Contractor Renewal - PLC of the Northeast

Contractor Renewal Form

URL

This field is for validation purposes and should be left unchanged.

Company Name:(Required)

Contact Name:(Required)

First Last

State:(Required)

Mailing Address:(Required)

Street Address City ZIP / Postal Code

Office Phone:(Required)

If none, enter 111-111-1111

Cell:(Required)

Email:(Required)

Additional Emails for weekly email updates:

Website or Facebook Page:

Best contact method? Check all that apply.(Required)

Phone

Text

Mail

Worksite visit

1. Is your company responsible for the execution of all phases of your harvesting operation from stump to roadside?(Required)

The undersigned, on behalf of the above-named company (applicant), herby applies for membership in the PLC of the Northeast. As a condition of membership, I agree that: – The burden of proof for eligibility rests with the applicant and all questions must be completed.

Yes

2. Do you have a Federal Tax ID #?(Required)

Yes

3. Do you have an Unemployment Insurance Account Number?(Required)

Yes

4. Do you have a current Workers’ Compensation Policy?(Required)

* PLC policy is that Members must have a current workers comp. insurance policy. However, affiliated sole proprietor applicants may also qualify for membership if they do not have a current policy by being Master Logger Certified® company. (Your insurance agent will have all of the information below)

Yes

Workers Compensation Insurance Agency:(Required)

If not listed, please add under other.

Cass Insurance

Chalmers Insurance

Clark Insurance

Cross Insurance

F.A. Peabody Insurance

Readfield Insurance

United Insurance

Unknown

Other

Workers Compensation Insurance Underwriter:

If not listed, please add under other.

Workers compensation modifier number rating:

A number between .25 and 2.

If you do not know your workers compensation modifier number, may we contact your agent to get the information?

Not Applicable

Yes

5. Do you have a current General Liability (GL) Insurance Policy?(Required)

Yes

General Liability Insurance Agency:

If not listed, please add under other.

Cass Insurance

Chalmers Insurance

Clark Insurance

Cross Insurance

F.A. Peabody Insurance

Readfield Insurance

United Insurance

Unknown

Other

General Liability Insurance Underwriter:

If not listed, please add under other.

Acadia

Acuity

Other

Training/Certification & Safety

6. Current number of full-time employees:(Required)

Including yourself.

Current number of part-time employees:(Required)

7. Do your employees participate in a logger training program?(Required)

Check all that apply.

Northeast Professional Logger (PLC)

Certified Logging Professional

Qualified Logging Professional

Vermont Logger Education to Advance Professionalism

New York Logger Trained

Other

None

8. Is your company certified by the Master Logger Certification Program®?(Required)

Yes

In Process

9. Do you have a written safety program on file?(Required)

(PLC members and Master Logger Certified Companies must have a written safety program on file as a condition of membership. The PLC will provide sample safety plans to assist with this process.)

Yes

10. Do you have ongoing workplace safety inspections?(Required)

Quarterly or Annually

Yes

11. Has your company violated the standards of the State Forest Practices Act or had civil violations (i.e. timber theft or trespass) within the past five years?(Required)

Yes

If yes, please explain.(Required)

12. During the past 12 months, have there been any significant changes in your company?(Required)

Yes

If yes, please explain.(Required)

Acadia Dividend & Logger Code of Practice

13. Would your company like to participate in the 2026 PLC/Acadia Insurance Dividend Group? (*participation in the Dividend Group is subject to underwriting approval by Acadia Insurance)(Required)

Yes (Type Name Below)

Acadia Confidentiality Waiver- As a condition of participation in the PLC/Acadia Insurance Dividend Group, Acadia Insurance requires the PLC to obtain a signed confidentiality waiver from each participating company.

On behalf of (“Company”), as a member of the PLC/Acadia Insurance Dividend Program, I hereby authorize Acadia Insurance and/or its appointed agents to release information relating to my insurance policies with Acadia Insurance, including but not limited to premiums and loss history, to the Executive Director of the PLC. The Executive Director of the PLC will keep this information confidential and will not share company specific information with the Executive Board, Full Board, or individual members of the PLC. I acknowledge and agree that the fore- going authorization will remain valid as long as the Company remains a member of the PLC and the PLC/Acadia Insurance Dividend program, unless expressly revoked in writing to Acadia Insurance and the PLC. The undersigned certifies that he/she is duly authorized to sign this authorization on behalf of the Company. Signature required to participate in the dividend program.

