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18-0703_PACIFIC POINT DEVELOPMENT PARNTERS, LLC_Bond Release SU2100002432400 PASEO ADELANTO SAN JUAN CAPISTRANO, CA 92675 (949) 493-1171 (949) 493-1053 FAx www.sanjuancapistrano.org July 5, 2018 Ironshore Indemnity, Inc. 725 S. Figueroa, Suite 3375 Los Angeles, CA 90017 Re: Release of Bonds — Pacific Point Development Partners LLC Dear Sir or Madam: MEMBERS OF THE CITY COUNCIL SERGIO FARIAS KERRY K. FERGUSON BRIAN L. MARYOTT PAM PATTERSON, ESQ. DEREK REEVE This letter is to inform you that the following bonds issued to Pacific Point Development Partners, LLC — Off -Site Circulation Subdivision Improvements are officially released as of July 5, 2018: BOND NO. PURPOSE BOND AMOUNT SU21000024 Off -Site Circulation Subdivision Improvements $ 2,571,000.00 The City of San Juan Capistrano hereby fully and forever releases and discharges the Ironshore Indemnity, Inc. from any and all liability under the abovementioned bond number. Enclosed please find the original released bond. If you have any questions, please do not hesitate to call me at (949) 443-6310. Sincerely, (tiW' Christy Jakl, CMC Assistant City Clerk Enclosures as noted cc: Steve May, Public Works and Utilities Director Joe Parco, City Engineer George Alvarez, City Engineer Joe Mankawich, Associate Engineer San Juan Capistrano: Preserving the Past to Enhance the Future 0 Printed on 100% recycled paper RELEA 1 19 Date:Premium: $19,283.00 Signature: City Clerk City of San Juan Ca no, CA SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000024 Replaces Bond No. SUR20000348 KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Development Partners LLC (hereafter designated as "Principal"), and ironshore Indemnity Inc. , as Surety (hereinafter called "Surety") agree to install and complete certain designated public improvements as conditioned by City Council Resolution No's. 92-6-16-4 and 03-09-16-06. WHEREAS, said Principal is required to furnish a bond pursuant to Municipal Code Section 9-5.101 and 9-5.109 et seq., for the faithful performance to guarantee certain work, more particularly described as follows: Off -Site Circ. subdivision improvements within Tract N/A as defined within Amendment #1 and Reinstatement of the Subdivision Improvement Agreement for Tract N/A NOW, THEREFORE, we, the Principal and Surety are held firmly bound unto the City of San Juan Capistrano, (hereafter called "Obligee") in the penal sum of Two Million Five Hundred Seventy One Thousand Dollars and 00/100 Dollars, ($2,571,000.00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors and administrators, jointly and severally, firmly by these presents. NOW, THEREFORE, the condition of this obligation is such that, if Principal shall promptly and faithfully perform said improvement obligations within the fully executed and recorded subdivision improvement agreement, then the obligation shall be null and void; otherwise it shall remain in full force and effect. Page 1 of 3 BE IT FURTHER RESOLVED: 1. As a part of the obligation secured hereby, and in addition to the face amount specified, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. 2. Said Principal, for value received, hereby stipulates and agrees that no change, extension of time, alteration, or modification of the contract documents or of the work to be performed thereunder, shall in any way affect its obligations or this bond, and it does hereby waive notice of any such change, extension of time, alteration, or modification of the contract documents or of work to be performed thereunder. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal herein named on the 19th day of May 5 2015 the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representatives pursuant to authority of its governing body. PRINCIPAL: Pacific Point Development Partners, LLC By: _ s Its: NEINJ ■'1pr i ?. �d S: ,n SURETY: Ironshore Indemnity Inc. Margaret, . Ginem , Attorney -in -Fact Surety Phone No. GAO WILLIS OF FLORIDA X2.11 W: BOY SCOUT BLVD, #1000 TAMPA, FL 33607 INQUIRIES: (813)281-2095 Page 2 of 3 (NOTARIZATION AND SEAL) (NOTARIZATION AND SEAL) APPROVED AS TO FORM: By: NOTE: Please attach Acknowledgement and Power of Attorney Page 3 of 3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE T.S�:`.:/TN61 •. i� .N .a2N, inN.'Mi.i �i<!. 