15-0505_Bond_SUR21000001_Pacific Point Dev_TR 14196 Premium: $1,164.00
SUBDIVISION FAITHFUL PERFORMANCE BOND
(GOVERNMENT CODE 66499.2)
Bond No. SUR21000001
Replaces Bond No. SUR20000316
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:
Landscape subdivision improvements within Tract 14196 as defined within Amendment#1 and
Reinstatement of the Subdivision Improvement Agreement for Tract 14196
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
One Hundred Fifty Five Thousand One Hundred Ninety Two Dollars and oo/1oo Dollars, ($155,192.00 ) 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 , 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)
Its: ��a-1-ao�',zL� �; +�r✓.Foc
SURETY:
Ironshore Indemnity Inc.
(NOTARIZATION AND SEAL)
By:
Margare . Ginem , Attorney-in-Fact
Surety Phone No.
CIO WILLIS of FLORIDA
4211 W!Boy SCOUT BLVD#tppp
TAMPA, FL 33667 Page 2 of 3
INQUIRIES:(813)281-2095
APPROVED AS TO FORM:
By:
NOTE: Please attach Acknowledgement and Power of Attorney
Page 3 of 3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189
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 Californiaor )
County of )
On � — ,�1U,�r
before me, �1'
❑at (ire ert ame and Titl of a Officer
Ppersonally appeared
Name(s)of Signers)
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.
certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
W.CORDI is true and correct.
Commission#2088325
Notary Public-California WITNESS my hand and official seal.
z Orange County a
My Comm.Expires Oct 31,2018
Signature I/ '>/t , jj
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: Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(les) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑Corporate Officer — Title(s): __-.- ❑Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General
❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact
❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator
❑Other: ❑ Other:
Signer Is Representing: , Signer Is Representing:
02014 National Notary Association - www.NationalNotary.org • 1-800-US NOTARY(1-800-876-6827) Item#5907
e en '189 and 1195.'ofthe 0761tode-and 'Sectiop 8-20 of the
-Seftat� Dill W50, an 6. s.gec.tions I
Government Cqk,rclafin es. ,'Tbo lielow.physiQ6.I format of the riew disclosure
gjp no public
-notice.is-on example; for pqrpQses of il usiration,
A bototy public or other 6fficefdohi'
plktingtbig
certificate verifies only the identity of the
individual who signed the doPurnpnt-to rah iCh'ihis
.certificate.is attached,and not the truthfulness*
accuracy,or validf th
ity 6 ar.dodunient
State'of California
,County of
01t before me,
ere
insert name and-title ofofficer),personally appeaTed -------------- who
proved:to iop;:on the basis of satisfactory evidence to b6 the persons)wbo9b hanle.(s) subscribed bsqibed to
-
the within,-instrument and acknowledged to me that; he/she/they executed the sarne-- in his/her/their.
authorized caipacity(ics), and that by bis/her/their sign4ture(s I) -on the instrument the p.erson(s), or the
entity, Upon-behalf of which the person(s)acted,executed the-instrument.
I certiy ifnf'
flider PENALTY QV PERJURY'under the laws of
tie.State Of'Chfifornia that the foregoing
paragraph fs true and'correct
WITNESS itiy hand -and offic-lait.seal,
Signature (Seal),
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 writ,en.
Signature
Anett Cardinale
ANETT CARDINALE
=``' Gommissla #FF B 02
Expires JOY 28, gpp 865,T418
.X Ri,[Z" 8ondnd Shnrlrml Fain lnnaenaa
This area for Official Notarial Seal
POWER OF ATTORNEY
Ironshore Indemnity Inc. III- 21000001
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
22"d 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 sear 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.
�4 Pm�yt
SEAL r
By:
Dan a L,Suss 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 lronshore 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.
AMYLTAYLORd
— Notary Public-Slate of Tennessee
+ Davidson County
q, . �+ My Commission Expires 01-09-16 Amy L.Tp
,J ,` NotaryPublic
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 MaY 20 15
SEAL f�
19s9
Paul S.G dant J
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."
