2026-03-01_COI_Summitt.pdf

SHOULD 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-MAIL

ADDRESS:

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

ER

OTH-

STATUTE

PER

LIMITS(MM/DD/YYYY)

POLICY EXP

(MM/DD/YYYY)

POLICY EFF

POLICY NUMBERTYPE OF INSURANCELTR

INSR

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

3/5/2025 k.p.d. Insurance LLC 1111 Gateway Loop Springfield OR 97477

Marisela Canales 541-741-0550 541-741-1674 marisela.canales@imacorp.com

License#: PC-1210733 The Cincinnati Specialty Underwriters Insurance Co 13037 SUMMFOR02A Continental Divide Insurance Company 35939

Summitt Forests, Inc.

2305 Ashland Street, Suite #104

PMB #432

Ashland OR 97520-3777

Landmark American Insurance Company 33138 National Fire & Marine Insurance Company 20079 Crum & Forster Indemnity Company 31348 SAIF Corporation 36196

1056059629

A X 1,000,000 X 100,000

X LOGGERS BFPD Excluded

X WA STOP GAP 1,000,000

2,000,000 X

Y Y CSU 0183947 3/1/2025 3/1/2026

2,000,000

B 1,000,000

X X X

Y 05APM02876804 3/1/2025 3/1/2026

NO HAPD COVERAGE

C X 2,000,000

X

LHA106877 3/1/2025 3/1/2026

2,000,000 X 0

F X

N

887885 11/1/2024 11/1/2025

500,000

500,000

500,000 D E

EXCESS AUTOMOBILE LIABILITY

POLLUTION LIABILITY

72XAS011081

PKC117728

3/1/2025 3/1/2025

3/1/2026 3/1/2026

$4,000,000 LIMIT

$1,000,000/$2,000,000

POLL LIAB RETRO DATE:

$5,000 DEDUCTIBLE

12/31/2021

*2nd Workers Comp policy: Zurich Insurance #1152905, WC Policy has $1Million Employers Liability Limits* **Additional Insured wording does not apply to the Workers Comp/Employers Liability Coverage** ***Excess/Umbrella Liability extends over the Workers Comp/Employers Liability Coverage*** RE: Solicitation #BPM002819 The State of Arizona, its Departments, Agencies, Boards, Commissions, Universities, Officers, Officials, Agents and Employees are included as Additional Insureds, for General Liability, when required by written contract or agreement, per form CSGA4034_0612, which includes Primary and Non-Contributory coverage; and for Automobile Liability, per form M-5876_0516. Waiver of Subrogation applies to General Liability, per form CSGA4087_1212.

Arizona Game and Fish Department 5000 W Carefree Highway Phoenix AZ 85086-5000

M-5144a (06/2007)

WAIVER OF TRANSFER OF RIGHTS OF

RECOVERY AGAINST OTHERS TO US

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

BUSINESS AUTO PHYSICAL DAMAGE COVERAGE FORM

GARAGE COVERAGE FORM

MOTOR CARRIER COVERAGE FORM

TRUCKERS COVERAGE FORM

With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi-fied by the endorsement.

This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below.

Includes copyrighted material of Insurance Services Office , Inc. with its permission.

Name Of Person(s) Or Organization(s):

(If no entry appears above, information required to complete this endorsement will be shown in the Declarations as applicable to this endorsement.)

The Transfer Of Rights Of Recovery Against Others To Us Condition does not apply to the person (s) or organiza-tion(s) shown in the Schedule. We will retain the additional premium shown above, regardless of any early termi-nation of this endorsement or the policy.

Endorsement Effective:

Named Insured:

Countersigned By:

(Authorized Representative)

SCHEDULE

Additional Premium $

M-5144a (06/2007) 02/25/2025

ARIZONA GAME AND FISH DEPARTMENT

5000 W CAREFREE HIGHWAY

PHOENIX, AZ 85086

SUMMITT FORESTS INC; SUMMITT ENTERPRISES INC

03/01/2025 12:01 AM

05 APM 028768 - 04POLICY NUMBER:

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Includes copyrighted material of Insurance CSGA 4087 12 12 Services Office, Inc., with its permission. Page 1 of 1

COMMERCIAL GENERAL LIABILITY

CSGA 4087 12 12

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

WAIVER OF TRANSFER OF RIGHTS OF RECOVERY

AGAINST OTHERS TO US - PER CONTRACT

This endorsement modifies insurance provided under the following:

COMMERCIAL GENERAL LIABILITY COVERAGE PART

PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART

The following is added to Paragraph 8. Transfer of Rights of Recovery Against Others to Us of SECTION

IV - CONDITIONS:

If you have agreed, in a written contract or agreement, to provide a waiver of any right of recovery against a person or organization, we will waive any right of recovery we may have against that person or organization because of payments we make for injury or damage arising out of your ongoing operations or "your work" done under a contract with that person or organization and included in the "products-completed operations hazard".

This waiver applies only to that person or organization for which you have agreed to in a written contract to provide said waiver.

M-5876 (05/2016)

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

BLANKET ADDITIONAL INSURED ENDORSEMENT

This endorsement modifies insurance provided under the following:

BUSINESS AUTO COVERAGE FORM

GARAGE COVERAGE FORM

TRUCKERS COVERAGE FORM

In consideration of payment of the additional premium listed below, LIABILITY COVERAGE is extended to any person or organization you are required to add to this policy as an additional insured in a written agreement between you and the additional insured that is executed prior to the "accident" provided that:

1) such insurance applies only to the ownership, maintenance or use of a covered auto; and

2) such insurance applies only to acts or omissions by you, your agents or your “employees” while such covered auto is being used in your business; and

3) such insurance does not apply to the acts or omissions of the additional insured or any of the additional insured’s agents or "employees" other than you; and

4) such insurance does not apply if the additional insured is subject to motor carrier insurance requirements and is not insured for hired "autos" under an "auto" liability insurance form that insures on a primary basis the owners of the "autos" and their agents and "employees" while the "autos" are being used exclusively in the additional insured’s business and pursuant to operating rights granted to the additional insured by a public authority; and

5) such inclusion of additional insured shall not increase our limit of liability under this policy.

All other terms, conditions and agreements remain unchanged.

M-5876 (05/2016)

Company Name Policy Number

Endorsement Effective

Named Insured Countersigned by

(Authorized Representative)

(The Attaching Clause need be completed only when this endorsement is issued subsequent to preparation of the policy .)

Additional Premium: $

02/25/2025

05 APM 028768 - 04

2,500

Continental Divide Insurance Company

SUMMITT FORESTS INC; SUMMITT ENTERPRISES INC

03/01/2025 12:01 AM