2/� F5+'. F:�;l.� /:�L '.� s�2 : E H �{.�{.:\{.n"/•.� /'.R[!:�2 +n /:L2. �i+v.C�=ti�vs22. �i� 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 p j Coun of C, ) On P., before me, Dale re Insertame and of the Officer personally appeared _ - Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/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. W. CORDI Commission # 2088325 a <Q a Notary Public - California x Z Orange County n My comm. Expires Oct 31, 2018 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Signer(s) Document Date: Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: _ Signer Is Representing: _ Signer's Name: .. ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationaiNotary.org - 1 -800 -US NOTARY (1-800-876-6827) Item #5907 ACKNOWLEDGEMENT BY SURETY STATE OF FLORIDA COUNTY OF HILLSBOROUGH I SS. On this 19th day of May, 2015 before me, personally came Margaret A. Ginem, who is personally known to me (or proved to me on the basis of satisfactory evidence) to be the person who executed the within Instrument as Attorney -In -Fact on behalf of Ironshore Indemnity Inc., and acknowledged to me that he/she executed the within instrument on behalf of said surety company and was duly authorized to do. In witness whereof, I have signed and affixed my official seal on the date in this certificate first above written. Signature_ Anett Cardinale rtiJptifv ANETTCARDINALE Commission # FF 138482 Expires July 28, 2018 Bonded Th. Troy F&n Insurance 800-305.1019 This area for Oficial Notarial Seal ,$fcm 13ill. 1.105.0. arfteflO. -.Sealorig I.A 89 bbil. 1195. of"the 0*11:04e. as Sealoti ON of ...elow. jftsical format of thip_fiew, disclosure WOcq js n pxaAnple,, forpurmes-of iljustratju�u p A fib twI91&blic otofh& 6ffidt--f 6oiV&tiAdthis: cerfi6mtivedfies.only the idi-,atity-6f the .certificate. is attached, and not the trUthfulnmi ,�curgq, ot villjlry of jhg;loumeuT. 8tqltd of California Cbunty of oil :,wordflac.— -.. I -.-. �(fietc Harm �an&tifle. of officerj,'personadly ap'peatlqJproyewho 3 4 '43ai6cata XOMe� oil -tho'basis of to wbPSO iiame�(�) is/u& �u th& withki •fastrmmt and acknowledged to me -that, helshelthey excoutud the sammin-histheritheir, %id that. by. 4a-; TL6 -irMmfnO:.gt 6.4 pAmotl(s), of tliL- lelitity 104 b:bkalf Of"AiCMK6 �rkeczdf eid tUiInstrurxient 4ijd6r PENALTY' 6P' 1?1 00 I . he )'a'_w''§ ot tk �Iao of - cAliferilla'. - t RY �un&r ha the farpgoi4, paragraph ilstrue and correct- WnNESS My hAn-d and officikt, wal, Signafure (Sear: POWER III- 21000024 Ironshore Indemnity Inc. KNOW ALL MEN BY THESE PRESENTS, that IRONSHORE INDEMNITY INC., a Minnesota Corporation, with its principal office in New York, NY does hereby constitute and appoint: David H. Carr, Anett Cardinale, Margaret A. Ginem its true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in nature of a bond. This authority is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC. on the 22nd day of April, 2013 as follows: Resolved, that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other writings obligatory in nature of a bond not to exceed $7,500,000 dollars, which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS THEREOF, IRONSHORE INDEMNITY INC. has caused this instrument to be signed by its Director, and its Corporate Seal to be affixed this 7th day of August, 2013 IRONSHORE INDEMNITY INC. is -• r� r By: Fla L. Sus n Director ACKNOWLEDGEMENT On this 7th Day of August, 2013, before me, personally came Daniel L. Sussman tome known, who being duly sworn, did depose and say that he is the Director of Ironshore Indemnity, Inc. , the corporation described in and which executed the above instrument; that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. J'A' � -i Amy L Tpy! Notary Public CERTIFICATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 191h Day of May20 15 9EAL 1919 Pauls. Gi dano Secretary 'WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties." AMYL