Loading...
HomeMy WebLinkAboutCOI_ Black Fox Timber Management Group Inc_7.18.25SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. INSURER(S) AFFORDING COVERAGE INSURER F : INSURER E : INSURER D : INSURER C : INSURER B : INSURER A : NAIC # NAME:CONTACT (A/C, No):FAX E-MAILADDRESS: PRODUCER (A/C, No, Ext):PHONE INSURED REVISION NUMBER:CERTIFICATE NUMBER:COVERAGES IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. OTHER: (Per accident) (Ea accident) $ $ N / A SUBR WVD ADDL INSD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. $ $ $ $PROPERTY DAMAGE BODILY INJURY (Per accident) BODILY INJURY (Per person) COMBINED SINGLE LIMIT AUTOS ONLY AUTOSAUTOS ONLY NON-OWNED SCHEDULEDOWNED ANY AUTO AUTOMOBILE LIABILITY Y / N WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OFFICER/MEMBER EXCLUDED? (Mandatory in NH) DESCRIPTION OF OPERATIONS below If yes, describe under ANY PROPRIETOR/PARTNER/EXECUTIVE $ $ $ E.L. DISEASE - POLICY LIMIT E.L. DISEASE - EA EMPLOYEE E.L. EACH ACCIDENT EROTH-STATUTEPER LIMITS(MM/DD/YYYY)POLICY EXP(MM/DD/YYYY)POLICY EFFPOLICY NUMBERTYPE OF INSURANCELTRINSR DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) EXCESS LIAB UMBRELLA LIAB $EACH OCCURRENCE $AGGREGATE $ OCCUR CLAIMS-MADE DED RETENTION $ $PRODUCTS - COMP/OP AGG $GENERAL AGGREGATE $PERSONAL & ADV INJURY $MED EXP (Any one person) $EACH OCCURRENCE DAMAGE TO RENTED $PREMISES (Ea occurrence) COMMERCIAL GENERAL LIABILITY CLAIMS-MADE OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO-JECT LOC CERTIFICATE OF LIABILITY INSURANCE DATE (MM/DD/YYYY) CANCELLATION AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. CERTIFICATE HOLDER The ACORD name and logo are registered marks of ACORD HIRED AUTOS ONLY 7/18/2025 HUB International Northwest,LLC P.O.Box 10167 Eugene OR 97440-2167 Lynn Wray 541-687-1117 541-342-8280 Lynn.Wray@HUBinternational.com Falls Lake Fire &Casualty Company 15884 BLACFOX-01 Arch Insurance Company 11150BlackFoxTimberManagementGroup,Inc. P.O.Box 687 McCloud CA 96057-0687 Underwriters at Lloyd's London 15792 State Compensation Insurance Fund of California 35076 1415840315 A X 1,000,000 X 300,000 X LBFPD 10,000 X Contractual Liab 1,000,000 2,000,000 X Y Y TMB000066604 4/22/2025 4/22/2026 2,000,000 A 1,000,000 X X X X Pollution Per CA9948 Y Y TMB000066604 4/22/2025 4/22/2026 B X 1,000,000 X PXFXS0034905 4/22/2025 4/22/2026 1,000,000 D X N Y 9084125 1/1/2025 1/1/2026 1,000,000 1,000,000 1,000,000 C Professional Liability - Foresters E&O AXPANEL0009125 4/22/2025 4/22/2026 Aggregate Limit: Each Claim Limit: Deductible: $2,000,000 $2,000,000 $5,000 Certificate Holder and all entities required by written contract are included as Additional Insured on a Primary and Noncontributory basis with Waiver of Subrogation with respects to the General Liability and Automobile Liability as required by written contract per attached endorsements.Subject to policy limits, terms,conditions and exclusions. Re:Task Order 24-49-12-201 Certificate Holder Includes:Compass Consulting Enterprises,Inc. County of San Bernardino Fire District and Public Works 598 S.Tippecanoe Ave. San Bernardino CA 92408 COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 1 of 7 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL LIABILITY BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE FORM In addition to words and phrases contained in the Commercial General Liability Coverage Form, other words and phrases that appear in quotation marks have special meaning. Refer to Paragraph VII. DEFINITIONS of this endorsement. For the purposes of the coverage provided by this endorsement these definitions apply in place of their definitions stated elsewhere in the policy. The following provisions apply only with respect to the coverage provided by this endorsement, However, the coverage expansions provided throughout this endorsement do not apply if the coverage is excluded either by the provisions of the coverage form or by endorsement. I. SECTION I – COVERAGES COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE, 2. Exclusions are amended as follows: A.Non-Owned Watercraft Paragraph 2. g. Aircraft, Auto or Watercraft (2) (a) is replaced with the following: (a)Less than 51 feet long; and B. Property Damage Extension 1. Borrowed Equipment Paragraphs (3) and (4) of exclusion j. Damage to Property do not apply to “property damage” to borrowed equipment while not being used to perform operations at the job site. 2.Elevators The following is added to exclusion j. Damage to Property: Paragraphs (3) and (4) of this exclusion do not apply to “property damage” arising from the use of elevators. II.SECTION I – COVERAGES, SUPPLEMENTARY PAYMENTS – COVERAGE A AND B In the Supplementary Payments – Coverages A and B: A.Paragraph 1.b. is amended to increase the limit for the cost of bail bonds from $250 to $1,000; and B.Paragraph 1.d. is amended to increase the limit for loss of earnings from $100 a day to $500 a day. III. WHO IS AN INSURED A.Paragraph 2. under SECTION II – WHO IS AN INSURED is expanded to include the following: 1. Additional Insured by Contract, Agreement, or Permit Any person(s) or organization(s) is an additional insured