2025-03-16_COI_GL__Auto__WC.pdf

12/13/2024

Leavitt Select Insurance Services, Inc.

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 WCF Mutual Insurance Company 10033

24/25

A

X

X

X

X Y CPS7959756 3/16/2024 3/16/2025

1,000,000

100,000

5,000

1,000,000

2,000,000

2,000,000

B X X Y 06627184 3/16/2024 3/16/2025

1,000,000

Uninsured motorist combined single limit 1,000,000

C 4007392 9/24/2024 9/24/2025

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 Q CA71801 INS POLEND U POLWHITEFONT UR3GRQTKBL4WUGOTJ7VAHDN5JG0005 RPUID TRACWHITEFONT BDF_PCA

Policy number: 06627184 Underwritten by:

United Financial Casualty Company

Insured:

COVE RIVER RANCH LLC

February 13, 2024

Policy Period: Mar 16, 2024 - Mar 16, 2025

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: March 16, 2024 March 16, 2025

Form 1198 (07/16)

Form_SCTNID_CTGRY.UT05216489_DECPAGE

06627184 Q CA71801 INS DECPAGE U POLWHITEFONT UR3GRQTKBL4WUGOTJ7VAHDN5JG0002 RPUID TRACWHITEFONT BDF_PCA

Policy number: 06627184 Underwritten by:

United Financial Casualty Company

Page of Policy Period: Mar 16, 2024

1 4

February 13, 2024 Mar 16, 2025

Online Service

Make payments, check billing activity, print policy documents, update your policy or check the status of a claim.

agent.progressive.com

LEAVITT GROUP INS

Contact your agent for personalized service.

1-801-308-1500

For customer service if your agent is unavailable or to report a claim.

1-800-444-4487

SALT LAKE CITY, UT 84115

2200 S MAIN ST #600

LEAVITT GROUP INS

Named insured

500 N MARKET PLACE DR STE 101

COVE RIVER RANCH LLC

CENTERVILLE, UT 84014

Commercial Auto Insurance Coverage Summary This is your Renewal Declarations Page

This Renewal Declarations Page is effective only if the minimum amount due to renew your policy is received or postmarked by March

16, 2024.

Your coverage begins on March 16, 2024 at 12:01 a.m. This policy expires on March 16, 2025 at 12:01 a.m.

Your insurance policy and any policy endorsements contain a full explanation of your coverage. The policy limits shown for an auto may not be combined with the limits for the same coverage on another auto, unless the policy contract allows the stacking of limits.

The policy contract is form 6912 (02/19) . The contract is modified by forms 2852UT (02/19), 1652UT (02/19), Z434 (02/19), 1198

(07/16), 4852UT (02/19), 4881UT (02/19), Z228 (01/11) and 8610 (02/19).

The named insured organization type is a corporation.

United Financial Casualty Company is an Ohio domiciled company.

Continued

Form 6489 UT (05/21) http://agent.progressive.com colleen-stanton Highlight

06627184 Q CA71801 INS DECPAGE U POLWHITEFONT UR3GRQTKBL4WUGOTJ7VAHDN5JG0002 RPUID TRACWHITEFONT BDF_PCA

Policy number: 06627184

COVE RIVER RANCH LLC

Page of 2 4

Outline of coverage

Auto coverage part Description Limits Deductible Premium………………………………………………………………………………………………………………………………………………………..

Bodily Injury and Property Damage Liability $1,000,000 combined single limit

Liability To Others $8,951

Uninsured Motorist $1,000,000 combined single limit 110 Underinsured Motorist $1,000,000 combined single limit 268………………………………………………………………………………………………………………………………………………………..

Rejected --Uninsured Motorist Property Damage………………………………………………………………………………………………………………………………………………………..

Without Workers Compensation $3,000

243Personal Injury Protection

See Auto Coverage Schedule Limit of liability less deductible

2,028Comprehensive

See Auto Coverage Schedule Limit of liability less deductible

10,437Collision

Subtotal policy premium

$22,037

Motor Truck Cargo coverage part Description Limits Deductible Premium Motor Truck Cargo $25,000 $2,683$1,000

Subtotal policy premium

$2,683 Waiver of Subrogation Fee 25 Additional Insured Fee 20 Total 12 month policy premium and fees $24,765

Discount if paid in full

Total 12 month policy premium if paid in full $22,177

-3882

Rated drivers

SCOTT SATTERLEE1. A

COLTON TUTTLE2.

Chantz Ogden3. R

Rated commodities

1. OTHER LIVESTOCK

Auto coverage schedule

1993 BIG T Trailer Stated Amount: * $5,000 (including Permanently Attached Equip)

VIN: 1B9UG1429PJ305023 Garaging Zip Code: 84701 Radius: 200 miles

Personal use: N Body type: Utility Trailer

1.

