Loading...
HomeMy WebLinkAboutCOI_ Black Fox Timber Management Group, Inc_04.29.26SHOULD 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 4/29/2026 HUB International Northwest,LLC P.O.Box 10167 Eugene OR 97440-2167 Steve Haggard 541-687-1117 541-342-8280 Steven.Haggard@HUBinternational.com Underwriters at Lloyd's London 15792 BLACFOX-01 State Compensation Insurance Fund of California 35076BlackFoxTimberManagementGroup,Inc. P.O.Box 687 McCloud CA 96057-0687 Obsidian Pacific Insurance Company 35602 Arch Specialty Insurance Company 21199 1966645798 C X 1,000,000 X 300,000 X LBFPD 10,000 X Contractual Liab 1,000,000 2,000,000 X Y Y TIMCL0000378300 4/22/2026 4/22/2027 2,000,000 C 1,000,000 X X X X Pollution Y Y TIMCL0000378300 4/22/2026 4/22/2027 D X 1,000,000 X PXFXS0034906 4/22/2026 4/22/2027 1,000,000 B X N Y 9084125 1/1/2026 1/1/2027 1,000,000 1,000,000 1,000,000 A Professional Liability - Foresters E&O AXPANEL0009126 4/22/2026 4/22/2027 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 TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 1 of 6 Named Insured: Black Fox Timber Management Group, Inc. Endorsement Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. GENERAL LIABILITY ENHANCEMENT ENDORSEMENT This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the applicable Coverage Part apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. A.SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY, Paragraph 2. Exclusions is amended as follows: 1.NON-OWNED WATERCRAFT EXTENSION Subparagraph (2)(a) of g. Aircraft, Auto Or Watercraft is deleted and replaced by the following: (2)A watercraft you do not own that is: (a)Less than 51 feet in overall length; and 2.PROPERTY DAMAGE LIABILITY – BORROWED EQUIPMENT Subparagraph (4) of Exclusion j. Damage To Property is amended to add the following: This exclusion does not apply to equipment which you borrow from a person or entity, other than an insured, unless the “property damage” occurs while such equipment is being used by an insured at a job site. 3.PROPERTY DAMAGE LIABILITY - ELEVATORS Exclusion j. Damage To Property is amended to add the following: Paragraphs (3) and (4) of this exclusion do not apply to liability arising out of the use of elevators. The insurance provided by this exception to Exclusions j.(3) and j.(4) as set forth in Paragraph 4. of this General Liability Enhancement Endorsement is excess over any other valid and collectible insurance available to the insured whether primary, excess (other than insurance written to apply specifically in excess of this policy), contingent or any other basis, that would also apply to the loss covered under this provision. 4.DAMAGES TO PREMISES RENTED TO YOU The last paragraph of 2. Exclusions is deleted and replaced by the following: Exclusions c. through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, when the damage is caused by fire. Exclusions c.through n. do not apply to damage to premises while rented to you, or temporarily occupied by you with the permission of the owner, when the damage is caused by other than fire unless the damage arises out of “your work”. A separate limit of insurance applies to these coverages as described in SECTION III – LIMITS OF INSURANCE. COMMERCIAL GENERAL LIABILITY TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 2 of 6 B.SECTION I – COVERAGES, COVERAGE C – MEDICAL PAYMENTS is amended to add the following only if COVERAGE C – MEDICAL PAYMENTS is not otherwise excluded from this coverage part: The Medical Payments Limit is changed to the greater of: 1.$10,000; or 2.The Medical Expense Limit shown in the Declarations of this coverage part. C.SUPPLEMENTARY PAYMENTS – COVERAGES A AND B is amended as follows: 1.The bail bonds limit shown in Paragraph 1.b. is increased from $250 to $1,000. 2.The actual loss of earnings limit shown in Paragraph 1.d. is increased from $250 to $500. D.ADDITIONAL INSUREDS 1.SECTION II – WHO IS AN INSURED is amended to include, as an additional insured, any person(s) or organization(s) for whom a written contract or written agreement between you and such person(s) or organization(s) exists and requires such person(s) or organizations(s) to be added as an additional insured to your Policy, but only for liability arising out of “bodily injury”, “property damage”, or “personal and advertising injury”. a.This endorsement applies only if the written contract or written agreement is: (1)Currently in effect or becomes effective during the term of this Policy; and (2)Executed prior to the “bodily injury”, “property damage”, or “personal and advertising injury”. b.The insurance afforded to such additional insured only: (1)Applies to the extent permitted by law; and (2)Will not be broader than the limits of insurance shown on the Declarations of this Policy or that which you are required by the written contract or written agreement to provide for such additional insured, whichever is less. c.The limits of insurance are inclusive of, and not in addition to, the limits of insurance shown in the Declarations of this Policy. 