when you have agreed, in a written contract, written agreement or because of a permit issued by a political, subdivision, that such person(s) or organization(s) be added as an additional insured on your policy, provided the injury or damage occurs subsequent to the execution of the contract or agreement. A person or organization is an additional insured under this provision only for that period of time required by the contract or agreement. However, no such person or organization is an insured under this provision if such a person or organization is included as an insured by an endorsement issued by us and made part of this coverage form. COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 2 of 7 a. Vendors Any person(s) or organization(s) (referred to herein as vendor) with whom you agreed, because of a written contract or agreement to provide insurance, but only with respect to “bodily injury” or “property damage” arising out of “your products” which are distributed or sold in the regular course or the vendor’s business, subject to the following additional exclusions: (1)The insurance afforded the vendor does not apply to: (a) “Bodily injury” or “property damage” for which the vendor is obligated to pay damages by reason of the assumption of liability in a contract or agreement. This exclusion does not apply to liability for damages that the vendor would have in the absence of the contract or agreement. (b)Any express warranty unauthorized by you; (c)Any physical or chemical changes in the product made intentionally by the vendor; (d)Repacking, unless unpacked solely for the purpose of inspection, demonstration, testing, or substitution of parts under instructions from the manufacturer, and then repackaged in the original container. (e)Any failure to make such inspections, adjustments, tests, or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products; (f)Demonstration, installation, servicing, or repair operations except such operations performed at the vendor’s premises in connection with the sale of the product; (g)Products which, after distribution or sale by you, have been labeled or relabeled or used as a container, part or ingredient of any other thing or substance by or for the vendor. (h)“Bodily injury” or “property damage” arising out of the sole negligence of the vendor for its own acts or omissions or those of its employees or anyone else acting on its behalf. However, this exclusion does not apply to: (i)The exceptions contained in Subparagraphs (d) or (f); or (ii)Such inspections, adjustments, test, or servicing as the vendor has agreed to make or normally undertakes to make in the usual course of business, in connection with the distribution or sale of the products (2)Any insured person or organization, from whom you have acquired such products, or any ingredient, part or container, entering into, accompanying, or containing such products. b. Lessors of Equipment (1)Any person(s) or organization(s) from whom you lease equipment; but only with respect to liability for “bodily injury”, “property damage”, or “personal and advertising injury” caused, in whole or in part, by your maintenance, operation, or use of equipment leased to you by such person(s) or organization(s). (2)With respect to the insurance afforded to these additional insureds, this insurance does not COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 3 of 7 apply to any “occurrence” which takes place after the equipment lease expires. c. Lessors of Land or Premises Any person(s) or organization(s) from whom you lease equipment; but only with respect to liability arising out of the ownership, maintenance, or use of that part of the premises leased to you; and subject to the following additional exclusions: This insurance does not apply to: (1)Any “occurrence” which takes place after you cease to be a tenant in that premises. (2)Structural alterations, new construction, or demolition operations performed by or on the behalf of such person or organization, d.Architects, Engineers, or Surveyors (1)Any architect, engineer, or surveyor engaged by you but only with respect to liability for “bodily injury” or “property damage” or “personal and advertising injury” caused, in whole or in part, by your acts or omissions or the acts or omissions of those acting on your behalf: (a)In connection with your premises; or (b)In the performance of your ongoing operations (2)With respect to the insurance afforded to these additional insureds, the following additional exclusion applies: This insurance does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of or the failure to render any professional services by you or for you, including: (a)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (b)Supervi sory, inspection, architectural, or engineering activities. e.Permits Issued By State Or Political Subdivisions Any state or governmental agency or subdivision or political subdivision but only with respect to operations performed by you or on your behalf for which the state or governmental agency or subdivision has issued a permit or authorization. This insurance does not apply to: (1)“Bodily injury”, “property