhone. Please excuse the typos.
On May 6, 2021, at 1:12 PM, Melissa Koboldt
wrote:
<
I haven't been able to find anyone who can take it yet, will keep you
posted.
Melissa Koboldt
Escrow agent
AIC Title Service
Tel:
or
Skype: melissa.koboldt www.aictitle.com
Cc: Richard Kahn
a
Gary Anzalone
<image001.jpg>
Fax:
; Larry Visoski
No to change FAA but yes to change warranty bos. Please See how
difficult Friday would be and we can decide after you let us
know. Thanks.
Sent from my iPhone. Please excuse the typos.
On May 5, 2021, at 6:41 PM, Melissa Koboldt
wrote:
The FAA has is registered with no comma-
<image001.png>
Do you still want it added?
3
EFTA00086008
Yes I can change the WBOS.
Everyone is booked in closings, I can see if it c