Liability Premium

Liability Premium

$125

Physical Damage ……………………………………………………………………………………………………………………………………………… Premium $289

Auto Total Comp Deductible

$500

Comp Premium

$88

Collision Deductible

$500

Collision Premium

$76

Continued

Form 6489 UT (05/21)

06627184 Q CA71801 INS DECPAGE U POLWHITEFONT UR3GRQTKBL4WUGOTJ7VAHDN5JG0002 RPUID TRACWHITEFONT BDF_PCA

COVE RIVER RANCH LLC

Page of 3 4

1969 BRENNER Trailer Stated Amount: * $25,000 (including Permanently Attached Equip)

VIN: 0000UT21199831592 Garaging Zip Code: 84701 Radius: 500 miles

Personal use: N Body type: Tank Trailer

2.

Liability Premium

Liability Premium

$107

Physical Damage ……………………………………………………………………………………………………………………………………………… Premium $2,608

Auto Total Comp Deductible

$500

Comp Premium

$226

Collision Deductible

$500

Collision Premium

$2275

2014 FRHT 125 Stated Amount: * $50,000 (including Permanently Attached Equip)

VIN: 3AKJGLD58ESFK2940 Garaging Zip Code: 84701 Radius: 500 miles

Personal use: N Body type: Truck Tractor

3.

Liability Premium

Liability Premium

$5181

UM

Premium

$49

UIM

Premium

$119

PIP

Premium

$127

Physical Damage ……………………………………………………………………………………………………………………………………………… Premium $10,204

Auto Total Comp Deductible

$1,000

Comp Premium

$783

Collision Deductible

$1,000

Collision Premium

$3945

2017 LOADTRAIL Trailer Stated Amount: * $5,700 (including Permanently Attached Equip)

VIN: 4ZEDT1429H1136283 Garaging Zip Code: 84701 Radius: 500 miles

Personal use: N Body type: Dump Body Trailer

4.

Liability Premium

Liability Premium

$107

Physical Damage ……………………………………………………………………………………………………………………………………………… Premium $1,040

Auto Total Comp Deductible

$500

Comp Premium

$82

Collision Deductible

$500

Collision Premium

$851

2018 RAM 5500 Stated Amount: * $60,000 (including Permanently Attached Equip)

VIN: 3C7WRNFL7JG171052 Garaging Zip Code: 84701 Radius: 100 miles

Personal use: N Body type: Pickup Truck

5.

Liability Premium

Liability Premium

$3431

UM

Premium

$61

UIM

Premium

$149

PIP

Premium

$116

Physical Damage ……………………………………………………………………………………………………………………………………………… Premium $7,896

Auto Total Comp Deductible

$500

Comp Premium

$849

Collision Deductible

$500

Collision Premium

$3290

*A vehicle's stated amount should indicate its current retail value, including any special or permanently attached equipment. In the event of a total loss, the maximum amount payable is the lesser of the Stated Amount or Actual Cash Value, less deductible. Be sure to check stated amount at every renewal in order to receive the best value from your Progressive Commercial Auto policy.

Premium discounts

Policy

06627184 Electronic Funds Transfer and Multi-Product

Continued

Form 6489 UT (05/21)

06627184 Q CA71801 INS DECPAGE U POLWHITEFONT UR3GRQTKBL4WUGOTJ7VAHDN5JG0002 RPUID TRACWHITEFONT BDF_PCA

COVE RIVER RANCH LLC

Page of 4 4

Loss Payee information Loss Payee Auto ROCK CANYON BANK

94 E TABERNACLE ST

ST. GEORGE, UT 84770

1993 BIG T Trailer (1B9UG1429PJ305023)

1. 1

Loss Payee Auto ROCK CANYON BANK

94 E TABERNACLE ST

ST. GEORGE, UT 84770

1969 BRENNER Trailer (0000UT21199831592)

2. 2

Loss Payee Auto ZIONS BANK

PO BOX 30709

SALT LAKE CITY, UT 84130

2014 FRHT 125 (3AKJGLD58ESFK2940)

3. 3

Additional Insured information Additional Insured Arizona Game and Fish Dept

5000 W Carefree Hwy

Phoenix, AZ 85086

1.

Waiver of Subrogation information

Waiver of Subrogation

Arizona Game and Fish Dept

5000 W Carefree Hwy

Phoenix, AZ 85086

1.

Form 6489 UT (05/21) colleen-stanton Highlight colleen-stanton Highlight