14. Loggers Code of Practice: (All PLC members must sign)(Required)

As a professional contractor and member of the PLC, our company meets or exceeds the following standards: 1. Promote ethical conduct in all aspects of my work. 2. Strive to meet high standards for harvesting practices that are consistent with the principles of sustainable forestry. 3. Operate responsibly in every phase of my business. 4. Respect private landowner rights and work to meet their objectives when they align with sustainable forestry principles and applicable laws. 5. Educate and inform landowners, loggers, and others about the importance of responsible forestry practices. 6. Participate in recognized certification programs that demonstrate compliance with industry standards. 7. Pursue continuous improvement through training, innovation, employee programs, and other means of professional development. 8. Comply with all federal, state, and local laws and regulations, as well as industry standards and guidelines. 9. Maintain safe harvest operations in accordance with Occupational Safety and Health Administration (OSHA) requirements, including safety planning and implementation. 10. Operate profitably and responsibly as a member of the business community, ensuring fair and lawful practices with employees, vendors, and partners. 11. Foster positive relationships with landowners, procurement personnel, mill representatives, and the public. 12. Promote a positive image of the industry by working with peers, trade associations, and other groups to elevate standards across the profession. 13. Uphold the integrity of the logging profession through responsible actions and commitment to high standards.

Company data – please check any that apply:

Type of harvesting operation:

Whole Tree

Cut to Length

Conventional

Trucking or Road Construction only

How many of each crew do you have?

Type of buncher:

rubber tires

tracked

Buncher: How many of each kind do you have?

Type of Harvester/Processor:

6 wheel

8 wheel

tracked

Harvester/Processor: How many of each kind do you have?

Type of skidder:

cable

grapple

Bulldozer

Skidder: How many of each kind do you have?

Type of forwarder:

over 18 ton

under 18 ton

Forwarder: How many of each kind do you have?

Type of delimber:

stroke

pull through

Delimber: How many of each kind do you have?

Trucking:

In-house

Contracted

Number of 6 axle log trucks/trailers:

Number of 6 axle trucks/chip van:

Number of wheelers:

Additional Equipment Not Listed:

Landowners – Who do you usually work for?

Large Landowners

Private Landowners

Own property

Other

15. Estimated total tons harvested/trucked (2026):(Required)

16. Estimated total acres harvested in (2026):

Membership/Certification Type (Choose one):

17. Membership/Certification Types(Required)

ONLY – PLC Contractor

ONLY – Master Logger Certified

BOTH – PLC Contractor and Master Logger Certified

18. Maine Based PLC Contractors ONLY – Did your company send 50% or more of its employees to 2026 PLC Spring Safety or Fleet training? Your PLC dues will be waived, but if your company is Master Logger Certified – you will owe certification dues (calculated below).(Required)

Yes

"PLC Dues Waived" – Logging or Affiliated Contractor – Maine Safety Discount

Logging Contractor – responsible for stump to roadside – Logger responsible for stump to roadside harvesting–business is primarily (50% or more) engaged in timber harvesting, eligible for Board Membership, voting member, dividend eligible. Membership dues are based on estimated previous year’s tonnage harvested. Affiliated Contractor – not responsible for stump to roadside – Includes – owner-operator/sub-contractor, chipping contractor, grinding contractor, slashing contractor or chip mill. Includes an exception for Master Logger Certified companies without workers compensation insurance. Voting member, dividend eligible, not eligible for Board Membership. Membership dues are based on estimated previous year’s tonnage harvested.

Less than 5,000 tons -PLC $0

5,000 – 25,000 tons-PLC $0

25,000-50,000 tons-PLC $0

50,000-100,000 tons-PLC $0

100,000-150,000 tons-PLC $0

Greater than 150,000 tons-PLC $0

n/a

"PLC Dues Waived & ML Dues Due" – Logging or Affiliated Contractor & Master Logger Certified (Combined Discounted Rate)

(PLC Dues Waived – Master Logger Dues Due) Logging Contractor – responsible for stump to roadside – Logger responsible for stump to roadside harvesting–business is primarily (50% or more) engaged in timber harvesting, eligible for Board Membership, voting member, dividend eligible. Membership dues are based on estimated previous year’s tonnage harvested. Affiliated Contractor – not responsible for stump to roadside – Includes – owner-operator/sub-contractor, chipping contractor, grinding contractor, slashing contractor or chip mill. Includes an exception for Master Logger Certified companies without workers compensation insurance. Voting member, dividend eligible, not eligible for Board Membership. Membership dues are based on estimated previous year’s tonnage harvested.