TAYLOR x _ - Nolary Public- Slateof Tennessee x % «exw Davidson County My Commission Expires 01.09-16 J'A' � -i Amy L Tpy! Notary Public CERTIFICATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 191h Day of May20 15 9EAL 1919 Pauls. Gi dano Secretary 'WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties." IRONSHORE MDEMNITY IHC FINANCIAL STATEMENT SUMMARY As of December 31, 2014 ASSETS bonds Preferred stocks Common stocks Mortgage loans on real estate: First tens Mortgage loans on real estate; Other than first Iles Properties occupied by the company Properties held for the production of Income Properties held for We Cash. cash equivalents and short-term investments Contract loam Derivatives Other Invested assets Receivables for securities Securities lending reinvested collateral assets Aggregate wrltLAns forinvested assets Subtotals. cash and Invested assets Title plants less $_ Changed off Investment Income due and accrued Uncollected preirrums and agents' balances in the course of collection Deterred premiums, agenW balances and Installments booked but deferred and not yet due Accrued retrospective premiums Amounts recoverablefrom reinsurers Funds held by or deposited with reinsured companies Other amounts receivable under reinsurance contracts Amounts receivable relating to uninsured plans Current federal and foreign income tax recoverable and Interest thereon Net deferred tax asset Guaranty funds receivable or on deposit Furniture and equipment, including health are delivery assets Netadjustment In assets and liabilities due to foreign exchange rates Receivables from parent, subsidiaries and affiliates Health are and other amounts receivable Aggregate wrtte-Ins for other than Invested assets Total assets excluding Separate Accounts, Segregated Accounts and Protected Cee. Accounts From Separate Accounts, Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS $347,414,611 Gross paid In and contributed surplus Ewrowivo"ir"I CERTIFICATE 1 certify that the above financial statements to the best -al my knowledge are a true and accurate reflection of the finaiclal condition of the Company as of December 31, 2014, Additionally, I certify that the above financial statements are In agreement with the Statutory Financial Statements filed with tho Texas Department of Insurance as of the same date, William J Gleason SYR, V"i�.IreastISt. Unassigned funds (surplus) Surplus as regards policyholders TOTALS SUBSCRIBED and sworn tome Ndsy day of MNYr ,'!1 / 5 Mycommissmon expirer_ 7-/(J—/T $63,582,066 0 $10,384,957 $1,020,805 $5,435,126 $2,383,909 $2,434,392 0 $29,158,576 $58,222,187 0 $1,545,075 $12,458,110 0 0 0 0 $4,185,929 $190,811,131 $190,811,131 0 5,000,000 0 $156,938,671 ($5,335,190) $156,603,481 $347,414,611 Notary Pubnc Printed Name A1_YSSA TURKOVITZ Notary Public, State of New York No. Oi TU6044514 ALYSSATURI CIVFTZ — -_ Qualifled 1n Westchester County Commieslfm fires July 10, 2018 Tic btic. Stets of New York C No.01TU6044514 Qualified In Westchester County Coramissim Exphes July 10, 2014 LIABILITIES $179,140,947 losses 0 Reinsurance payable on paid losses and loss adjustment expenses 31,640,141 Loss adjustment expenses 0 Commissions payable, contingent commissions and other similar charges 0 Other expenses texciudingtaxes. 8censes and fees) 0 Taxes, licenses and fees (exdudmg federal and foreign income taxes) 0 Current federal and foreign income taxes 0 Net deferred tax liability $15,632,951 Unearned premiums 0 Advance premium 0 Ceded reinsurance premiums payable (net of coding commissions) 0 Funds held by company under reinsurance trestles 0 Amounts withheld or retained by company for account of others 0 Remittances and Items not allocated 0 Provision for reinsurance $226,614,039 Net adjustments in assets and tabilltles due toforeign exchange rates 0 Drafts outstanding $990,960 Payable to parent subsidiaries and affiliates $73,567,547 Derivatives 0 Payable for securities 0 Payable for securities lending $33,586,257 Liability for amounts held under uninsured plans 0 Aggregate wrltrins for liabilities 0 Total liabilities excluding