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17-0905_SIEMENS INDUSTRY, INC_Payment Bond1.2 Pavment Bond (Labor and Materials). KNOW ALL MEN BY THESE PRESENTS ThAt Bond Number: 8245-68-61. / 9265280 hereinafter designated as the "City"), by action20 L7, has awarded to WHEREAS, the City of San Juan C taken or a resolution passed apistrano ( October 15th siemens tndustrv tnc. hereinafter designated as the "Principal," a contract for the work Oescr¡oem No. 11101 - (the "Project"¡; and WHEREAS, said Principal is required to furnish a bond in connection with said contract; providing that if said Principal or any of its Subcontractors shall fail to pay for any materials, provisions, provender, equipment, or other supplies used in, upon, for or about the performance of the work contracted to be done, or for any work or labor done thereon of any kind, or for amounts due under the Unemployment lnsurance Code or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department from the wages of employees of said Principal and its Subcontractors with respect to such work or labor the Surety on this bond will pay for the same to the extent hereinafter set forth. Federal lnsurance Company and Fidelity NOW THEREFORE, we, the Principal ¿¡çland Depositcompanyof Maryland as Surety, are held and firmly bound unto the City in the penal sum of *Dollars 195,898.00 ) lawful money of the United States of America, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and SeVerally, firmly by theSe pfeSentS. One Hundred Ninety-Five Thousand Eight Hundred Ninety-Eight and No/Cents THE CONDITION OF THIS OBLIGATION lS SUCH that if said Principal, his or its subcontractors, heirs, executors, administrators, successors or assigns, shall fail to pay any of the persons named in Civil Code Section 9100, fail to pay for any materials, provisions or other supplies, used in, upon, for or about the performance of the work contracted to be done, or for any work or labor thereon of any kind, or amounts due under the Unemployment lnsurance Code with respect to work or labor performed under the contract, or for any amounts required to be deducted, withheld, and paid over to the Employment Development Department or Franchise Tax Board from the wages of employees of the contractor and his subcontractors pursuant to Revenue and Taxation Code Section 18663, with respect to such work and labor the Surety or Sureties will pay for the same, in an amount not exceeding the sum herein above specified, and also, in case suit is brought upon this bond, all litigation expenses incurred by the City in such suit, including reasonable attorneys' fees, court costs, expert witness fees and investigation expenses. This bond shall inure to the benefit of any of the persons named in Civil Code Section 9100 so as to give a right of action to such persons or their assigns in any suit brought upon this bond. It is further stipulated and agreed that the Surety on this bond shall not be exonerated or released from the obligation of this bond by any change, extension of time for performance, addition, alteration or modification in, to, or of any contract, plans, specifications, or agreement pertaining or relating to any scheme or work of improvement herein above described, or pertaining or relating to the furnishing of labor, materials, or equipment therefore, nor by any change or modification of any terms of payment or extension of the time for any payment pertaining or relating to any scheme or work of improvement herein above described, nor by any rescission or attempted rescission or attempted rescission of the contract, agreement or bond, nor by any conditions precedent or subsequent in the bond attempting to limit the right of recovery of claimants otherwise entitled to recover under any such contract or agreement or 6 1 1 47 .021 00\29379545. 1 -48-OO 61 ,13 - BOND FORMS under the bond, nor by any fraud practiced by any person other than the claimant seeking to recover on the bond and that this bond be construed most strongly against the Surety and in favor of all persons for whose benefit such bond is given, and under no circumstances shall Surety be released from liability to those for whose benefit such bond has been given, by reason of any breach of contract between the owner or City and original contractor or on the part of any obligee named in such bond, but the sole conditions of recovery shall be that claimant is a person described in Civil Code Section 9100, and has not been paid the full amount of his claim and that Surety does hereby waive notice of any such change, extension of time, addition, alteration or modification herein mentioned, including but not limited to the provisions of sections 2819 and 2845 of the California Civil Code. lN WITNESS WHEREOF, we have hereunto set our hands and seals this zottr day of October (Attach Attorney-in-Fact Certificate) Siemens lndu lnc Contractor/ Federal lnsurance Company and Fidelity and Deposit f-nmnanrr nf [t/larvland Su By -Fact Brittany D. Clavin, Attorney-ln-Fact /bV* ww tnrr{err- 61 1 47 .021 00U9379545. 