damage”, or “personal and advertising injury” arising out of operations performed for the federal government, state, or municipality; or (2)“Bodily injury” or “property damage” included within the “products- completed operations hazard”. f. Any Other Party Any other person(s) or organization(s) who is not an insured under Paragraph through e. above, but only with respect to liability for “bodily injury”, “property damage”, or “personal and advertising injury” caused, in whole or in part, by yours acts or omissions or the acts or omissions of those acting on your behalf; (1)In the performance of your ongoing operations; (2)In connection with your premises owned by or rented to you; or (3)In connection with “your work” and included within the “products-completed operations hazard”, but only if: (a)The written contract or agreement requires you to provide coverage to COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 4 of 7 additional insureds; and (b)This Coverage Part provides coverage for “bodily injury” or “property damage” included within the “products-completed operations hazard”. With respect to the insurance afforded to these additional insureds, this coverage does not apply to: “Bodily injury”, “property damage”, or “personal and advertising injury” arising out of the rendering, or failure to render, any professional architectural, engineering, or surveying services, including: (1)The preparing, approving, or failing to prepare or approve, maps, shop drawings, opinions, reports, surveys, field orders, change orders, or drawings and specifications; or (2)Supervisory, inspection, architectural, or engineering activities. The limit of insurance that apply to additional insureds under this extension is described in Section III. – Limits of Insurance. How this insurance applies when other insurance is available to the additional insured is described in the Other Insurance Condition in Section IV – Commercial General Liability Conditions 2.Subsidiaries Any subsidiary and subsidiary thereof, of yours which is a legally incorporated entity of which you own a financial interest of more than 50% of the voting stock on the effective date of the Coverage Part. The insurance afforded herein for any subsidiary not named in this Coverage Part as a named insured does not apply to injury or damage with respect to which an insured under this Coverage Part is also and insured under another policy or would be an insured under such policy but for its termination or the exhaustion of its limits of insurance. 3.Newly Formed Or Acquired Organizations In Paragraph 3. a. of Section II – Who Is An Insured, is increased from the 90th day to 180th day. However, this expansion does not apply if coverage for newly formed or acquired organizations is excluded either by the provisions of the Coverage Part or by endorsement. IV.SECTION III – LIMITS OF INSURANCE A. Damage To Premises Rented To You Paragraph 6. of Section III – Limits of Insurance is replaced with the following: 6.Subject to Paragraph 5. Above, the Damage To Premises Rented To You Limit is the most we will pay under Coverage A. for damages because of “property damage” to any one premises, while rented to you, or in the case of damage by fire, while rented to you or temporarily occupied by you with permission of the owner. The most we will pay in any one “occurrence” is the higher of the following: (a)$300,000; or (b)The amount shown in the Declarations for Damages to Premises Rented to You Limit. B.Medical Payments Paragraph 7. of Section III – Limits of Insurance is replaced with the following: 7.Subject to Paragraph 5. Above, the Medical Expense Limit is the most we will pay under Coverage C. for all medical expenses because of “bodily injury” sustained by any one person. The most we will pay for “bodily injury” sustained by any one person is the higher of the following: (a)$10,000; or COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 5 of 7 (b)The amount shown in the Declarations for Medical Expenses Limit. V. SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS The following items are amended: A. Duties In The Event Of Occurrence, Offense, Claim, Suit. Or Loss The following items are added to Paragraph 2. Duties In The Event Of Occurrence, Offense, Claim Or Suit of Section IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: e. Additional Insureds Other Insurance If we cover a claim or “suit” under this Coverage Part that may also be covered by other insurance available to an additional insured, such additional insured must submit such claim or “suit” to the other insurer for defense and indemnity. However, this provision does not apply to the extent that you have agreed in a written agreement that this insurance is primary and non- contributory with the additional insured’s own insurance. f. Knowledge Of An Occurrence, Offense, Claim, Or Suit Paragraphs a. and b. apply to you or to any additional insured only when such “occurrence, offense, claim, or “suit” is known to: (1)You or any additional insured that is an individual; (2)Any partner, if you or an additional insured is a partnership; (3)Any manager, if you or an