protected call liabilities 0 PrauciM rnH Irabl6Sles 0 $5,530,837 TotaiNabditles 0 0 POLICYHOLDEIti S SURPLUS 0 Aggregatevmte-ins for special surplus funds 0 0 Common coal stock $7,124,971 Preferred capital stock $347,414,611 Aggregate wrlWns for other than special surplus 0 Surplus Notes TOTALS $347,414,611 Gross paid In and contributed surplus Ewrowivo"ir"I CERTIFICATE 1 certify that the above financial statements to the best -al my knowledge are a true and accurate reflection of the finaiclal condition of the Company as of December 31, 2014, Additionally, I certify that the above financial statements are In agreement with the Statutory Financial Statements filed with tho Texas Department of Insurance as of the same date, William J Gleason SYR, V"i�.IreastISt. Unassigned funds (surplus) Surplus as regards policyholders TOTALS SUBSCRIBED and sworn tome Ndsy day of MNYr ,'!1 / 5 Mycommissmon expirer_ 7-/(J—/T $63,582,066 0 $10,384,957 $1,020,805 $5,435,126 $2,383,909 $2,434,392 0 $29,158,576 $58,222,187 0 $1,545,075 $12,458,110 0 0 0 0 $4,185,929 $190,811,131 $190,811,131 0 5,000,000 0 $156,938,671 ($5,335,190) $156,603,481 $347,414,611 Notary Pubnc Printed Name A1_YSSA TURKOVITZ Notary Public, State of New York No. Oi TU6044514 ALYSSATURI CIVFTZ — -_ Qualifled 1n Westchester County Commieslfm fires July 10, 2018 Tic btic. Stets of New York C No.01TU6044514 Qualified In Westchester County Coramissim Exphes July 10, 2014 RELEA ED 10 Date; t Signature: City Clerk _ SUBDIVISION LABOR AND MATMAL'abtffiffP15 Crano. [:A (GOVERNMENT CODE 66499.2) Bond No. SUR21000024 Replaces Bond No. SUR20000348 KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Development Partners, LLC (hereafter designated as "Principal"), and Ironshore Indemnity Inc. as Surety (hereinafter called "Surety") agree to install and complete certain designated public improvements as conditioned by City Council Resolution No's. 92-6-16-4 and 03-09-16-06. WHEREAS, said Principal is required to furnish a bond pursuant to Municipal Code Section 9-5.101 and 9-5.109 et seq., for the faithful performance to guarantee certain work, more particularly described as follows: Off -Site Circ. subdivision improvements within Tract N/A as defined within Amendment #1 and Reinstatement of the Subdivision Improvement Agreement for Tract N/A NOW, THEREFORE, we the Principal and Surety are held firmly bound unto the City of San Juan Capistrano, (hereafter called "Obligee") in the penal sum of Two Million Five Hundred Seventy One Thousand Dollars and 00/100 Dollars ($ 2.571.000.00 ) lawful money of the United States, for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors and administrators, jointly and severally, firmly by these presents. NOW, THEREFORE, the condition of this obligation is such that if the above bound Principal, his or its heirs, executors, administrators, successors or assigns, shal in all things stand to and abide by and well and truly keep and perform the covenants, conditions and provisions per City Council Resolution No's. 92-6-16-04 and 03-09-16- 06, on his or their part, to be kept and performed at the time and in the manner therein specified, and in all respects according to their true intent and meaning, and shall indemnify and save harmless the City, its offers, agents and employees as therein stipulated, and, as necessary enter into a Subdivision Agreement, then this obligation shall become null and void; otherwise it shall be and remain in full force and effect. Page 1 of 3 BE IT FURTHER RESOLVED: 1. As a part of the obligation secured hereby, and in addition to the face amount specified therefore, there shall be included costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing such obligation, all to be taxed as costs and included in any judgment rendered. 