2.The insurance provided to the additional insured by this endorsement applies as follows: a.Architect, Engineer, Or Surveyor If the additional insured is an architect, engineer, or surveyor, this insurance does not apply to “bodily injury”, “property damage” or “personal and advertising injury” arising out of the rendering of or failure to render any professional services including: (1)The preparing, approving, or failing to prepare or approve maps, drawings, opinions, reports, surveys, change orders, designs or specifications; or (2)Supervisory, inspection, or engineering services. This exclusion applies even if the claims against any insured allege negligence or other wrongdoing in the supervision, hiring, employment, training or monitoring of others by that insured, if the “occurrence" which caused the "bodily injury" or "property damage", or the offense which caused the "personal and advertising injury", involved the rendering of or the failure to render any professional services by or for you. b.Lessors Of Equipment If the additional insured is a lessor of equipment, this insurance only applies to liability caused, in whole or in part, by your maintenance, operation or use of equipment leased to you by such additional insured and does not 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 land or a premise, but only with respect to liability arising out of the ownership, maintenance, or use of that part of the land or premises leased to you; and subject to the following additional exclusions: (1)Any “occurrence” which takes place after you cease to be a tenant at that premises. (2)Structural alterations, new construction, or demolition operations performed by or on the behalf of such person or organization. COMMERCIAL GENERAL LIABILITY TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 3 of 6 d.Permits Issued By State Or Political Subdivisions If the additional insured is a state or governmental agency or political subdivision that has issued a permit or authorization, then this insurance applies to operations performed by you or on your behalf. This insurance does not apply to "bodily injury", "property damage" or "personal and advertising injury" arising out of operations performed for the federal government, state, political subdivision or municipality; or "bodily injury", or "property damage" included within the “products-completed operations hazard”. e.Vendors If the additional insured is a vendor, that person(s) or organization(s) is only an additional insured with respect to "bodily injury" or "property damage" arising out of "your products" which are distributed or sold in the regular course of the vendor's business, but only if this Policy provides coverage for “bodily injury” or “property damage” included within the “products-completed operations hazard”. (1)This insurance afforded to 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 change in the product made intentionally by the vendor; (d)Repackaging, except when unpacked under the instructions of the manufacturer for the sole purpose of inspection, demonstration, testing or the substitution of parts and then repackaged in the original container; (e)Any failure by the vendor to make 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 "your products"; (f)Demonstration, installation, servicing or repair operations, except such operations performed at the vendor's premises in connection with the sale of "your products"; (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; or (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, 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 "your products". (2)This insurance does not apply to 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. (3)The coverage afforded the additional insured under this provision will be excess over any valid and collectible insurance available to the additional insured as an additional insured under a policy issued to a manufacturer or distributor for products manufactured, sold, handled or distributed unless you require that this insurance be primary and non- contributory. f.Any Other Party Any other person(s) or organization(s) is an additional insured but only for “bodily injury”, “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: (1)In connection with premises owned by or rented to you; (2)In the performance of your ongoing operations; or (3)In connection with “your work” and included within the “products-completed operations hazard”, but only if: 1.The written contract or written agreement requires you to provide coverage to additional insureds; and COMMERCIAL GENERAL LIABILITY TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 4 of 6 2.This coverage part provides coverage for “bodily injury” or “property damage” included within the “products-completed operations hazard”. 3.With respect to the insurance afforded to an additional insured as provided in Paragraphs D.1. and D.2. above, the most we will pay on behalf of the additional insured is the amount of insurance: a.Required by the contract or agreement; or b.Available under the applicable Limits of Insurance shown in the Declarations; whichever is less If an Additional Insured endorsement is attached to this Policy that specifically names a person or organization as an insured, then the above Paragraph D. ADDITIONAL INSUREDS does not apply to such person(s) or organization(s). 