1 -49-OO61 13-BONDFORMS Notary Acknowledgment A notarv public or other officer comoletinq this certificate verifies bnlv the identitv of the individual -who sioned the document t-o which this'certificate is attached, anð not the truthfulness, accuracy, or validity of that document. STATE OF CALIFORNIA ,\ COU NTY Or Q-r..fOr¡.fYL0 On before me,Public, personally appeared \-\,'ü, J,e\noñ who proved to me n the basis of satisfactory evidence to be the person{sf whose name{alis/a¡e-subscribed to the within instrument and acknowledged to me that he/sheltlrey executed the same in his/frc#h€,ir-authorized capacity(ies|, and that by his/he#their signature{rf on the instrument the person(s)l or the entity upon behalf of which the person@ acted, executed the instrument. I certify under PENALW OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. CANDACE GALLAHER Commisslon # 2117338 ilolary Publlc - Calllornia orango County WITNE my han t. I OPTIONAL Though the information below is not requ¡red by law, it may prove valuable fo persons relying on the document and could prevent fraudulent removal and reattachment of this form to another document. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT lndividual Corporate Officer Title or Type of Document r Partner(s)Limited General , Attorney-ln-Fact : Trustee(s) , Guardian/Conservator ; Other: Signer is representin g: Name Of Person(s) Or Entity(ies) nt Than Named Above NOTE: This acknowledgment is to be completed for Contractor/Principal 6 1 1 47 .02 1 00\29379545. 1 -50-00 61 13 - BOND FORMS Notary Acknowledgment A notarv oublic or other officer comoletino this certificate verifies bnlv tne identitv of the individual "who sioned the document t'o which this'certificate is attached, anð not the truthfulness, accuracy, or validity of that document. Missouri STATE OF øSùffiORtI&Ax COUNTY OF st. Louts On October 2Oth 20_u_, before me,Sandra L. Ham Notary Public, personally appeared Brittany D. Clavin who proved to me on the basis of sat¡sfactory ev¡dence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that heishe/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. der the laws of the State of California that the foregoing paragraph IS WITNESS my hand and officialseal á Signature of Notary Public OPTIONAL Though the informat¡on below is not required by law, ¡t may prove valuable fo persons rely¡ng on the document and could prevent fraudulent removal and reattachment of th¡s form to another document. CAPACITY CLAIMED BY SIGNER DESCRIPTION OF ATTACHED DOCUMENT ¡ , lndividual ¡ ' Corporate Officer Title(s)Title or Type of Document 1 Partner(s)Limited General Two ¡ Attorney-ln-Fact r Trustee(s) I Guardian/Conservator i Other: Signer is representing: Name Of Person(s) Or Entity(ies) Number of Pages October 20th,2077 Date of Document Federal lnsurance Company and Fidelity and Deposit Company of Maryland Commiss My Commlsslon and 0l 2021 Seol #4¿ NOTE This acknowledgment is to be completed for the Attorney-in-Fact. The Power-of Attorney to local representatives of the bonding company must also be attached. END OF PERFORMANCE BOND 6 1 1 47 .O21 00\2937954s. 1 -47-OO 61 13 - BOND FORMS EHIJEIEI' Power of Attorney Federal Insurance Company I Vigilant Insurance Company I Pacific Indemnity Company Know All by These PreseDts, That FEDERAL INSURANCE COMPANY, an lndiana corÞoration, VIGILANI INSI]RANCE COMPANY, a New ìork corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and appoint Pamela A. Beelman, Cynthia L. Choren, Brittany D. Clavin, Joann R. Frank, Sandra L. Ham, Heidi A. Notheisen, Karen L. Roiderand Debra C. SchneiderofSt. Louis, Misso each as their true and lawful Attorney-in-Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behalf as surety thereon or otherwise, bonds on behalfofcontractors in connection with bids, proposals or contracts to the Commonwealth ofKentucky in an unlimited amount. It is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department of Highways of the Commonwealth of Kentucky at le ast thirty days prior to the modifìcation or revocation. In Witness Whereof, saitl FEDERAL INSIIRANCE COMPANY, VIGILANT INSURÁNCE COMPANY, and PACIFIC INDEMNITY COMPÄNY have each executed and attested these presents and affixed their corporate seals on this 22d day of September, 2O17. ÈUureTn. eF-Is,\åf #'t^f-o^ k4"-,-, I [rv;n ltl. (]hL