additional insured is a limited liability company; (4)Any “executive officer” or insurance manager, if you or an additional insured is a corporation; (5)Any trustee, if you or any additional insured is a trust; or (6)Any elected or appointed official, if you or an additional insured is a political subdivision or public entity. This duty applies separately to you and any additional insured. B. Other Insurance The following items are added to paragraph 4. Other Insurance, b. Excess Insurance of Section IV – COMMERCIAL GENERAL LIABILITY CONDITIONS: (5)This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: (a) Property Damage To Borrowed Equipment Or Use Of Elevators If the loss arises out of “property damage” to borrowed equipment or the use of elevators to the extent not subject to Exclusion j. Damage to Property of Section I – Coverage A – Bodily Injury and Property Damage Liability; (b)When You Are Added As An Additional Insured To Other Insurance Any other insurance available to you covering liability for damages arising out of the premises or operations, or products and completed operations, for which you have been added as an additional insured by that insurance; or (c)When You Add Others As An Additional Insured To This Insurance Any other insurance available to an additional insured. However, the following provisions apply to other insurance available to any person or organization who is an additional insured under this coverage part. i.Primary Insurance When Required By Contract This insurance is primary if you have agreed in a written contract or written agreement that this insurance is to be primary. If other insurance is also primary, we will share with all that other insurance by the method described in c. below COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 6 of 7 ii.Primary And Non-Contributory To Other Insurance When Required By Contract If you have agreed in a written contract, written agreement, or permit that this insurance is primary and non-contributory with the additional insured’s own insurance, this insurance is primary and we will not seek contribution from that other insurance. Paragraphs a. and b. do not apply to other insurance to which the additional insured has been added as an additional insured. C.Representations Paragraph 6. of Section IV – COMMERCIAL GENERAL LIABILITY CONDITIONS is replaced by the following: a.When You Accept This Policy By accepting this policy, you agree: (1)The statements in the Declarations are accurate and complete; (2)Those statements are based upon representations you made to us; and (3)We have issued this policy in reliance upon your representations. b. Unintentional Failure To Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under this Coverage Part because of such failure. However, you must report such error or omission to us as soon as practicable after its discovery. D.Transfer Of Rights Of Recovery Against Others To Us Paragraph 8. of Section IV – Commercial General Liability Conditions is replaced with the following: If the insured has rights to recover all or part of any payment we have made under this Coverage Part, those rights are transferred to us. The insured must do nothing after loss to impair them. At our request, the insured will bring “suit” or transfer those rights to us and help us enforce them. However, we may waive any right of recovery we may have against any person or organization to the extent required of you by a written contract executed prior to any “occurrence” or “suit”, provided that the “occurrence” or “suit” arises out of operations contemplated by such contract. The waiver applies only to the person or organization designated in such contract. VI.DEFINITIONS A. Amended Definitions 1.Advertisement The following is added to the definition of “advertisement”: However, “advertisement” does not include: The design, printed material, information or images contained in, on, or upon the packaging or labeling of any goods or products; or An interactive conversation between or among persons through a computer network. 2.Coverage Territory The final paragraph in the definition of 4. “coverage territory” is replaced by the following: provided the insured’s responsibility to pay damages is determined in the United States of America (including its territories and possessions), Puerto Rico or Canada, in a “suit” on the merits according to the substantive law in such territory or in a settlement we agree to. 3.Insured Contract (1)Paragraph a. in the definition of 9. “insured contract” is replaced by the following: A contract for a lease of premise. However, that portion of the contract for a lease of premises that indemnifies any person or organization for damage by fire to premises while rented to you COMMERCIAL GENERAL LIABILITY CGL 71 03 00 07 20 CGL 71 03 00 07 20 Includes copyrighted material of Insurance Services Office, Inc., with its permission. Page 7 of 7 or temporarily occupied by you with permission of the owner is subject to the Damage to Premises Rented to You Limit described in Section III – Limits or Insurance; (2)The first paragraph of Paragraph f. in the definition of 9. “insured contract” is replace by the following: That part of any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for a municipality) under which you assume the tort liability of another party to pay for “bodily injury” or “property damage” to a third person or organization, provided the “bodily injury” or “property damage” is caused, in whole or in part, by you or by those acting on your behalf. Tort liability means a liability that would be imposed by law un the absence of any contract or agreement. 