IRONSNORE INDEMNITY INC
FINANCIAL STATEMENT SUMMARY
As of December 31,2014
ASSETS
LIABILITIES
Bonds
$179,140,947 Losse
$63,582,066
Preferred stocks
p Reinsurance payable on paid kisses and Inas adjustment expenses
Common stocks 0
31,840,141 Lou adjustment expenses $10,384,957
Mortgage loans on real estate:Tint Eens 0 Commissions payable,contingent commissions and other similar charges $1,020,805
Mortgage loans on real estate,Other than first liens 0 Other expenses(04uding taxes.licenses and fees) $5,435,126
Properties occupied by the company 0 Taxes,licenses and fees(excluding federal and foreign Income taxes) $2,383,909
Properties held for the production of Income 0 Current federal and foreign Income taxes
Properties held for sa e 0 $2,434,392
Net deferred tax liability
0
Cash,rash equivalents and short-term Investments $15,64951 Unearned premiums
$29,158,576
Contract Barrs 0 Advance premium
Derivatives 0 Ceded reinsurance premiums payable(net of ceding commissions) $58,222,187
Other invested assets 0 Funds held by oompany under reinsurance treaties p
Receivables for securities 0 Amounts withheld or retained by company for account of others
Securities lending reinvested collateral assets 0 Remittances and Items not allocated
Aggregate write-Ins forinvestedassets 0 Provision for reinsurance $1,545,075
Subtotals.cash and Invested assets $226,614,039 Net adjustments Jew assets and kablitlesdue toforeign exchange rates
Title plants less$_Charged off 0 Drafts outstanding
Investment Income due and accrued $990,960 Payable to parent,subsidiaries a nd affiliates $12,458,110
Unoollected prem ums and agents'balancesin the course of collection $73,567,547 Derivatives
0
Deferred premiums,agents'balances and Installments booked but deferred and not 0
yet due Payablefor securitles 0
Accrued retrospective prerniums 0 Payable for securities lending 0
Amounts recoveraWe from reinsurers $33,586,257 Liability for amounts held under uninsured plans 0
Funds held by or deposited with reinsuredcompanles 0 Aggregate write-Ins for liabilities $4,185,928
Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities
$190,811,131
Amounts reaNab;erelating touninsured plans 0 Protected call liabilities
Current federal and foreign income tax recoverable and interest thereon 0
Nctdclenedtaxasset $5,530,837 Total liabilities
$190,812,131
Guaranty funds receivable or on deposit 0
Furniture and equipment,Including healthcare deiveryessets 0 POUCYNOLDEIWSSURPWS
Net adjustment In assets and liabilities due to fordgn exchange rates 0 Aggregate wnto-lns for special surplus funds
0
Receivables from parent,subsidiaries and affiliates 0
Health care and other amounts receivable 0 Common caotal stock 5 000 ODO
Aggregate write4ns for other than Invested assets $7,124,971 Preferred capital stock
Total assets excluding Separate Amounts,Segregated Amounts and Protected Cel. $347,414,611
Aggregate write mfor other than special surplusAccounts p
From Separate Amounts,Segregated Accounts and Protected Cell Amounts 0 Surplus Notes
TOTALS _ $3A7 414,611 Gross paid In and contributed surplus $156,938,671
Unassigned funds(surplus; ($5,33S,1901
Surp,us as regards policyholders $156,603,481
TOTALS $347,414,611
SUBSCRIBED and sworn to me this,relay of }��. ,"0.,�s
f
f1-5fr+ � Mycomrrdssen exwres_ ']-fU-/Sr
NotaryPublic
CERTIFICATE % Pti'ited Name Nt��LYSSPublic,State O V W (
I certify that the abovefinandal statements to thebestof my NO.U1f�4
knowledge are a true and amurate reflection of the financial ALYSSA TURKOVTrZ
condition of the Company as of December 31,2014, +' , QUeffiad in Westchester County
Additionally,Icertify that the above financial statements are I� � yli� r- i' 171i1jt397C1i1 7C�7¢fl r�ldI�f 10,2018
in agreement with the Statutory Financial Statements filed with the Tfxac No",IPONG Sbate of New York
Department of insurance as of the same date, v
No.01TU6044514
William Gesson Qualified In Westchester County
L9xYP I Tr01WIL Commission Expires July 10,2014
SUBDIVISION LABOR AND MATERIAL BOND
(GOVERNMENT CODE 66499.2)
Bond No. SUR21000001
Raplaces Bond No. SUR20000316
KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Deveiopment 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:
Landscape subdivision improvements within Tract 14196 as defined within Amendment#1 and
Reinstatement of the Subdivision Improvement Agreement for Tract 14196
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
One Hundred Fifty Five Thousand One Hundred Ninety Two Dollars and 00/100 Dollars ($155,192.00 ) 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, shat
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:
Its: � 1A ac;.