rts. ;\rsist:rnt Sctlctuly Given under my hand and seals ofsaid Companies Stcphr.tì trl ilrnay- \iict l)t c:itletrt atwhitehousestation,NJ,this 20th day Of OCtObef ,2017 . tur^rufn. e}tmltÊf ffiffi@ @ffi@ @ffi STATE OF NEIVJERSEY CountyofHunterdon ss. Onthis 22d dayofSeptember,2OlT beforeme,aNotaryPublicofNewJersey,personallycameDawnM.Chloros,tomeknowntobeAssistantSecretaryofFEDERALlNSURANCE COMPANY, VIGILANT INSURANCE COMPANY. and PACIFIC INDEMNITY COMPANY, the companies which executed the f'oregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY. VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals affixed to the folegoing Power of Attorney are such corporate seals and were thereto afIìxed by authority ofsaid Companies; and that she signed said Power ofAttorney âs Assistant Secretary ofsaid Companies by like aurhority; and that she is acquainted with Stephen M. I Ianey, and knows him to be Vice President of said Companies; and that the signature of Stephen M. I laney, subscribed to said Power of Attorney is in the genuine handwr¡ting of Stephen M. Haney, and was thereto subscribed by authority ofsaid Companies and in deponent's presence. Notarial Seal NOTARY PUBLIC OF NEW JERSEY Nô.2S18ô0ô Cffiñlrdon Ërplı8 Jlly 10, 2019 Norery Publlc CERTIFICATION Resolutions adopted by the Boards ofDirectors ofFEDERAL INSURANCE COMPANY, VICILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on August 30, 2Ol6: entered ìnto in the ordinary course ofbusiness (each a "Written Commitment ): seal of the Companyorotheruise. (2) Each duly appointed attorney-in-fâct of the Company is hereby authorized to execute any \{ritten Comitment for and on beha¡f of the Company, under the seal of the Company or othevise, to the extent that such action is authorized by the grant oflrcwets prcvided for in such person's written appointment as such attorney-in-fact. in-fact of the Company with full power and authority to execu¡e, for ând on behalf of the Company, under the seâl of the Company or othewise, such Written Comitments of the written Comitments. Company the authority to execute, for and on behalf of the Company, under the Companys seal or otheruise, such written Comitmenls of the Compâny âs âre specifìed in such writtendelegation,whichspecification may be by general typeor clasof lvritten Commitme¡rts or bl'specificationofoneormoreparticularWrittenCo¡mitments. fa6imile on such written Colmitment or written appointment or delegation. the Company, and such Resolution shaìl not limit or othevise âffect the exercise ofany such power or âuthority otheruise validlygranted or vested." I, Dawn M. Chloros, Assistant Secrctary of FEDERAL INSURANCE COMPANY, VIGILANI' INSTIRANCE COMPANY, and PACIFIC INDEMNTIY COMPANY (the "Companies") do hereby certify that (i) the foregoing Resolutions adopted by the Board ofDirectors ofthe Companies are true, correct and in full force and effect,(iD the Companies are duly licensed and authorized to transact surety business in all 50 of the United States of America and the District of Columbia and are authorized by the U,S. Treasury Department: further, Federal and Vigilant are licensed in the U.S. Virgin Islands, and Federal is licensed in Guam, Puerto Rico, and each ofthe Provinces ofCanada except Prince Edward Island; and (iii) the foregoing Power ofAttorney is true, correct and in full force and effect. Form 15¡0- 01928- U KY HWY (rev. 12-16) I)rvjn Il. (llì k nr É.,\rsist¡n t Str:r'etl¡¡ f' IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIùI, VERIFY THE ÀUTHENTICITY OF THIS BOND OR NOTIFYUS OFANY OTHER MATTER, PLEASE CONTACTUS AT: TelenhônelqoRlqo?-?¿ql FâylqoÂ)qôl-16q6 p-mril.crrrctvørhilhhcom FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31,2016 (in thousands of dollars) ASSEÏS LIABILITIES AND SUBPLUS TO POLICYHOLDERS Cash and Short Term lnvestments.. United States Government, State and $ (86,eeo)Outstanding Losses and Loss Expenses..... $ Unearned Premiums...... Ceded Reinsurance Premiums Payable....... 11,482,308 2,723,875 566,868 29,339 1,144,976 Municipal Bonds 8,135,311 5,471,330 130,689 '1,289,903 Other Bonds.Provision for Reinsurance Stocks Other lnvested Assets TOTAL INVESTM ENTS ...........,14,940,243 TOTAL LIABILITIES 15,947,366 lnvestments in Affiliates: Chubb lnvestment Holdings, lnc. .............. Pacif ic lndemnity Company...... Executive Risk lndemnity 1nc..................... Great Northern lnsurance Company ......... 3,727,406 2,926,619 1,250,965 504,162 319,s05 277,361 214,956 162,929 163,668 70,204 1 ,5'1 0,1 07 1,303,050 Capital Stock............ Paid-ln Surplus......... 