4.Mobile Equipment Paragraph f. (1) in the definition of 12. “mobile equipment” is replaced by the following: (1)Equipment, of at least 1,000 pounds gross vehicle weight, designed primarily for: (a)Snow removal; (b)Road maintenance, but not construction or resurfacing; or (c)Street cleaning; 5.Personal and Advertising Injury Paragraph f. in the definition of 14. “personal and advertising injury is replaced with the following: f.Copying, in your “advertisement”, a person’s or organization’s “advertising idea” or style of “advertisement”; B. Added Definitions “Advertising idea” means any idea for an “advertisement”. All other terms and conditions of the policy remain unchanged. COMMERCIAL GENERAL LIABILITY CGL 71 05 00 07 20 CGL 71 05 00 07 20 Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 1 of 2 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LOGGING AND LUMBERING OPERATIONS COVERAGE ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Deductible: $1,000 per “occurrence” Annual Premium: Information required to complete this Schedule, if not shown above, will be shown in the Declarations A.The following is added to SECTION I - COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY: With respect to “logging and lumbering operations”, this insurance applies to: 1.FIRE SUPPRESSION EXPENSES Fire suppression expenses incurred by others for which the Named Insured is legally liable, solely by reason of such expenses having been incurred as a direct consequence of fire resulting from and immediately attributable to an “occurrence arising out of “logging and lumbering operations” of the Named Insured. 2.“PROPERTY DAMAGE” TO TIMBERLAND NOT OWNED BY ANY INSURED “Property damage” to timberland or standing, felled, or bucked timber for which the insured is legally liable that is: a.At premises rented by or in the care, custody, and control of the Named Insured; and b.Not owned by any insured Which arises out of the “logging and lumbering operations” of the Named Insured. 3.“PROPERTY DAMAGE” TO AUTOS AND RAILROAD CARS NOT OWNED BY ANY INSURED “Property damage” to autos and railroad cars for which the insured is legally liable that are not owned by any insured which occurs while such vehicles are being loaded or unloaded by or on the behalf of the Named Insured and arises out of such “loading or unloading”. 4.TIMBER TRESPASS “Property damage” to timberland or standing timber for which the insured is legally liable that is: a.Not owned by the Named Insured; or b.Not in the care, custody, or control of the Named Insured Which arises out of the “logging and lumbering operations” of the Named Insured. B.EXCLUSIONS The following are added to 2. Exclusions of COVERAGE A - BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 1.The insurance provided in Paragraphs A.1. and A. 2. in this form shall not apply to damages because of fire or fire suppression if the fire arose out of any of the following operations conducted by or on the behalf of the insured: a.The burning of slash at times or under conditions prohibited or not approved by proper state or federal authorities, or b.The felling or bucking of timber, the operations of logging equipment (including railroad equipment) or the “loading or unloading” of timber at a time during which suspension of such operations had been directed by the proper state or federal authorities. 2.The insurance provided in Paragraph A. 2. In this form shall not apply while timber is being transported. CGL 71 05 00 07 20 Includes copyrighted material of Insurance Services Offices, Inc. with its permission Page 2 of 2 3.This insurance does not apply to that portion of any damages for “property damage” otherwise payable by us, in settlement or otherwise, representing funds or property that have accrued or will accrue, directly or indirectly, to your benefit as a result of the “occurrence” for which a claim is made. You agree to reimburse us for payment made by us which we would not have been obligated to make under the terms of this policy had you paid the person or entity making claim for “property damage” the funds or value of the property that accrued, or will accrue, to your benefit as a result of the “occurrence” for which a claim is made. C.DEDUCTIBLE 1.Our obligation under this endorsement to pay damages and fire suppression expenses on your behalf applies only to the amount of damages and fire suppression expenses in excess of the deductible amount stated in the Schedule above. The deductible amount applies to all damages or fire suppression expenses covered by this endorsement as the result of any one “occurrence”, regardless of the number of persons or organizations who sustain damages because of that “occurrence”. 