2. Said Principal hereby stipulates and agrees that no change, extension of time, alteration, or modification of the terms of the agreement or of the work to be performed thereunder, shall in any way affect its obligations or this bond, and it does hereby waive notice of any such change, extension of time, alteration or modification of the terms of the agreement or of the work or to the specifications. IN WITNESS WHEREOF, this instrument has been duly executed by the Principal herein named on the 19th day of May , 2015 , the name and corporate seal of each corporate party being hereto affixed and these presents duly signed by its undersigned representatives pursuant to authority of its governing body. PRINCIPAL: Pacific Point Development Partners, LLC (NOTARIZATION AND SEAL) By: Y Its:.tel' c�i O\V'y i�_ SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: Margare A. Ginem , Attorney -In -Fact CIO WILLIS OF FLORIDA Surety Phone No. 4211 W. BOY SCOUT BLVD, 01000 TAMPA, FL 33607 INQUIRIES: (813)281-2095 Page 2 of 3 APPROVED AS TO FORM: By: NOTE: Please attach Acknowledgement and Power of Attorney Page 3 of 3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT •. 'N.� .N .A - .T�•✓a{ r �2 :r r :.r/,+Y. -:.Kir :ic�'1i. "c.s�cr'F..'a:i: x .: r.:. r a:[. s. .v. . 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 County ofym �( On I A IFAIII before me, Date f1h personally appeared and Title of the Officer Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/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. W. CORGI Commission # 2098325 zIQ Notary Public - CaliforniazOrange County My Comm, Ex Tres Oct 31, 2019 I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is true and correct. WITNESS my hand and official seal. Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Number of Pages: Document Date: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: Signer's Name: ❑ Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑ General ❑ Individual ❑ Attorney in Fact ❑ Trustee ❑ Guardian or Conservator ❑ Other: Signer Is Representing: 02014 National Notary Association • www.NationalNotary.org • 1 -800 -US NOTARY (1-800-876-6827) Item #5907 ACKNOWLEDGEMENT BY SURETY STATE OF FLORIDA COUNTY OF HILLSBOROUGH I SS. On this 19th day of May, 2015 before me, personally came Margaret A. Ginem, who is personally known to me (or proved to me on the basis of satisfactory evidence) to be the person who executed the within Instrument as Attorney -In -Fact on behalf of Ironshore Indemnity Inc., and acknowledged to me that he/she executed the within instrument on behalf of said surety company and was duly authorized to do. In witness whereof, I have signed and affixed my official seal on the date in this certificate first above writte . Signature Anett Cardinale ANETT CARDINALE _ . commission # FF 138482 l Expires July 28, 2018 rjJf ' 90ndedThruTroy FWi 1l.=no.800.3B5.70f0 This area for Official Notarial Seal ift 1100, amwa�- -.9e ' 1 1 d 1195, -of, 'thd: CiVI C. -P& =4 seaw 00, of W '-SeaW 13R, Ofiqli�- 1: 89 W1 . - I jQoVcMMOt.Cp relafing-To noiafies, pblft- nOeIW.-PbY�icA format -of tpnew. disclosure , Ael. notice;fan. I _ ma�nplejpr-purp.q. _ubjjC of Ofhdr 6ffid(, Cerdficate Vetifies.0rily the -. id6ntiy 6f the inclVictual who kIgne4 the d6duio WW Atu .certificate. is attached, and not the trtithfWiiessj AC6W?'qY' oir vIkq&jv of th4woomielit- :State bf C a] itoMi.a. County. of .ba before fne,_.- - . - - .; �- - . '. - . . . . 0610 insert narn� andtitle O"f-officer), pemonally app=4d - who'. 54 -, nba to t iiarrki) sAit 'sc tp 99. ot'tho. bans. of saiisfictoty, evidoO to bwthb,.PeM6�( ) iohos�q i 'the withiri -hjstr=ent. and acknowledged -to me, . that helshelthey executed the same. in- .his/herltheir p#orii40paefiy(i"), -aod that by )iwh(T -sigbame(ro 'on,:thy -M'.'S'trvfnot the vjbrsopw'or the efitity. tipoh. &*Alf of-whiph the person(x),40ed, ek6mited tli( Irtsfiuin6nt fY'UYj&r PENA ftrlbe )'&'W''§ of StAto of CAlifom para&ra0h, i' true andcorrecl- WUNESS mg hW and official SeRL Signafiire. Seal). Ironshore Indemnity Inc. KNOW ALL MEN BY THESE PRESENTS, that IRONSHORE INDEMNITY INC., a Minnesota Corporation, with its principal office in New York, NY does hereby constitute and appoint: David H. Carr, Anett Cardinale, Margaret A. Ginem its true and lawful Attorney(s)-In-Fact to make, execute, seal and deliver for, and on its behalf as surety, any and all bonds, undertakings or other