20,980 3,106,809 8,296,020Unassigned Funds Vigilant lnsurance Company Chubb European lnvestment Holdings, SLP. Chubb Gustom lnsurance Company.......... Chubb National lnsurance Company ......... Chubb lndemnity lnsurance Company....... Other Aff iliates ................... SURPLUS TO POLICYHOLDERS.............11,423,809 Premiums Receivable Other Assets TOTAL LIABILITIES AND SURPLUS TOTAL ADMITTED ASSETS ...$zt 371 175 TO POLICYHOLDERS.$ 27,371,175 lnvestments are valued in accordance with requirements of the National Association of lnsurance Commissioners. At December 3'1 , 201 6, investments with a carrying value of $565,702,495 were deposited with government authorities as required by law. State, County & City of New York, - ss Dawn M. Chloros, Assistant Secretary of the Federal lnsurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal lnsurance Company on December 31 , 2016 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the 12 months ending December 31, 2016. Subscribed and sworn to before me this March 3,2017. Ryurr-m.0).1¡^fif JEANETTE SHIPSEY Notary Public, State of New York No.02SH5074142 Qualified ¡n Nassau County Assistant Secretary Notary Public Commission March 1 201 9 Form 1 5-10-03134 (Rev- 3/14 ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZUzuCH AMERICAN INSURANCE COMPANY, a corporation of the State of New York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by Thomas O. McClellan, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Brittany D. Clavin of St. Louis, Missouri , its true and lawful agent and Attorney- in-Fact, to make, execute, seal and deliver, for, and on its behalfas surety, and as its act and deed: any and all bonds and undertakings, and the execution ofsuch bonds or undertakings in pursuance ofthese presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected offìcers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMEzuCAN CASUALTY AND SURETY COMPANY at its office in Owings Mills, Maryland., and the regularly elected offìcers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its office in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certif! that the extract set forth on the reverse side hereofis a true copy ofArticle V, Section 8, of the By-Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURICH AMERICAN INSURANCE COMPANY, COLONIAL AMBRICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this l4th day of October, A.D. 2015. ffi@@ - Ø (). "WfáÉ'( ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND Í,; à &"",{- By: Thomas O. McClellan Vice President By: Eric D. Barnes Secretary 4..r.¿""*"- a". /J*,^^J State of Maryland County of Baltimore Onthisl4th dayofOctober,4.D.2015, beforethesubscriber,aNotaryPublicoftheStateofMaryland,dulycommissionedandqualified,ThomasO. McClellan, Vice President and Eric D. Barnes, Secretary ofthe Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution ofsame, and being by me duly swom, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals ofsaid Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction ofthe said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. ^..'l;Ìl i::í;í... ir'iì;ì!(¡¡\? ;:t'. 1 ì'ii\ -r !1:ttt.. / -(r.r.,,;*i,N By: Constance A. Dunn, Notary Public My Commission Expires: July 9,2019 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attorneys-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any officer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modifu of revoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power ofAttorney is still in full force and effect on the date ofthis certificate; and I do further certify that Article V, Section 8, of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMEzuCAN INSURANCE COMPANY at a meeting duly called and held on the l5th day of December 1998. RESOLVED: "That the signature of the President or a Vice President and the attesting signature of a Secretary or an Assistant Secretary and the Seal of the Company may be affrxed by facsimile on any Power of Attorney...Any such Power or any certihcate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the l0th day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy ofany power ofattorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 20th day of October 2017 @ffi @ Æ"-¿¿ Ì).*/' By: Gerald F. Haley, Vice President F'IDELITY ^AIqD I}EPOSNT COMPANY 60 0 Red Brc ot er"¿.,IIrYåT,ffi i'e* Mills, MD 2 1 I 1 7 Statement of Financial Condition As Of December 31,2015 ASSETS Bonds Stocks Cash and Short Term Invostmenfs......... Reinsurance Recoverable ...... Ceded Reinsurance Premiums Payable Secudties Lending Collateral Liabilþ Capital Stock, PaidUp $ 5,ooo,ooo 164,696,179Surptus Surplus as regards Policyholders. Other Accounts Receivable.... 