2.We may pay any part or all of the deductible amount to effect settlement of any claim or “suit” and, upon notification of the action taken, you shall reimburse us within 30 days after reimbursement is requested for such part of the deductible amount as has been paid by us. 3.If you do not reimburse us within 30 days: a.Effective the date of the first loss for which the deductible amount was not reimbursed, the deductible will no longer apply. b.Effective the date of the first loss for which the deductible amount was not reimbursed, the premium will be increased pro rata by the deductible factor used to calculate the reduced premium; and c.The additional premium developed by this calculation will be due and payable to us within 10 days of notice. Your failure to pay the additional premium will result in cancellation of the policy for non-payment of premium. D.The following is added to DEFINITIONS: “Logging and lumbering operations” means all operations associated with the felling of timber and production of lumber, including road building operations, the operation of saw or planning mills, operations incidental to any of these, and the ownership, maintenance, or use of “mobile equipment” in connection with such operations, if such operations are conducted by or for the Named Insured. COMMERCIAL AUTO CAP 70 71 00 07 20 CAP 70 71 00 07 20 Includes copyrighted material of Insurance Services Offices, Inc. withits permission. Page 1 of 3 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTO BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM In addition to words and phrases contained in the Coverage Forms shown above, other words and phrases that appear in quotes have special meaning. Refer to Section I - Changes To All Coverage Forms,paragraph D.in this endorsement. For purposes of the coverage provided by this endorsement, these definitions apply in place of their definitions stated elsewhere in the policy. The following provisions apply only with respect to Commercial Auto coverage provided by this endorsement I. Changes To All Coverage Forms A. SECTION II – COVERED AUTOS LIABILITY COVERAGE The following items are added or amended: 1. Fellow Employee Exclusion B.5. Fellow Employee does not apply if the “bodily injury” to any fellow employee results from the use of a covered “auto” you own or hire. Any coverage provided under this exception is excess over any other collectible insurance. 2. Supplementary Payments - Increased Limits Under A.2.a. Supplementary Payments, paragraph (2)is amended to provide a limit of up to $2,500 for the cost of bail bonds and paragraph (4)is amended to provide a limit of up to $300 a day for reasonable expenses. 3. Subsidiaries And Newly Acquired Or Formed Organizations The following is added to paragraph A.1. Who Is An Insured: Any legally incorporated subsidiary in which you own more than 50% of the voting stock on the effective date of the Coverage Form. However, the Named Insured does not include any subsidiary that is an Insured under any other automobile policy or would be an insured under such a policy but for its termination or the exhaustion of its Limit of Insurance. b.Any organization that is acquired or formed by you and over which you maintain majority ownership. However, the Named Insured does not include any newly formed or acquired organization: (1)That is a partnership, joint venture, or limited liability company; (2)That is an insured under any other policy; (3)That has exhausted its Limit of Insurance under any other policy, or (4)180 days or more after its acquisition or formation by you, unless you have given us notice of the acquisition or formation. Coverage does not apply to “bodily injury” or “property damage” that results from an “accident” that occurred before you formed or acquired the organization. B. SECTION III – PHYSICAL DAMAGE COVERAGE of the Business Auto Coverage Form The following items are added or amended: 1. Additional Temporary Transportation Expense Coverage Paragraph A.4.a. Transportation Expenses is amended to provide a limit of $75 per day for up to 30 days. 2. Deductible Paragraph D. Deductible, is amended to include the following: a. Two or more deductibles If another policy, that is not an automobile policy or coverage form issued by us applies to the same “accident”, the following applies: (1)If the deductible under this Business Auto Coverage Form is the smaller or smallest deductible, it will be waived. COMMERCIAL AUTO CAP 70 71 00 07 20 CAP 70 71 00 07 20 Includes copyrighted material of Insurance Services Offices, Inc. withits permission. Page 2 of 3 (2)If the deductible under this Business Auto Coverage Form is not the smaller or smallest deductible, it will be reduced by the amount of the smaller or smallest deductible. b. Waiver of Deductible No deductible applies to glass damage if the glass is repaired rather than replaced. 3. Extra Expense The following is added to paragraph A. Coverage: Extra Expense Coverage We will pay for the expense of returning a stolen covered “auto” to you, if applicable. 