SURETY:
Ironshore Indemnity Inc.
(NOTARIZATION AND SEAL)
By:
MargareVA. Ginem , Attorney-in-Fact
Surety Phone No.
C/O WILLIS OF FLORIDA
4211 Wi Boy SCOUT BLVD.#1000 Page 2 of 3
TAMPA, FL 33607
INQUIRIES:(813)281-2095
APPROVED AS TO FORM:
By:
NOTE: Please attach Acknowledgement and Power of Attorney
Page 3 of 3
CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT CIVIL CODE§ 1189
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 j& C )
County of f{ �) )
On I r w before me, ld
Date In rt ame and tie of the Officer
personally appeared to.
Name(s)of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Ware
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.
I certify under PENALTY OF PERJURY under the laws
of the State of California that the foregoing paragraph
W. CORDI is true and correct.
Commission#2088325 WITNESS my hand and official seal.
z Notary Public-California
z Orange County
My Comm.Expires Oct 31,2018 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: _ _ Document Date:
Number of Pages: Signer(s) Other Than Named Above:
Capacity(les) Claimed by Signer(s)
Signer's Name: Signer's Name:
❑Corporate Officer — Title(s): ❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General
❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact
❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator
❑Other: ❑ Other:
Signer Is Representing: Signer Is Representing:
02014 National Notary Association •www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907
-$eriatiD', kill 1050, =ehd'S$ec.fioris 1189 and 1195:of OvIt Code and Section 820of the
Goyerninent Code., relating-to relating-tonota4es,publI"C_ The below physical format the hew disclosure
notice;is-an exaTnpl e; for purposes of illustration:
A notary public j4pjbtri"b,
.: c or other order do i this
certificate verifies only the ideritityof the
individual who signed the do6u which this
meTit.to
certificate is attached,and not the truthfulness,
accuracy,or validity of that document.
State of California
County df
Oft before me, he�e
insert name and title of officer),personally appeared w110
proved tai me on the basis of satisfactory evidence to bethe-person(i)whose name -ibed t(i
(s) is/4rt s0srr
the within instrument and acknowledged to me- that hehhe/thqy executed the same. in his/her/their
authorized capacity(es), tkqd that'.by.11js/her/thpi signAtqre($) 'On the instrument the'person(s),: of the
eri,tity tipbii behalf of.:which the person(s)ac ,
ted,ekec�ated tb&.�instrui n'ent
cQrtifyvo&r PENALTY OF' P�RJVkY wider the laws a*s of the,State of'CAlOornia. that the famo:
Ing.
paragraph is true and correct
WITNESS.niy hand and officiaI sea],
Signature (Sea]).
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
*^"'V"41 ANETT CARDINALE
I = Commission#FF 138482
4a Expires July 28,2018
"KV,�;',* Bonded Thru Troy Fein Inwranoe 60O.M.7olo
This area for Oficial Notarial Seal
POWER OF ATTORNEY
Ironshore Indemnity Inc. III- 21000001
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 seat 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.
o<.
- 6Ert —
D,9
By.( L.Suss 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.