writings obligatory in nature of a bond. This authority is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC. on the 22nd day of April, 2013 as follows: Resolved, that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or persons as Attorney -In -Fact to execute on behalf of the Company any bonds, undertakings, policies, contracts of indemnity or other writings obligatory in nature of a bond not to exceed $7,500,000 dollars, which the Company might execute through its duly elected officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney -In -Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company. Any Attorney -In -Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney. Resolved, that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed and sealed and certificate so executed and sealed shall, with respect to any bond of undertaking to which it is attached, continue to be valid and binding on the Company. IN WITNESS THEREOF, IRONSHORE INDEMNITY INC. has caused this instrument to be signed by its Director, and its Corporate Seal to be affixed this 7th day of August, 2013 IRONSHORE INDEMNITY INC. S SEAL 1919 i + By, Dan a l.5uss n Director ACKNOWLEDGEMENT On this 7th Day of August, 2013, before me, personally came Daniel L. Sussman to me known, who being duly sworn, did depose and say that he is the Director of Ironshore Indemnity, Inc. , the corporation described in and which executed the above instrument; that he executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation. �" �, .4tiv Amy L. Tey] Notary Public CERTIFICATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 19th Day of May20 15 t L �EALOf 1919 L PauIS.G dano Secretary "WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties." _AMYL TAYLOR _ Notary Public- Slate of Tennessee ? Davidson County 14 My CDmn.lDn E%p'ves 01.09-16 �" �, .4tiv Amy L. Tey] Notary Public CERTIFICATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 19th Day of May20 15 t L �EALOf 1919 L PauIS.G dano Secretary "WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and subjects such person to criminal and civil penalties." IRONSHORE MDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31, 2014 ASSETS Bonds Preferred stocks Common stocks Mortgage loans on real estate: First liens Mortgage Irons on red estate; Other than first Hens Properties occupied by the company Properties held for the production of income Properties held for We Cash. cash equivalents and short-term investments Contract loans Derivatives Other invested assets Receivables for securities Securities lending reinvested collateral assets Aggregate write -Ins forinvested assets sub] c,rais L]Ih nn6 Inv ell ni 1C10% Title plants less $._. Charged off Investment Income due and accrued Uncollected prenrums and agents' balances in the course of collection Deferred premiums, agent& balances and Installments booked but deferred and not yet due Accrued retrospective premiums Amounts recoverable from reinsurers Funds held by or deposited with reinsured companies Other amounts receivable under reinsurance contracts Amounts receivable relating to uninsured plans Current federal and foreign Income tax recoverable and interest thereon Net deferred tax asset CERTIFICATE I certify that the above financial statements to the bestof my knowledge are a true and accurate reflection of the financial condition of the Company es of December 31, 2014, Additionally, I certify that the above financial statements aro In agreementwlth the Statutory Financial Statements filed with the Trxa. Department of Insurance as of the same date, William J Gleason VQF YP—&Tt�elvi9f.. Unassigned fundsjsurplus) Surytus as regards policyholders TOTALS $63,582,066 0 $10,384,957 $1,020,805 $5,435,126 $2,383,909 $2,434,392 0 $29,158,576 $58,222,187 0 $1,545,075 $12,458,110 0 0 0 0 $4.185.928 $190,811,131 $190,811,131 0 5,000,000 0 $156,938,671 ($5,335,190) $156,603,481 $347,414,611 SUBSCRIBED and sworn tomethis'dayof%�%j�y� Myconnrr as4n expires: -7-/V—/T Notary Public [hinted Name ALYSSA TURKOVITZ Notwy Public, State of New York No. 01TU6044514 ALY MTURKO x ❑uallfled in Westchester County •� Is�LGc.