19,935,944 TOTALADMII"TEDASSETS $ 210,1gS,g23 LIABILITTES, SURPLUS AND OTIIER F'UNDS Reserve for Taxes and Expenses $ 46A36 I 142,878,497 22,315,096 337,835 24,731,,651 40,456,309 0 169,696,779 g zla,lgsign Secretary of the FIDELÌTY ¿No DeposIT COMPANY oF MARyLeno, do hereby a correct exhibit of the assots and liabilities of the said Company on the 3 I st TorArLrABrLrrrES.............. $ 40,502J45 TOTAL Securities car¡ied at $57,996,983 in the above statement are deposited with various states as required by law. Seculities canied on the basis prescribed by the National Association of Insurance Commissioners. On the basis of market quotations for all bonds and stocks owned, the Cornpany's total admitted assets at December 31, 2015 would be 82L2,I37 ,'195 and surplus as regards policyholders $171,635,049. I, DENNIS F. IGRRIGAN, Corporate cettify that the foregoing statement is day of December;2015. State of Illinois \ City of Schau*Urrg f, SS: Subscribed and swom to, beforc mc, aNotary Publio of the State of lllinois, in the City of Schaumburg this lsth day of March,20t6. Corporate Sectetary Nalary Public SURETY RIDER To be attached to and form a parl of Bond No. 8245-68-61 / 9265280 dated effective r0/7s/2017 (MONTH-DAY.YEAR) S¡emens lndustry lnc. (PRTNCTPAL) Federal lnsurance Company and Fidelity and Deposit Company of Maryland executed by , as Principal, and by , as Surety, in favor of City of San Juan Capistrano (oBLIGEE) in consideration of lhe mutual agreements herein contained the Principal and the Surety hereby consenl to changing The bond number from: B24s-68-61 /s26s2$o To: az¿s-oa-21 / 926s2go Nothing herein contained shall vary, alter or extend any provision or condition of this bond excepl as herein expressly stated. This rider is effective TOhs/20t7 (MONTH-DAY-YEAR) Oclober 25,2017 (MONTH-DAY.YEAR) Signed and Sealed Siemens lndustry lnc. lnsurance and Fidelity and Deposit Company of Maryland By: Brittany D. Clav¡n, s-0443/GEEF 10/99 ACKNOWLEDGMENT BY SURETY STA'I-E OF Missouri City of St, Louis ss. On this 25th dayof October 2017 , bel'ore mc pcrsonally appeared Brittany D. Clavin , lcrown to me to be the Attorney-in-Fact of Federal Insurance Company and Fidelity and Deposit Company of Maryland , the corporalion that executed the within instrument, ancl acknowledgcd to me that such corporation exccutcd tlte same . IN M/I'INESS WHEREOF, I have hereurto set my hand and affixed my official seal, at my o{ïìce in the aforesaid County, the day and ycar in this certificate fìrst above writtetr. L. Ham My Comnrission Expires: 0UlB/2021 (Seal) Notary Public in the SLate of Missouri County of St. Louis Commissiort #12450177 Seol 2021 te of Louls oloN c n s-0230/GEEF 2/98 EHIJEIEI' Power of Attorney FederallnsuranceCompanylVigilantlnsuranceCompanylPacificlndemnityCompany Know AII by These Ptesents, That FEDERAL INSIJRANCE COMPANY, an Indiana corporation, VIGILAITT INSURANCE COMPANY, a New York corporarion, and PACIFIC INDEMNITYCOMPANY,aWisconsincorporation,doeachherebyconstituteandappoint Pamela A. Beelman, Cynthia L. Choren, Brittany D. Clavin, Joann R. Frank, Sandra L. Ham, Heìdi A. Notheisen, Karen L. Roider and Debra C. Schneider of St. Louis, Missou thereon or otherwise, bonds on behalfofcontractors in connection with bids, proposals or contracts to the Commonwealth ofl(entucky in an unlimited amount. It is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner - Department ofHighways ofthe Commonwealth ofKentucky at least thirty days prior to the modification or revocation. In Witness Whereof, said FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY have each executed and artesred rhese presents and afïìxed their corporate seals on this 22d day of Septembe¡ 2017, Ètrsrr--fn. eh"foÀ.Êf []¡r¡¡r¡ il'T, (lh kl|t s. Assist:rn t Strrettr|y Sle¡rhcn i\'.I. lhncy. Vict Prtritlcnf STATE OF NEWJERSEY County of Hunterdon Onthis 22d dayofseptember,2OlT beforeme,aNotaryPublicofNewJersey,personallycameDawnM.Chloros,tomeknowntobeAssistantSecretaryofFEDERALINSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY. the companies which executed the foregoing Power of Attorney, and the said Dawn M. Chloros, being by me duly sworn, did depose and say that she is Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY and knows the corporate seals thereof, that the seals afÏìxed to the foregoing Power of Attorney are such corporate seals and were thereto affìxed by authority of said Companies; and that she signed said Power of Attomey as Assistant Secretary of said Companies by like authority; and that she is acquainted with Stephen M, Haney, and knows him to be Vice President ofsaid Companies; and that the signature ofStephen M. llaney, subscribed to said Power ofAttorney is in the genuine handwrit¡ng of Stephen M. Haney, and was thereto subscribed by authority ofsaid Companies and in deponent's presence. Notarial Seal I(AÏHEñINË J. A!