You Need Hunting Lease Liability Insurance. Outdoor Underwriters Has A Policy You Can Afford. Louisiana Forestry Association LFA and Outdoor Underwriters, Inc. have joined together to provide affordable Hunting Lease Liability. 2009 Application Hunting Lease Liability Insurance Type of Insurance: Comprehensive General Liability Limit of Liability: $1,000,000 Each Occurrence $2,000,00 Aggregate Deductible: $ ‐0– Per Occurrence Named Insured: LFA—Member hunting clubs leasing land from LFA member landowners. A separate certificate will be issued to each hunting club and all landowners. Master policy basis. Landowners can be listed as an Additional Insured party. Step 1: Enter your hunt club and landowner s information: Your Club Name__________________________________________________________________________________________________ Club Contact Name_______________________________________________________________________________________________ Address___________________________________________________________________________________________________________ City_______________________________________________State_____________________________________Zip___________________ Telephone Home __________________________________________ Work ____________________________________________ Signature of Club representative_______________________________________________________________________________ Landowner Name________________________________________________________________________________________________ Address___________________________________________________________________________________________________________ City_______________________________________________State_____________________________________Zip___________________ Telephone Home __________________________________________ Work ____________________________________________ Location of acreage to be covered Parish ____________________________________Number of acres_______________ Leasing from more than one landowner? Please attach a separate sheet with the above information for each landowner. Step 2: Calculate your hunt club premium: Premium Calculation—Hunting Lease Liability Insurance Number of acres to be covered__________________X .12 cents per acre $_______________________________ This line subject to $150 minimum premium Plus add $26.00 for each landowner Additional Insured $________________________________ 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, Inc. Master Policy effective date is August 1, 2009 to August1, 2010. Applications received after August1, 2009 will be effective upon approval and will expire August1, 2010. Step 3: Both your club and each landowner must be a member of the Louisiana Forestry Association. Landowner Membership dues are: Hunting Club Membership dues are: Based on Forest Acreage .021 Per Acre OR $25.00 $25.00 per year Please make check for membership dues payable to: Louisiana Forestry Association. Please contact Louisiana Forestry Association at 318‐443‐2558 with any questions concerning the membership. Step 4: Mail all checks and forms to: Louisiana Forestry Association PO Box 5067 Alexandria, La 71307 Check #1: The insurance premium must be made payable to: Outdoor Underwriters, Inc. Refer to rates . Check #2: LFA dues must be made payable to: Louisiana Forestry Association. Refer to rates in Step 3 . IMPORTANT NOTICE All questions relating to insurance coverage should be directed to Outdoor Underwriters, Inc. toll free at 866‐961‐4101 or 803‐451‐5826. Questions concerning LFA membership status should be directed to LFA at 318‐443‐2558. This program is only available to LFA members in good standing. For hunting lease liability insurance both the hunt club and landowner must be members of LFA to qualify. Separate checks must be written to LFA and Outdoor Underwriters, Inc. Combined payments on one check will be returned. Club must have a written lease with any and all landowners listed on the application for coverage to apply. The Louisiana Forestry Association LFA is a private nonprofit organization of landowners, foresters, loggers and companies dedicated to forest conservation and sustainable use of our natural resources. Formed in 1947, LFA is comprised of 4,000 members representing all phases of Louisiana’s diverse forestry community.