Premium Calculation If you wish to purchase the Combined Timberland & Hunting Lease Liability Insurance you must fill out the Hunt Lease Liability application and the Timberland Liability application and then use the formula below for your calculations. (This is for one landowner leasing all of his/her property to one club)
Combined Timberland and Hunting Lease Liability Number of acres to be covered _________________ X .35 cents per acre…..= $___________________ (Includes fire damage liability on hunting lease liability only.) (THIS LINE SUBJECT TO $175 MINIMUM PREMIUM) Plus total number of insured landowners _______ X $30 each....…………….= $____________________ Total amount due for combined timberland and hunting lease liability insurance……………………………………………...= $____________________
Join the Arkansas Forestry Association Both the landowner and the hunt club must be a current member of the Arkansas Forestry Association to participate in this insurance program. Landowner Membership dues are:
Please make check for insurance payable to Outdoor Underwriters, Inc.
(Based on Forest Acreage)
Coverage is subject to approval by Outdoor Underwriters. Master Policy effective date are listed below. Applications received will be effective upon approval and expired according to the policy terms. EFFECTIVE DATES: (Please check desired effective date).
0-160 Acres. . . . . . . . . . . . . $ 50 per year 161-500 Acres. . . . . . . . . . . $ 65 per year 501-1,000 Acres. . . . . . . . . .$ 95 per year 1,001-3,000 Acres. . . . . . . . $175 per year 3,001-5000 Acres. . . . . . . . .$325 per year 5.001-7,000 Acres. . . . . . . . $500 per year All acreage over 7,000. . . . .$500 + $.02 per acre
January 1 to January 1
April 1 to April 1
August 1 to August 1
October 1 to October 1
IMPORTANT NOTICE All questions relating to insurance coverage should be directed to Outdoor Underwriters, Inc. at 866-961-4101. Questions concerning AFA membership status should be directed to AFA at 501-374-2441 or info@arkforest.org. These programs are only available to AFA members in good standing. For hunting lease liability both the hunt club and landowner must be members of AFA to qualify. Separate checks must be written to AFA and Outdoor Underwriters, Inc. COMBINED PAYMENTS ON ONE CHECK WILL BE RETURNED. Check #1: The insurance premium must be made payable to Outdoor Underwriters, Inc. (Refer to rates). Check #2: AFA dues must be made payable to Arkansas Forestry Association. (Refer to dues schedule on next panel). MAIL ALL CHECKS AND FORMS TO:
Outdoor Underwriters, Inc. 140 Stoneridge Dr., Suite 265 Columbia SC 29210
Hunting Club Membership dues are: Hunting Club Dues: $2 per member with a minimum of $40. Mission Statement The Arkansas Forestry Association works to advance the cause of forestry, develop a public appreciation for the environment and economic value of the forests of Arkansas, and encourage the wise use and management of forest resources. AFA advocates responsible scientific forest management, represents its members’ interests in the public policy arena, and serves as a watchful guardian of private property rights. Please make check for membership dues payable to: Arkansas Forestry Association. Printed 1-23-13
Hunting Lease Liability Insurance
Timberland Liability Insurance Type of Insurance: * Comprehensive General Liability * Limit Of Liability: $1,000,000 Each Occurrence $2,000,000 Aggregate * Deductible: $250 per occurrence
Type of Insurance: * Comprehensive General Liability * Limit Of Liability: $1,000,000 Each Occurrence $2,000,000 Aggregate * Deductible: $ -0- per occurrence
Named Insured: AFA - Timberland owner who is a member of the Arkansas Forestry Association.
Named Insured: AFA - Member hunting clubs leasing land from AFA member landowners. A separate certificate will be issued to each hunting club.
* Owners, Landlord, & Tenant - Liability Limit to $1,000,000 per occurrence. * Special Master policy rating basis. * Liability coverage for the Landowner does not provide protection for owned Timber. (Separate coverage is available for fire, lightening, wind, flood, ice and theft). Contact Outdoor Underwriters, Inc.
* Master policy basis. * Landowners would be listed as an additional insured party. Application—Hunting Hunting Lease Liability Insurance
Application—Timberland Timberland Liability Insurance Landowner Name:_____________________________________________ Number of acres:______________
Landowner Name:_____________________________________________ Number of acres:__________ Address:_____________________________________________________________________________ City:___________________________________ State:_____________________ Zip:_______________ Telephone: (Home)___________________________ (Work)___________________________________
Address:_________________________________________________________________________
Location (County): ________________________________ E-Mail Address: _______________________
Telephone: (Home)_____________________________ (Work)____________________________________
Leasing from more than one landowner? Please attach a separate sheet with the above information for each landowner.
Location (County): ________________________________ E-Mail Address: __________________________
Your Hunt Club Name: _______________________________ E-Mail Address: _____________________ Address:_____________________________________________________________________________ City:___________________________________ State:__________________ Zip:__________________ Telephone: (Home)____________________________(Work)___________________________________ Signature of club representative:___________________________________________________________ Premium Calculation---Hunting Lease Liability Insurance ONLY
Number of acres to be covered __________X .15 cents per acre = $____________
includes fire damage liability
(THIS LINE SUBJECT TO $150 MINIMUM PREMIUM)
Plus Total Number of Landowners X $30 each Total amount due for hunting lease liability insurance
= $____________ = $____________
Please make check for insurance payable to Outdoor Underwriters, Inc. Coverage is subject to approval by Outdoor Underwriters. Master Policy effective date are listed below. Application received will be effective upon approval and expired according to the policy terms.
EFFECTIVE DATES: (Please check desired effective date).
January 1 to January 1 April 1 to April 1 August 1 to August 1 October 1 to October 1
City:________________________________________ State:_____________________ Zip:_____________
Describe any past losses:___________________________________________________________________ Are locations fenced or posted?
Y
N
Any dams/spillways/bridges?
Any leased hunting or commercial hunting? Y
N
Any property ever used for mining?
Y
N
Any watercraft or docks?
Y
N
Any of the property leased for farming?
Y
N
Any buildings?
Y
N
Are certificates of insurance required
Any lakes or ponds?
Y
N
Y
N
for any leased or commercial hunting?
Y
N
Describe what the property is used for:_________________________________________________________ Signature of Landowner:____________________________________________________________________ Premium Calculation---Timberland Liability Insurance ONLY
Number of acres to be covered______________X .24 cents per acre
= $____________________
(THIS LINE SUBJECT TO $150 MINIMUM PREMIUM)
Please make check for insurance payable to Outdoor Underwriters, Inc. Coverage is subject to approval by Outdoor Underwriters. Master Policy effective date are listed below. Application received will be effective upon approval and expired according to the policy terms.
EFFECTIVE DATES: (Please check desired effective date). January 1 to January 1 April 1 to April 1 August 1 to August 1 October 1 to October 1