Loggers Broad Form Insurance

You must complete the application and then scan and email to steve@athenainsurance.com or fax to 209 223-1870. Do not save or save as because the data will be removed. You can save a printed copy of the .pdf document.

For a .PDF app click here – Loggers Broad form app click here lbf_third_party_ll

You can also complete a web questionnaire below.

Loggers Broad Form Insurance is a form of General Liability. It is a “broadening” of liability coverage” not offered under the Standard General Liability policy. Most timber-men, foresters, State Departments require “loggers broad form” and a standard general liability policy. Thus two policies.

If you would like a quote on your Standard General Liability policy please let us know or complete a form.

Do you want to begin a quote now?
- Yes
Quote now?
- No

APPLICANT INFORMATION
LOGGERS THIRD PARTY PROPERTY DAMGAGE LIABILITY POLICY APPLICATION
Note: At the end of this form there is an "upload" button which will allow you to upload .pdf files. Feel free to submit your current/expiring policy, loss runs and any hold harmless agreement you hold. If you need assistance in completing this form call 209 223-1870.
Underwriters will rely upon each and every response given in this application and any supplemental application or questions in deciding whether or not to insure you. And if so, at what premium, terms and conditions. Underwriters regard every response to be material to their decisions. Failing to answer or answering any question below incorrectly could invalidate any policy of insurance written by underwriters for your business.
Contact Information
Name of person completing this form*
Phone*
Email*
Enter Email Confirm Email
Applicants Information
Name of Company*
Entity type*
Name of owner or first named insured if different from company name*
For example, the company name is xyz, inc. and the owner is name Steve Valencia. Steve Valencia would be the first named insured. Although there are other officers in a corporation only one can be named as first named insured and they alone are the only person to which all legal notices are directed.
LTO license number / Timber License
Contractor's License Number
Physical address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Is the physical address the same as the "mail address?"*
Mailing address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Website
Phone*
Cell Phone
Fax number
Email*
Number of employees*
Number of years in business*
Briefly describe your experience*
Coverage Required
What is your desired effective date if approved?*
DD slash MM slash YYYY
Limits*
Deductible*
Payroll "estimates" for the next 12 months in the following
1. Logging on your lands*
1. Payroll*
2. Logging by owner*
2. Payroll*
3. Logging by employees*
If none type none
3. Payroll*
If none type none
4. Log Road Building*
If none type none
4. Payroll*
If none type none
5. Subcontract Logging*
If none type none
5. Payroll*
If none type none
6. Subcontract Log Hauling*
If none type none
6. Payroll*
If none type none
7. Truck Drivers*
If none type none
7. Payroll*
If none type none
8. Other describe*
If none type none
8. Payroll*
If none type none
Please provide percentage Owner/Officers/Partners are active at job site

Logging Operations
List areas of operation: (States, Counties, Towns & Regions)
List all areas project to work in over the next twelve months
Do you own the land upon which you or others are operating?*
- Yes
- No
If "NO", are all required permits in place with appropriate authorities?*
- Yes
- No
Is there a signed contract with the owner?*
- Yes
- No
Please provide a description of your logging operations*
What precautions do you take to prevent trespassing onto others Land?*
For example do you require it be surveys and marked. Are foresters required to flag the boundaries and / or trees?
What methods do you use to determine boundaries and identify trees for cutting?*

Loggers Broad Form

Make the Wise Choice (209) 223-1870 (m-f 9:00am to 4:30pm pst)

Loggers Broad Form Insurance

Loggers Broad Form Insurance

For a .PDF app click here – Loggers Broad form app click here lbf_third_party_ll

APPLICANT INFORMATION

LOGGERS THIRD PARTY PROPERTY DAMGAGE LIABILITY POLICY APPLICATION

Contact Information

Applicants Information

Coverage Required

Payroll "estimates" for the next 12 months in the following

Logging Operations

Activities: Please check all that apply

Additional Insured

Underwriting continued

Commercial General liability is required along with LBF.