U-1
_X_
lQ
- _ NdY L.YhYLl7H
a - - Notary Publlc-Slate of Tennessee
Davidw,County
'•4t_ ^'.c�sSY C ���Expree Ot-0316
J
7ay1
�au�` Notary FutilSC
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
,,ate
Y f'Y
6914
Paul S.Gi danq r
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 INDEMNITY INC
FINANCIAL STATEMENT SUMMARY
As of December 31,2014
ASSETS LIABILITIES
Bonds
$179,149,947 Losses $63,582,066
Preferred stocks pReinsurance payable on paid lasses and lass adjustment expenses p
Common snicks 31,840,141 Loss adjustment expenses $10,384,957
Mortgage loans on real estate;Tint tens 0 Commissions payable,contingent commissions and other similar charges $1,020,805
Mortgage loans on real estate,Other than first Rens 0 Other expenses(excluding taxes.licenses and fees) $5,435,126
Properties occupied by the company 0 Taxa„licensesand fees(exdudmg federal and foreign hwome taxes) $2,383,909
Properties held for the production of income 0 Current federal and foreign income taxes $2,434,392
Properties held forsa!e 0 Net deferred tax liability 0
Cash,cash equivalents and short-term investments $15,632,951 unearned premiums $29,158,576
Contract Loans 0 Advance premium
Derivatives 0 Ceded reinsurance prerniums payable(net of ceding commissions) $S8,222,187
Other invested assets 0 Funds held by company under reinsurance treaties p
Receivables for securities 0 Amounts withheld or rebind by company for aecountof others
Securities tending reinvested collaterg assets 0 Remittances and items not allocated
Aggregate wrlteansforinvestedassets 0 Provision for reinsurance
$1,545,075
Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and tabilltles due toforelgnexchange rates
Title plants less$Charged off 0 Drafts outstanding
Investment Income due and accrued $990960 Payable to parent subsidiaries and affiliates $12,458,130
Uncollected premums and agents'balances in the course of collection $73,567,547 Derivatives
D
Deferred premlums,agents'balances and Installments booked but deferred and not 0
yet due Payable for securities 0
Accrued retrospecNvepremiums 0 Payable for securities tending 0
Asnounts recoverabi e from reinsurers $33,586,257 Liability foramounts held under uninsured plans 0
Funds held by or deposited with reirssumd companies 0 Aggregate wrlte4n&for liabilities
$4,185,928
Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811131
Amounts receivable relating to unlnsured plans 0 Protected cell liabilities
Current federal and foreign Income ax recoverable and interest thereon 0
Net deferred tax asset $5,530,837 Total gabilkies
$190,812,131
0
Guaranty funds receivable or on deposit
Furniture and equipment,including health are delivery assets 0 POUC44MDEWS SURPLUS
Net adjustment In assets and liabilities due to foreign exchange rates 0 Aggregate waste-Ins for speclal surplus funds 0
Receivables from parent,subsidiaries and affiliates 0
Health are and other amounts receivable 0 Common notal stock 5 0001100
Aggregate write-ins for otherthanInvested assets $7,124x971 Preferred capital stock
Total assets exduding Separate Accounts,Segregated Accounts and Protected Cel: $347,414,611
Aggregate write-ms for other than special surplus p
Accounts
From Separate Accounts Segregated Accounts and Protected Cell Accounts 0 Surplus Notes
TOTALS 5347,414,611 Gross paid In and contobuted surplus $156,938,671
Unassigned funds{surplus; ($5r335,190)
Surp us as regards policyholders $156,603,481
TOTALS $347,414,611
SUBSCRMEOand lvrora to mn 1lAiYi ay of M}q4 143/S
Mymmrrds cnexpires: 7-/6'-/S
Noaryf+ubllc
CERTIFICATE Pri•rted Name ALYSSA TURKOV(TZ
L certify that the above financial statements to the bestof my Notary Public,State of New YcricNO.01TU6044514
knowledge are a true and accurate reflection of the nnanclxl ALYS%WRKOV7f!
condition of the Company es of December 31,2014, r} Quelffled tr1 Westchemer County
Additionally,I certify that the above financial statements are I•Y ,�. ,+y /f' i4 , ' 01=91116610n EVM July%2018
in agreement with the Statutory Financial Statements filed with the Texa4 '1rpW416MIr.mo Of kewYork -.
Department of Insurance as of the same date, r
No.01TU6044514
WBllam16leason QuaflBed In Westchester County
9%YY_&1LU1VUL Conrmission Explres July 10,2014