4. Hired Auto Physical Damage The following is added to paragraph A. Coverage: Hired Auto Physical Damage Coverage If hired “autos” are covered “autos” for Liability Coverage and if Comprehensive, Specified Causes of Loss, or Collision coverages are provided under the Business Auto Coverage Form for any “auto” you own, then the Physical Damage Coverages provided are extended to “autos” you hire or borrow, subject to the following limit: The most we will pay for “loss” to any hired “auto” is: (1)$50,000 (2)The actual cash value of the damaged or stolen property at the time of “loss” or (3)The cost of repairing or replacing the damaged or stolen property; whichever is smallest, minus a deductible. The deductible will be equal to the largest deductible applicable to any owned “auto” for that coverage. No deductible applies to “loss” caused by fire or lightning. Hired Auto Physical Damage Coverage, provided herein, is excess over any other collectible insurance. Subject to the above limit, deductible, and excess provisions, we will provide coverage equal to the broadest coverage applicable to any covered “auto” you own. We will also cover loss of use of the hired “auto” if it results from an “accident”, you are legally liable, and the lessor incurs an actual financial loss, subject to a maximum of $1,000 per “accident”. This extension of coverage does not apply to any “auto” you hire or borrow from any of your “employees”, partners’ (if you are a partnership), members (if you are a limited liability company), or members of their households. 5. Personal Effects The following is added to paragraph A.4. Coverage Extensions: Personal Effects We will pay up to $400 for loss to wearing apparel and other personal effects which are: (1)Owned by an “insured”; and (2)In or on your covered “auto”. This coverage applies only in the event of a total theft of your covered “auto”. This insurance is excess over any other collectible insurance and no deductible applies. 6. Towing Paragraph A.2. Towing is deleted and replaced with the following: Towing We will pay up to $250 for towing and labor costs incurred each time a covered “auto” is disabled. However, the labor must be performed at the place of disablement. 7. Lease Gap The following is added to paragraph A. Coverage: Lease Gap Coverage If a long-term leased “auto” is a covered “auto” and the lessor is named in the policy as a Loss Payee, we will pay in the event a total “loss” your additional legal obligation to the lessor for any difference between the actual cash value of the “auto” at the time of the “loss” and the “remaining balance” of the lease, subject to a payment of 50% or a limit of $25,000, whichever is less, for this difference amount. However, this insurance is applicable only when the covered “auto” is not subject to any other Lease Gap or similar coverage. C. SECTION IV – BUSINESS AUTO CONDITIONS of the Business Auto Coverage Form 1.The following subparagraphs are added to paragraph 2. Duties In the Event Of Accident, Claim, Suit Or Loss: COMMERCIAL AUTO CAP 70 71 00 07 20 CAP 70 71 00 07 20 Includes copyrighted material of Insurance Services Offices, Inc. withits permission. Page 3 of 3 Knowledge of an “accident”, claim, “suit”, or “loss” by an “employee” of yours shall not constitute knowledge by you, until you, an executive officer, partner, or other persons employed by you in a supervisory capacity shall have received actual notice of “loss”. If you report an “accident”, “claim”, “suit”, or “loss” to an insurer providing other than Commercial Auto Liability Insurance, which later develops into a Commercial Auto Liability claim, covered under this Coverage Part, failure to report such “accident”, claim”, “suit”, or “loss” shall not be deemed in violation of these condition. However, you shall give notification to us, as soon as reasonably possible when it is determined that the “accident”, “claim”, “suit”, or “loss” may be a Commercial Auto Liability claim. 2.The following conditions are added: a. Autos Rented By Employees Any “auto” hired or rented by your “employee” on your behalf and at your direction will be considered an “auto” you hire. Paragraph B.5. Other Insurance in the Business Auto Coverage Form is amended to include the following: If an “employee’s” personal insurance also applies on an excess basis to a covered “auto” hired or rented by your “employee” on your behalf and at your direction, this insurance will be primary to the “employee’s” personal insurance. b. Hired Auto Coverage Territory If hired “autos” are covered “autos” for Liability Coverage, then subparagraph (5) of paragraph B.7. Policy Period, Coverage Territory is replaced by the following: For “short-term” hired “autos”, the coverage territory with respect to Liability Coverage is anywhere in the world provided that if the “insureds” responsibility to pay damages for “bodily Injury” or “property damage” is determined in a “suit”, the “suit” is brought in the United States of America, the territories an possessions of the United States of America, Puerto Rico or Canada or in a settlement to which we agree. c. Unintentional Failure to Disclose Hazards If you unintentionally fail to disclose any hazards