€IAAR NOTARY PUBLIC OF IIEW JERSEI No. ?810S06 CffiriÍ8Ëlúr Êxplßê July lG, 20tg Norâry CERTIFICATION Resolutions adopted by the Boards ofDirectors ofFEDERAL INSURANCE COMPANY, VIGILANT INSURANCE COMPANY, and PACIFIC INDEMNITY COMPANY on Augusr 30,2016: entered into in the ordinarycourse ofbusiness (each a "Writlen Commitment')l 0) Each of the Chairman, the President and the Vice Presidents of the Company is hereby authorized to execute anywritten Commitment for and on behalfofthe Company, under the seâl of the Company or otheruise. (2) Each duly appointed attorney-in-fact ofthe Company is hereby authorized to execute any written Comitment for and on behalfofthe Company, under the seal ofthe Company or otheMise, to the extent that such action is author¡zed by the grant ofpowers provided for in such person's written appointment as such atbrney-in-{act. (3) Each of the Chairmn, the President and the Vice Presidents of the Compânyis hereby authorized, for and on behalfofthe Compâny, to appoint in wúring âny person the âttorney- in-fact of the Company with full power and authority to execute, for and on behalf of the Company, under the seal of the Company or otheNise, such Written Comitments of the Company æ maybe specified in such witten appointment, which specification may be by general q,pe or clas of Written Commitments or by specification of one or more particuÌar Written Colmitments. (4) Each of the Chaiman, the President and the vice Presidents of theCompanyisherebyauthodzed.forildonbehalfoftheCompâny,todelegateinwritingtoanyotheromcerofrhe Company the âuthority to execute, for and on behalf of the Company, under the Companys seâl or otheNise, such Written Comitments of the Company as are specified in such writtendelegation,whichspecification may be by general typeor clasof written Comitments or byspecificationofoneormoreparticularWrittenComitments. fasimile on such Written Comitment orwiltten appointment or delegation, the Compâny, and such Resolution shall not limit or otheMise âff€ct the exercise ofany such power or authority otheryise validly grânted or vested." I, Dawn M. Chloros, Assistant Secretary of FEDERAL INSURANCE COMPANY, VIGILANT INSTjRANCE COMPANY, and PACIFIC INDEMNITY COMPANY (rhe "Companies") do hereby cenify that (D the foregoing Resolutions adopted by the Board ofDirectors ofthe Companies are true, colrect and in full force and effect, (iD the Companies are duly licensed and authorized to transact surety business in all 5O of the United States of America and the District of Columbia and are åuthorized by the U.S. Treasury Department; further, Federal and Vigilant are licensed in the U.S. Virgin Islands, and Federal is licensed in Guam, Puerro Rico, and each ofthe Provinces ofCanada except Prince Edward Isìand; and (iii) the foregoing Power ofAttorney is true, correct and in full force and effect. Civen under my hand and seals ofsaid Companies at whitehouse station, NJ, this 25th day Of OCtObef , 2017 . ùuur¡--tn. t}'üsl-el þfe*^ d"--, @ffi@@ @ffi@ Form 15-10- 01928- U ft HWI (rev. 12-16) lÌrv¡r tr|. (ll¡loltn. ,\ssist¡nt SLuetirr'ç' IN THE EVENT YOU WISH TO NOTIFY US OF A CLAIN'I, VERIFY THE AUTHENTICITY OF THIS BOND OR NOTIFY US OFANY OTHER MA'I"TER, PLEASE CONTACTUS AT: Telephone (908) 903- 3493 Fax (908) 9O3- 3656 e-mail: surew(ôchubb.com FEDERAL INSURANCE COMPANY STATEMENT OF ASSETS, LIABILITIES AND SURPLUS TO POLICYHOLDERS Statutory Basis DECEMBER 31,2016 (in thousands of dollars) ASSEIS LIABILITIES AND SU RPLUS TO POLICYHOLDERS Cash and Short Term lnvestments.. United States Government, State and $ (86,eeo)Outstanding Losses and Loss Expenses..... $ Unearned Premiums...... Ceded Reinsurance Premiums Payable....... Provision for Beinsurance ................. Other Liabilities.................... 11,482,308 2,723,875 566,868 29,339 1,144,976 Municipal Bonds 8,135,311 5,471,330 130,689 1,289,903 Other Bonds. Stocks.......... Other lnvested Assets........ TOÏAL INVESÏMENÏS 14,940,243 TOTAL LIABILITIES '15,947,366 lnvestments in Affiliates: Chubb lnvestment Holdings, lnc. ...............3,727,406 2,926,619 1,250,965 504,162 319,505 277,361 214,956 162,929 163,668 70,204 1 ,510,107 1,303,050 Capital Stock 20,980 3,106,809 8,296,020 Pacific lndemnity Company Paid-ln Surplus......... Executive Risk lndemnity 1nc..................... Great Northern lnsurance Company ......... Vigilant lnsurance Company...... Chubb European lnvestment Holdings, SLP Chubb Custom lnsurance Company......... Chubb National lnsurance Company ........ Chubb lndemnity lnsurance Company...... Unassigned Funds SURPLUS TO POLICYHOLDERS.............1'1,423,809 Other Affiliates Premiums Receivable Other Assets TOTAL ADMITTED ASSETS $ 27,371,175 TOTAL LIABILITIES AND SURPLUS TO POL|CYHOLDERS........ ç 27,371,175 lnvestments are valued in accordance with requirements of the National Association of lnsurance Commissioners. At December 31, 2016, investments with a carrying value of $565,702,495 were deposited with government authorities as required by law. State, County & City of New York, - ss: Dawn M. Chloros, Assistant Secretary of the Federal lnsurance Company being duly sworn, deposes and says that the foregoing Statement of Assets, Liabilities and Surplus to Policyholders of said Federal lnsurance Company on December 31, 2016 is true and correct and is a true abstract of the Annual Statement of said Company as filed with the Secretary of the Treasury of the United States for the '12 months ending December 31 , 201 6. Subscribed and sworn to before me this March 3,2017. R$.uNTn,0NnÀfif JEANETTE SHIPSEY Notary Public, State of New York No.02SH5074142 Qualified in Nassau County Assistant Secretary Notary Public Commission March 1 201 I Form 15-10-031 3A (Rev-3/14 ZURICH AMERICAN INSURANCE COMPANY COLONIÄL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS: That the ZURICH AMERICAN INSURANCE COMPANY, a corporation of the State ofNew York, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, a corporation of the State of Maryland, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND a corporation of the State of Maryland (herein collectively called the "Companies"), by Thomas O, McClellan, Vice President, in pursuance of authority granted by Article V, Section 8, of the By-Laws of said Companies, which are set forth on the reverse side hereof and are hereby certified to be in full force and effect on the date hereof, do hereby nominate, constitute, and appoint Brittany D. Clavin of St. Louis, Missouri , its true and lawful agent and Attorney- in-Fact, to make, execute, seal and deliver, for, and on its behalfas surety, and as its act and deed: any and all bonds and undertakings, and the execution of such bonds or undertakings in pursuance ofthese presents, shall be as binding upon said Companies, as fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected officers of the ZURICH AMERICAN INSURANCE COMPANY at its office in New York, New York., the regularly elected officers of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at its offìce in Owings Mills, Maryland., and the regularly elected officers of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at its ofhce in Owings Mills, Maryland., in their own proper persons. The said Vice President does hereby certiÍ! that the extract set forth on the reverse side hereof is a true copy ofArticle V, Section 8, of the By-Laws of said Companies, and is now in force. IN WITNESS WHEREOF, the said Vice-President has hereunto subscribed his/her names and affixed the Corporate Seals of the said ZURJCH AMERICAN INSURANCE COMPANY, COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and FIDELITY AND DEPOSIT COMPANY OF MARYLAND, this l4th day of October, A.D. 2015. ffi@@ *Ø d F3( rá¿á( ATTEST: ZURICH AMERICAN INSURANCE COMPANY COLONIAL AMERICAN CASUALTY AND SURETY COMPANY FIDELITY AND DEPOSIT COMPANY OF MARYLAND fr"a A #4"-{* By: Thomas O. McClellan Vice President By: Eric D. Barnes Secretary State of Maryland County of Baltimore On this 14th day of October, A.D. 2015, before the subscriber, a Notary Public of the State of Maryland, duly commissioned and qualified, Thomas O. McClellan, Vice President and Eric D. Barnes, Secretary of the Companies, to me personally known to be the individuals and officers described in and who executed the preceding instrument, and acknowledged the execution ofsame, and being by me duly sworn, deposeth and saith, that he/she is the said officer of the Company aforesaid, and that the seals affixed to the preceding instrument are the Corporate Seals of said Companies, and that the said Corporate Seals and the signature as such officer were duly affixed and subscribed to the said instrument by the authority and direction ofthe said Corporations. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed my Official Seal the day and year first above written. *l;it, ir',í,,;,,';ì 4. .f.