Less than 5,000 tons-PLC and ML $300

5,000 – 25,000 tons-PLC and ML $500

25,000-50,000 tons-PLC andML $750

50,000-100,000 tons-PLC and ML $900

50,000-150,000 tons-PLC and ML $900

Greater than 150,000 tons-PLC and ML $1,100

n/a

"PLC Dues Waived" – Forest Contractor – Trucking Only or Forest Road Construction – Maine Safety Discount

Forest Contractor – Forest Trucking Only or Forest Road Construction – 50% or more of business is from forest activities – voting member, dividend eligible, not eligible for Board Membership. Membership dues are based on previous year’s data.

0-2 Employees – $0

3-5 Employees – $0

6-10 Employees – $0

11+ Employees – $0

n/a

Logging or Affiliated Contractor & Master Logger Certified (Combined Discounted Rate)

Less than 5,000 tons-PLC&ML $500

5,000 – 25,000 tons-PLC&ML $700

25,000-50,000 tons-PLC&ML $1,150

50,000-100,000 tons-PLC&ML $1,550

50,000-150,000 tons-PLC&ML $1,800

Greater than 150,000 tons-PLC&ML $2,000

n/a

Logging or Affiliated Contractor & Master Logger Certified (Combined Discounted Rate)*

Less than 5,000 tons-PLC&ML $500

5,000 – 25,000 tons-PLC&ML $700

25,000-50,000 tons-PLC&ML $1,150

50,000-100,000 tons-PLC&ML $1,550

50,000-150,000 tons-PLC&ML $1,800

Greater than 150,000 tons-PLC&ML $2,000

n/a

A. CHOOSE A OR B – Logging or Affiliated Contractor

1. Logging Contractor – responsible for stump to roadside – Logger responsible for stump to roadside harvesting–business is primarily (50% or more) engaged in timber harvesting, eligible for Board Membership, voting member, dividend eligible. Membership dues are based on estimated previous year’s tonnage harvested. 2. Affiliated Contractor – not responsible for stump to roadside – Includes – owner-operator/sub-contractor, chipping contractor, grinding contractor, slashing contractor or chip mill. Includes an exception for Master Logger Certified companies without workers compensation insurance. Voting member, dividend eligible, not eligible for Board Membership. Membership dues are based on estimated previous year’s tonnage harvested.

Less than 5,000 tons-PLC $250

5,000 – 25,000 tons-PLC $250

25,000-50,000 tons-PLC $500

50,000-100,000 tons-PLC $750

100,000-150,000 tons-PLC $1,000

Greater than 150,000 tons-PLC $1,000

n/a

A. CHOOSE A OR B -Logging or Affiliated Contractor*

Less than 5,000 tons-PLC $250

5,000 – 25,000 tons-PLC $250

25,000-50,000 tons-PLC $500

50,000-100,000 tons-PLC $750

100,000-150,000 tons-PLC $1,000

Greater than 150,000 tons-PLC $1,000

n/a

Master Logger Certified Only

Master Logger Certified Company – Company has completed the Master Logger Certification Program initial audit process, been approved by the Master Logger Certification Board, upholds and meets the nine Master Logger Goals. Certification fee is based on estimated previous year’s tonnage harvested.

Less than 5,000 tons-ML $350

5,000 – 25,000 tons-ML $550

25,000-50,000 tons-ML $800

50,000-100,000 tons-ML $1,000

50,000-150,000 tons-ML $1,000

Greater than 150,000 tons-ML $1,200

n/a

B. CHOOSE A OR B – Forest Contractor – Trucking Only or Forest Road Construction

0-2 Employees – $100

3-5 Employees – $250

6-10 Employees – $500

11+ Employees – $750

n/a

B. CHOOSE A OR B – Forest Contractor – Trucking Only or Forest Road Construction

0-2 Employees – $100

3-5 Employees – $250

6-10 Employees – $500

11+ Employees – $750

n/a

Log A Load Donation

Please add a Log A Load donation in the amount below to my renewal invoice. Donation will be set to the Children’s Hospital associated with your area.

My company is interested in learning more about discounted dues, additional savings and benefits that are available for businesses that are both PLC members and Master Logger Certified.

Yes

Total Dues (Includes PLC Dues & Master Logger Dues)

Payment Options:

Pay by credit card or FREE ACH – we will e-mail you a secure link.

Mail a check to: PLC Northeast, PO Box 1036, Augusta, ME 04332

No PLC payment is due (If Master Logger – Cert. fee is still due) Choose harvest volume above.

Other

Payment Method