4.SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS, Paragraph 4. Other Insurance, is amended to include: This insurance is excess over any of the other insurance, whether primary, excess, contingent or on any other basis: a.As respects the coverage provided by this endorsement, regardless of whether other insurance is available to an additional insured on a primary basis, this insurance will be primary or primary and noncontributory if a written contract or written agreement between you and the additional insured specifically requires that this insurance be primary and noncontributory. b.When you are added as an additional insured to other insurance, this insurance is excess over 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. E.SECTION II – WHO IS AN INSURED is amended as follows: 1.BROADENDED NAMED INSURED Paragraph 1.d. is amended to add the following: If you are an organization other than a partnership, limited liability company or joint venture, any of your subsidiary companies or any company over which you own a financial interest of more than 50% of the voting stock on the effective date of this policy will qualify as an insured only if other valid and collectible insurance does not apply. 2.NEWLY ACQUIRED ORGANIZATIONS Paragraph 3.a. is deleted and replaced by the following: Coverage under this provision is afforded only until the 180th day after you acquire or form the organization or the end of the policy period, whichever is greater. F.Paragraph 6. of SECTION III – LIMITS OF INSURANCE is deleted and replaced by the following: Subject to Paragraph 5. above, the Damage To Premises Rented To You Limit is the most we will pay under SECTION I – COVERAGES, COVERAGE A for damages because of “property damage” to any one premises while rented to you, or temporarily occupied by you with permission of the owner. The Damage To Premises Rented To You Limit is the amount set forth in the Declarations or $300,000, whichever is greater. G.SECTION IV – COMMERCIAL GENERAL LIABILITY CONDITIONS are amended as follows: 1.ADDITIONAL INSUREDS OTHER INSURANCE If we cover a claim or “suit” under this coverage part that may also be covered under 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 contract or written agreement that this insurance is primary and non-contributory with the additional insured’s own insurance. 2.KNOWLEDGE AND NOTICE OF OCCURRENCE, OFFENSE, CLAIM OR SUIT COMMERCIAL GENERAL LIABILITY TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 5 of 6 The notification requirements of Paragraphs 2.a. and 2.b. Duties In The Event Of Occurrence, Offense, Claim Or Suit apply only when the “occurrence”, offense, claim or “suit” is known to: a.You or an additional insured that is an individual; b.Any partner, if you or an additional insured is a partnership; c.A member, if you or an additional insured is a joint venture; d.Any “executive officer” or insurance manager, if you or an additional insured is a corporation; e.Any trustee, if you or an additional insured is a trust; f.Any elected or appointed official, if you or an additional insured is a political subdivision or public entity; or g.Any member, if you or an additional insured is a limited liability company. This duty applies separately to you and any additional insured. 3.FAILURE TO DISCLOSE HAZARDS The following is added to Paragraph 6. Representations: If you unintentionally failed to disclose all hazards or prior “occurrences” existing at the inception of this Policy, but reported such error or omission to us as soon as practicable after discovery, then we will not deny coverage under this Coverage Part because of such failure. This provision does not affect our right to collect any additional premium or exercise our right of cancellation or non-renewal. 4.WAIVER OF TRANSFER OF RIGHTS OF RECOVERY AGAINST OTHERS TO US The following is added to Paragraph 8. Transfer Of Rights of Recovery Against Others To Us: 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 the 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 written contract. The waiver applies only to the person or organization designated in such written contract. H.SECTION V – DEFINITIONS is amended as follows: 1.ADVERTISEMENT Paragraph 1. is amended to add the following: However, “advertisement” does not include: c.The design, printed material, information or images contained in, on, or upon the packaging or labeling of any goods or products; or d.An interactive conversation between or among persons through a computer network. 2.COVERAGE TERRITORY The final paragraph in Paragraph 4. 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 a.Paragraph 9.a. is deleted and replaced by the following: A contract for a lease of premises. 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 or temporarily occupied by you with permission of the owner is subject to the COMMERCIAL GENERAL LIABILITY TGL006 0624 Includes copyrighted material of Insurance Services Office, Inc. with its permission. Page 6 of 6 Damage To Premises Rented To You Limit described in SECTION III – LIMITS OF INSURANCE. b.The first paragraph of 9.f. is deleted and replaced 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 by, 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 in the absence of any contract or agreement. 4.MOBILE EQUIPMENT Paragraph 12. is amended to add the following: Paragraph f.