� Cofnmissi Expires July 10, 2016 N bflc, State of New York r No.01TU6044514 Quallfied In Westchester County Commission Expires July 10, 2014 LIABILITIES $179,140.947 lases 0 Reinsurance payable on paid losses and loss adjustment expenses 31,840,141 toss adjustment expenses 0 Commissions payable, contingent commissions and other similar charges 0 Other expenses (exclu ling taxes. licenses and fees) 0 Taxes, licenses and fees (exdudmg federal and foreign Income taxes) 0 Current federal and foreign income taxes 0 Net deferred tax liability $15,632,951 Unearned premiums 0 Advance premium 0 Ceded reinsurance premiums payable (net of ceding commissions) 0 Funds held by company under reinsurance treaties 0 Amounts withheldor retained by company for account of others 0 Remittances and Items not Bloated 0 Provision for reinsurance $226,614,039 Net adjustments In assets and kabllltles due to foreign exchange rates 0 Draftsoutstandlnil $990.960 Payable to parent, subsidiaries end affiliates $73,567,547 Derivatives 0 Payable for securities 0 Payable for securities lending $33,58y257 Liability for amounts held under uninsured plans 0 Aggregate write -IIs for liabilities 0 Total nablllties excluding protected cell Ilabllldes 0 Protected cell liabilities 0 $5,530,837 Totatilabilities CERTIFICATE I certify that the above financial statements to the bestof my knowledge are a true and accurate reflection of the financial condition of the Company es of December 31, 2014, Additionally, I certify that the above financial statements aro In agreementwlth the Statutory Financial Statements filed with the Trxa. Department of Insurance as of the same date, William J Gleason VQF YP—&Tt�elvi9f.. Unassigned fundsjsurplus) Surytus as regards policyholders TOTALS $63,582,066 0 $10,384,957 $1,020,805 $5,435,126 $2,383,909 $2,434,392 0 $29,158,576 $58,222,187 0 $1,545,075 $12,458,110 0 0 0 0 $4.185.928 $190,811,131 $190,811,131 0 5,000,000 0 $156,938,671 ($5,335,190) $156,603,481 $347,414,611 SUBSCRIBED and sworn tomethis'dayof%�%j�y� Myconnrr as4n expires: -7-/V—/T Notary Public [hinted Name ALYSSA TURKOVITZ Notwy Public, State of New York No. 01TU6044514 ALY MTURKO x ❑uallfled in Westchester County •� Is�LGc.� Cofnmissi Expires July 10, 2016 N bflc, State of New York r No.01TU6044514 Quallfied In Westchester County Commission Expires July 10, 2014 0 Guaranty funds receivable or on deposit Furniture and equipment, Including health are delivery assets 0 POUCYHOLDERYSSURPLUS Netadjustment In assets and liabilities due to foW.Sn exchange rates 0 Aggregate wnte-Ins for special surplus funds Receivables from parent„ subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common appal stock Aggregate write-ins for other than invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts, Segregated Accounts and Protected Cult $347,414,511 Aggregate write+nsfor other than special surplus Accounts From Separate Accounts Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS f S3d7.414,611 Gross paid In and oontnbutedsurplus CERTIFICATE I certify that the above financial statements to the bestof my knowledge are a true and accurate reflection of the financial condition of the Company es of December 31, 2014, Additionally, I certify that the above financial statements aro In agreementwlth the Statutory Financial Statements filed with the Trxa. Department of Insurance as of the same date, William J Gleason VQF YP—&Tt�elvi9f.. Unassigned fundsjsurplus) Surytus as regards policyholders TOTALS $63,582,066 0 $10,384,957 $1,020,805 $5,435,126 $2,383,909 $2,434,392 0 $29,158,576 $58,222,187 0 $1,545,075 $12,458,110 0 0 0 0 $4.185.928 $190,811,131 $190,811,131 0 5,000,000 0 $156,938,671 ($5,335,190) $156,603,481 $347,414,611 SUBSCRIBED and sworn tomethis'dayof%�%j�y� Myconnrr as4n expires: -7-/V—/T Notary Public [hinted Name ALYSSA TURKOVITZ Notwy Public, State of New York No. 01TU6044514 ALY MTURKO x ❑uallfled in Westchester County •� Is�LGc.� Cofnmissi Expires July 10, 2016 N bflc, State of New York r No.01TU6044514 Quallfied In Westchester County Commission Expires July 10, 2014