2024-09-24_Certificate_of_Insurance_Cove_River.pdf

11/6/2023

Leavitt Group Insurance Advisors 2200 S. Main Street Suite 600 Salt Lake City UT 84115

Colleen Stanton (801)308-1500 (801)308-1427 colleen-stanton@leavitt.com

Cove River Ranch LLC 202 N West haven Rd

Venice UT 84701

Scottsdale Insurance Company 41297 United Financial Casualty Company 11770 Utah Workers Compensation Fund 10033

23/24

A

X

X

X

X Y CPS7753168 3/16/2023 3/16/2024

1,000,000

100,000

5,000

1,000,000

2,000,000

2,000,000

B X X Y 06627184 3/16/2023 3/16/2024

1,000,000

Uninsured motorist combined single limit 1,000,000

C 4007392 9/24/2023 9/24/2024

X

1,000,000

1,000,000

1,000,000

The State of Arizona, and its departments boards, commissions, universities, office officials, agents, and employees Arizona Game and Fish Dept.

5000 W Carefree Hwy Phoenix, AZ 85086 C Stanton-Exec/COSTAN

The ACORD name and logo are registered marks of ACORD

CERTIFICATE HOLDER

© 1988-2014 ACORD CORPORATION. All rights reserved.

ACORD 25 (2014/01)

AUTHORIZED REPRESENTATIVE

CANCELLATION

DATE (MM/DD/YYYY)CERTIFICATE OF LIABILITY INSURANCE

LOCJECT

PRO-

POLICY

GEN'L AGGREGATE LIMIT APPLIES PER:

OCCURCLAIMS-MADE

COMMERCIAL GENERAL LIABILITY

PREMISES (Ea occurrence) $

DAMAGE TO RENTED

EACH OCCURRENCE $

MED EXP (Any one person) $

PERSONAL & ADV INJURY $

GENERAL AGGREGATE $

PRODUCTS - COMP/OP AGG $

$RETENTIONDED

CLAIMS-MADE

OCCUR

AGGREGATE $

EACH OCCURRENCE $UMBRELLA LIAB

EXCESS LIAB

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

INSR

LTR TYPE OF INSURANCE POLICY NUMBER

POLICY EFF

(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY) LIMITS

PER

STATUTE

OTH-

ER

E.L. EACH ACCIDENT

E.L. DISEASE - EA EMPLOYEE

E.L. DISEASE - POLICY LIMIT

ANY PROPRIETOR/PARTNER/EXECUTIVE

If yes, describe under DESCRIPTION OF OPERATIONS below

(Mandatory in NH)

OFFICER/MEMBER EXCLUDED?

WORKERS COMPENSATION

AND EMPLOYERS' LIABILITY Y / N

AUTOMOBILE LIABILITY

ANY AUTO

ALL OWNED SCHEDULED

HIRED AUTOS

NON-OWNED

AUTOS AUTOS

AUTOS

COMBINED SINGLE LIMIT

BODILY INJURY (Per person)

BODILY INJURY (Per accident)

PROPERTY DAMAGE $

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.

INSD

ADDL

WVD

SUBR

N / A

(Ea accident)

(Per accident)

OTHER:

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.

IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must 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).

COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:

INSURED

PHONE

(A/C, No, Ext):

PRODUCER

ADDRESS:

E-MAIL

FAX

(A/C, No):

CONTACT

NAME:

NAIC #

INSURER A :

INSURER B :

INSURER C :

INSURER D :

INSURER E :

INSURER F :

INSURER(S) AFFORDING COVERAGE

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE

THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN

ACCORDANCE WITH THE POLICY PROVISIONS.

INS025 (201401)

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Form_SCTNID_CTGRY.XX07161198_POLEND

06627184 E CA71801 INS POLEND U POLWHITEFONT 6XOPE2OJVIBVEQ2GAJ63GQBGAH0002 RPUID TRACWHITEFONT BDF_PCA

Policy number: 06627184 Underwritten by:

United Financial Casualty Company

Insured:

COVE RIVER RANCH LLC

November 6, 2023

Policy Period: Mar 16, 2023 - Mar 16, 2024

Mailing Address United Financial Casualty Company

PO Box 94739

Cleveland, OH 44101

For customer service, 24 hours a day, 7 days a week

1-800-444-4487

SALT LAKE CITY, UT 84115

2200 S MAIN ST #600

LEAVITT GROUP INS

500 N MARKET PLACE DR STE 101

COVE RIVER RANCH LLC

CENTERVILLE, UT 84014

Additional insured endorsement

Name of Person or Organization

Arizona Game and Fish Dept 5000 W Carefree Hwy Phoenix, AZ 85086

This endorsement modifies insurance provided under the commercial auto policy and any endorsements thereto affording liability coverage.

The person or organization named above is an insured with respect to such liability coverage as is afforded by the policy, but this insurance applies to said insured only as a person liable for the conduct of another insured and then only to the extent of that liability. We also agree with you that insurance provided by this endorsement will be primary for any power unit specifically described on the Declarations Page and showing liability coverage.

Limit of Liability

Bodily Injury Not applicable

Property Damage Not applicable

Combined Liability $1,000,000 each accident

All other terms, limits and provisions of this policy remain unchanged.

This endorsement applies to Policy Number: 06627184

Issued to (Name of Insured): COVE RIVER RANCH LLC

Effective date of endorsement: Policy expiration date: November 3, 2023 March 16, 2024

Form 1198 (07/16)

Form_SCTNID_CTGRY.XX02198610_POLEND

06627184 E CA71801 INS POLEND U POLWHITEFONT 6XOPE2OJVIBVEQ2GAJ63GQBGAH0002 RPUID TRACWHITEFONT BDF_PCA

Policy number: 06627184 Underwritten by:

United Financial Casualty Company

Insured:

COVE RIVER RANCH LLC

November 6, 2023

Policy Period: Mar 16, 2023 - Mar 16, 2024

Mailing Address United Financial Casualty Company

PO Box 94739

Cleveland, OH 44101

For customer service, 24 hours a day, 7 days a week

1-800-444-4487

SALT LAKE CITY, UT 84115

2200 S MAIN ST #600

LEAVITT GROUP INS

500 N MARKET PLACE DR STE 101

COVE RIVER RANCH LLC

CENTERVILLE, UT 84014

Waiver of Subrogation Endorsement

This endorsement modifies insurance provided under the following:

Commercial Auto Policy Motor Truck Cargo Liability Coverage Endorsement Commercial General Liability Coverage Endorsement

We agree to waive any and all subrogation claims against the person or organization designated below.

Name of Person or Organization:

Arizona Game and Fish Dept 5000 W Carefree Hwy

Phoenix, AZ 85086

This endorsement applies to policy number: 06627184 Issued to: COVE RIVER RANCH LLC

Endorsement effective: November 3, 2023 Expiration: March 16, 2024

All other terms, limits and provisions of this policy remain unchanged.

Form 8610 (02/19)