(1) does not apply to self-propelled vehicles of less than 1,000 pounds gross vehicle weight. 5.PERSONAL AND ADVERTISING INJURY Paragraph 14.f. is deleted and replaced by the following: Copying, in your “advertisement”, a person’s or organization’s “advertising idea” or style of “advertising”. 6.The following definition is added: “Advertising idea” means any idea for an “advertisement”. I.Liberalization Clause If we adopt a change in the coverage form, CG 00 01, which broadens coverage without an additional premium charge, the broader coverage will apply to this policy on the effective date of approval in the state shown in the Named Insured’s address in the Declarations of this policy. All other terms and conditions of the Policy remain the same. TGL014 0624 Includes copyrighted material of Insurance Services Office, Inc., Page 1 of 3 with its permission. COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. LOGGING AND LUMBERING OPERATIONS COVERAGE This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART With respect to coverage provided by this endorsement, the provisions of the Coverage Part apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: Black Fox Timber Management Group, Inc. Endorsement Effective Date: SCHEDULE Information required to complete this Schedule, if not shown above, will be shown in the Declarations. A.The following is added to SECTION I – COVERAGES, 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. However, there is no coverage while the timber is being transported. TGL014 0624 Includes copyrighted material of Insurance Services Office, Inc., Page 2 of 3 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.The following exclusions are added to Paragraph 2. Exclusions of SECTION I – COVERAGES, COVERAGE A – BODILY INJURY AND PROPERTY DAMAGE LIABILITY: 1.The insurance provided in Paragraphs A.1. and A. 2. above 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.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 will result in cancellation of the policy for non-payment of premium. TGL014 0624 Includes copyrighted material of Insurance Services Office, Inc., Page 3 of 3 with its permission. D.The following is added to SECTION V – 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 AUTOMOBILE TCA009 0624 Includes copyrighted material of Insurance Services Office, Inc., With its permission. Page 1 of 4 Named Insured: Black Fox Timber Management Group, Inc. Endorsement Effective Date: THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMERCIAL AUTOMOBILE BROADENING ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the applicable Coverage Part apply unless modified by the endorsement. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. For the purposes of this endorsement only, the insurance provided below broadens coverage under the Business Auto Coverage Form. A.SECTION II – COVERED AUTOS LIABILITY COVERAGE is amended as follows: 1.Broadened Insured Status Paragraph A. Coverage, Subparagraph 1. Who Is An Insured is amended to include as an “insured”: The following are also “insureds”: a.Any legally incorporated subsidiary in which you have a financial interest greater than 50% of the voting stock on the effective date of this policy. However, this does not apply to any organization that qualifies as an “insured” under any other automobile liability policy issued to that organization as a Named Insured or if that organization would have been an “insured” except for the exhaustion of the policy limits. b.Any organization you newly acquire or form, other than a partnership, joint venture or limited liability company, and over which you maintain ownership or majority interest, will quality as an “insured” if there is no other similar insurance available to that organization. However, the coverage provided by this provision: (1)Is effective on the acquisition or formation date and is afforded up to 180 days after acquisition or formation; (2)Does not apply to “bodily injury” or “property damage” resulting from an “accident” that occurred before you acquired or formed the organization. 2.Coverage Extensions - Supplementary Payments Paragraphs a.(2) and a.(4) under Supplementary Payments are revised as follows: a.In a.(2), the limit for the cost of bail bonds is increased to $2,500; and b.In a.(4), the limit for the actual loss of earnings is increased to $399 per day. 3.Limited Fellow Employee Coverage The following is added to Paragraph 5. Fellow Employee: But this exclusion does not apply if the "bodily injury" results from the use of a covered "auto" you own or hire. Such coverage as is afforded by this provision is excess over any other collectible insurance. B.SECTION III – PHYSICAL DAMAGE COVERAGE is amended as follows: COMMERCIAL AUTOMOBILE TCA009 0624 Includes copyrighted material of Insurance Services Office, Inc., With its permission. Page 2 of 4 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. (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 for Glass Breakage No deductible applies to glass breakage 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 a.