*---{4.,å>^^,n.4^J By: Constance A. Dunn, Notary Public My Commission Expires: July 9,2019 EXTRACT FROM BY-LAWS OF THE COMPANIES "Article V, Section 8, Attomevs-in-Fact. The Chief Executive Officer, the President, or any Executive Vice President or Vice President may, by written instrument under the attested corporate seal, appoint attomeys-in-fact with authority to execute bonds, policies, recognizances, stipulations, undertakings, or other like instruments on behalf of the Company, and may authorize any offìcer or any such attorney-in-fact to affix the corporate seal thereto; and may with or without cause modif, ofrevoke any such appointment or authority at any time." CERTIFICATE I, the undersigned, Vice President of the ZURICH AMERICAN INSURANCE COMPANY, the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY, and the FIDELITY AND DEPOSIT COMPANY OF MARYLAND, do hereby certify that the foregoing Power ofAttorney is still in full force and effect on the date ofthis certificate; and I do further certi$ that Article V, Section 8, of the By-Laws of the Companies is still in force. This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the ZURICH AMERICAN INSURANCE COMPANY at a meeting duly called and held on the 15th day of December 1998. RESOLVED: "ThatthesignatureofthePresidentoraVicePresidentandtheattestingsignatureofaSecretaryoranAssistantSecretary and the Seal of the Company may be affixed by facsimile on any Power of Attorney...Any such Power or any certificate thereof bearing such facsimile signature and seal shall be valid and binding on the Company." This Power of Attorney and Certificate may be signed by facsimile under and by authority of the following resolution of the Board of Directors of the COLONIAL AMERICAN CASUALTY AND SURETY COMPANY at a meeting duly called and held on the 5th day of May, 1994, and the following resolution of the Board of Directors of the FIDELITY AND DEPOSIT COMPANY OF MARYLAND at a meeting duly called and held on the lOth day of May, 1990. RESOLVED: "That the facsimile or mechanically reproduced seal of the company and facsimile or mechanically reproduced signature of any Vice-President, Secretary, or Assistant Secretary of the Company, whether made heretofore or hereafter, wherever appearing upon a certified copy of any power of attorney issued by the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed. IN TESTIMONY WHEREOF, I have hereunto subscribed my name and affixed the corporate seals of the said Companies, this 25th day of October 2017 @ffi @ ,Æ.*n¿ By: Gerald F. Haley, Vice President F'IDELTTY ANü} I}EPOSNT COMPANY OFMARYLAND 600 Red Brook Blvd., Suite 600, Owings Mills, MD 21117 Statement of FinancÍal Condition As Of Dccember 31,2015 ASSETS Bonds Stocks Cash and Short Termlnvestmerits.. Reinsurance Recoverable ...,.. Other Accounts Receivable..., TOTAL ADMI1TED ASSETS LIABILITTES, SUR}LUS AND OTIIER F'UNDS Reserve for Taxes and Expenses ..........,... $ Ceded Reinsurance Premiums Payable Secuiities Lending Collateral Liability TOTAL LIABILITIES g 142,878,497 22,315,096 337,835 24,731,651 19,935,844 $ 210J9S,923 46,436 40,456349 0 $ 40,502,745 Capital Stock, PaidUp ....,...,....,,....... $ Surplus 5,000,000 164,696,178 Surplus as rogards Policyholders.... 769,696,778 TOTAT I 210,199,923 Securities carried at $57,996,983 in the above statement are deposited with various states as requíred by law. Secul'ities canied on the basis prescribed by the National Associafion of Insurance Commissioners. On the basis of market quotations for all bonds and stocks owned, the Cornpany's total admitted assets at December 31, 2015 woulci be $2I2,I37,'195 and surplus as regards policyholders $171,635,049. I, DENNIS F. IGRRIGAN, Corporate Secretary of the FIDELITY AND DEposIT CoMpANy oF MARvLAND, do hereby certifi that the foregoing statemenf is a corect exhibit of the assets and liabilities of the saïd Company on the 3lst day ofDecembeq 2015. Corporate Secrctary State of Illinois City of Schaumburg SS Subscribed and sworn to, before me, a Notary ?ublic ofthe State oflllinois, in thc City ofschaumburg, this l5th day ofMarch, 2016. ì. s l'.t¡r,}o-*"t \t .'fv \I U - SlatB ol llllnols lrxpires 2fìla Notary Public ACKNOWLEDGMENT A notary public or other officer completing this certificate verifies only the identity of the individual who signed the document to which this certificate is attached, and not the truthfulness, accuracy, or validity of that document. State of California RiversideCounty of ) on October 30th, 20L7 before me,Candace Gallaher - Notary Public (insert name and title of the officer) personally appeared Michael Hutchens who proved to me on the basis of satisfactory evidence to be the personþf whose name(9 is/arer subscribed to the within instrument and acknowledged to me that helshelthey executed the same in his/herlttreir authorized capacity(ieeÌíand that by his/herltheir signature($on the instrument the person{¿lí or the entity upon behalf of which the person(,s)'acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and corect. @ CAI{DACE GALLAHER WITNESS hand and official Comml¡slon # 2117338 l{olary Publlc' Calllornia Onnge CounlY Comm.Jul 19 Signature (Seal)