existing at the inception date of your policy, we will not deny coverage under the Business Auto Coverage Form because of such failure. However, you must report such error or omission to us as soon as practicable after its discovery. D.The following definition is added to SECTION V – DEFINITIONS of the Business Auto Coverage Form: “Remaining balance” means the amount you owe on the lease at the time of “loss” less any amounts representing taxes; overdue payments; penalties, interest, or charges resulting from overdue payments; additional mileage charges; excess wear and tear charges; lease termination fees. “Long term lease” means any “auto” leased for six months or more. “Short-term” means less than six months. II. Changes To The Business Auto Coverage Form A. SECTION III – PHYSICAL DAMAGE COVERAGE The following is added to Exclusion B.3.a.: However, mechanical breakdown does not apply to the accidental discharge of an airbag. B. SECTION IV – BUSINESS AUTO CONDITIONS Paragraph c.in B.5. Other Insurance is replaced by the following: c.Regardless of the provisions of paragraph a.above, this coverage form’s Liability Covered Auto Liability Coverage is primary for any liability assumed under an “insured contract” and other Liability insurance available to an “insured” shall be considered excess and non-contributory when required by an “insured contract”. All other terms and conditions of the policy remain unchanged. COMMERCIAL AUTO CA 99 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CA 99 48 10 13 © Insurance Services Office, Inc., 2011 Page 1 of 1 POLLUTION LIABILITY – BROADENED COVERAGE FOR COVERED AUTOS – BUSINESS AUTO AND MOTOR CARRIER COVERAGE FORMS This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by the endorsement. A. Covered Autos Liability Coverage is changed as follows: 1. Paragraph a. of the Pollution Exclusion applies only to liability assumed under a contract or agreement. 2. With respect to the coverage afforded by Paragraph A.1. above, Exclusion B.6. Care, Custody Or Control does not apply. B. Changes In Definitions For the purposes of this endorsement, Paragraph D. of the Definitions Section is replaced by the following: D. "Covered pollution cost or expense" means any cost or expense arising out of: 1. Any request, demand, order or statutory or regulatory requirement that any "insured" or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of "pollutants"; or 2. Any claim or "suit" by or on behalf of a governmental authority for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to or assessing the effects of "pollutants". "Covered pollution cost or expense" does not include any cost or expense arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of "pollutants": a. Before the "pollutants" or any property in which the "pollutants" are contained are moved from the place where they are accepted by the "insured" for movement into or onto the covered "auto"; or b. After the "pollutants" or any property in which the "pollutants" are contained are moved from the covered "auto" to the place where they are finally delivered, disposed of or abandoned by the "insured". Paragraphs a. and b. above do not apply to "accidents" that occur away from premises owned by or rented to an "insured" with respect to "pollutants" not in or upon a covered "auto" if: (1) The "pollutants" or any property in which the "pollutants" are contained are upset, overturned or damaged as a result of the maintenance or use of a covered "auto"; and (2) The discharge, dispersal, seepage, migration, release or escape of the "pollutants" is caused directly by such upset, overturn or damage. ABC AT 12:01 AM PACIFIC PRESIDENT AND CEO SCIF FORM 10217 (REV.7-2014) AB HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR POLICY OTHER THAN AS STATED. NOTHING ELSEWHERE IN THIS POLICY SHALL BE TIME INDICATED AT OLD DP 217 LIMITATIONS OF THIS ENDORSEMENT. ABCDE BROKER COPY PACIFIC STANDARD TIME OR EXTEND ANY OF THE TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS EF STANDARD TIME OR THE ALLEFFECTIVE DATESARE COUNTERSIGNED AND ISSUED AT SAN FRANCISCO: SAN FRANCISCO ENDORSEMENT AGREEMENT HOME OFFICE CD AUTHORIZED REPRESENTATIVE NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE WAIVER OF SUBROGATION_____________________ BLANKET BASIS 9084125-25_____________ RENEWAL NF 5-22-41-24 EFFECTIVE JANUARY 1, 2025 AT 12.01 A.M. PAGE 1 OF 1 AND EXPIRING JANUARY 1, 2026 AT 12.01 A.M. BLACK FOX TIMBER MANAGEMENT GROU PO BOX 687 MCCLOUD, CA 96057 WE HAVE THE RIGHT TO RECOVER OUR PAYMENTS FROM ANYONE LIABLE FOR AN INJURY COVERED BY THIS POLICY. WE WILL NOT ENFORCE OUR RIGHT AGAINST THE PERSON OR ORGANIZATION NAMED IN THE SCHEDULE. THIS AGREEMENT APPLIES ONLY TO THE EXTENT THAT YOU PERFORM WORK UNDER A WRITTEN CONTRACT THAT REQUIRES YOU TO OBTAIN THIS AGREEMENT FROM US. THE ADDITIONAL PREMIUM FOR THIS ENDORSEMENT SHALL BE % OF THE TOTAL POLICY PREMIUM.2.00____ SCHEDULE________ PERSON OR ORGANIZATION JOB DESCRIPTION______________________ _______________ ANY PERSON OR ORGANIZATION BLANKET WAIVER OF FOR WHOM THE NAMED INSURED SUBROGATION HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER JANUARY 7, 2025 2572