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 in Paragraph b. below. b.The most we will pay for “loss” to any hired “auto” is: (1)$50,000; (2)The actual cash value of the damages 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 the 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, in 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 Coverage The following is added to Paragraph A.4. Coverage Extensions: Personal Effects a.We will pay up to $400 for “loss” to personal property and effects which are: COMMERCIAL AUTOMOBILE TCA009 0624 Includes copyrighted material of Insurance Services Office, Inc., With its permission. Page 3 of 4 (1)Owned by an “insured”; and (2)In or on your covered “auto”. b.This coverage applies only in the event of a total theft of your covered “auto”. c.This insurance is excess over any other collectible insurance and no deductible applies. 6.Towing and Labor Paragraph A.2. Towing And Labor is deleted and replaced by the following: Towing And Labor 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 Coverage The following is added to Paragraph A. Coverage: Lease Gap Coverage a.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 of 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 payment of 50% or a limit of $25,000, whichever is less, for the difference amount. However, this insurance is applicable only when the covered “auto” is not subject to any other Lease Gap or similar coverage. b.For the purposes of this coverage, the following definitions apply: (1)“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. (2)“Long term lease” means any “auto” leased for six (6) months or more. 8.Airbag Coverage The following is added to subparagraph 3.a. under Paragraph B. Exclusions: The accidental discharge of an airbag shall not be considered mechanical or electrical breakdown and therefore shall not be excluded. C.SECTION IV – BUSINESS AUTO CONDITIONS is amended as follows: 1.Subparagraph 2.a. under Paragraph A. Loss Conditions is amended to add the following: Knowledge of any “accident”, claim, “suit” or “loss” by an “employee” will not be deemed to be knowledge by you until notice of such “accident”, claim, “suit” or “loss” has been received by: a.You, if you are an individual; b.Any partner or insurance manager if you are a partnership; c.An executive office or insurance manager if you are a corporation. If you report an “accident”, claim, “suit”, or “loss” to an insurer providing other than commercial auto insurance, which later develops into a commercial auto claim covered by this Coverage Part, failure to report such “accident” claim, “suit”, or “loss” shall not be deemed in violation of these conditions. However, you shall give notification to us as soon as reasonably practicable when it is determined that the “accident”, claim, “suit”, or “loss” may be a commercial auto claim. 2.The following is added to Paragraph B. General Conditions: Unintentional Failure To Disclose Hazards If you unintentionally fail to disclose all hazards existing on the effective date of this policy, we will COMMERCIAL AUTOMOBILE TCA009 0624 Includes copyrighted material of Insurance Services Office, Inc., With its permission. Page 4 of 4 not deny coverage under this Coverage Form because of such failure. However, this provision does not affect our right to collect additional premium due to us as a result of these undisclosed hazards in accordance with our filed rating plans. 3.Subparagraph c. in Paragraph B.5. Other Insurance is deleted and replaced by the following: Regardless of the provisions of Paragraph a. above, SECTION II – COVERED AUTOS LIABILITY COVERAGE of this Coverage Form 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”. 4.The following conditions are added: a.Autos Rented By Employees (1)Any “auto” hired or rented by your “employee” on your behalf and at your direction will be considered an “auto” you hire. (2)Paragraph B.5. Other Insurance is amended to include the following: If an “employee’s” personal insurance policy 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 policy. b.Hired Auto Coverage Territory (1)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 or in a settlement to which we agree. (2)For the purposes of this condition, “short-term” means less than six (6) months. All other terms and conditions of the policy remain unchanged. Endorsement Agreement Nothing in this endorsement shall be held to vary, alter, waive or extend any of the terms, conditions, agreements, or limitations of this policy other than as above stated. Nothing elsewhere in this policy shall be held to vary, alter, waive or limit the terms, conditions, agreements or limitations in this endorsement. Countersigned and Issued at San Francisco January 1, 2026 2572 Authorized Representative President and CEO SF – END Rev. 2/2025 OLD DP 217 Waiver of Subrogation 9084125-2026 Home Office Renewal San Francisco NF All Effective Dates are 5-22-41-24 at 12:01 AM Pacific Page 1 of 1 Standard Time or the Time Indicated at Effective January 1, 2026 at 12:01 AM Pacific Standard Time and Expiring January 1, 2027 at 12:01 AM 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 2.00% of the total policy premium. Schedule Person or Organization Any person or organization for whom the named Insured has agreed by written contract to furnish this waiver Job Description Blanket Waiver of Subrogation