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15-0505_Bond_SUR21000005_Pacific Point Dev_TR 15609 Premium: $3,387.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000005 Replaces Bond No. SUR20000317 KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Development Partners. LLG (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: Street subdivision improvements within Tract 15609 as defined within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract 15609 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 Four Hundred Fifty One Thousand Five Hundred Fifty Four Dollars and 00/100 Dollars, ($451,554.00 ) 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: ,��,'�.4�: ', ,r•U+�y� SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) e�? -z cl- By: Margaret . Ginem , Attorney-in-Fact Surety Phone No. C/O WILLIS OF FLORIDA 4211 W.BOY SCOUT BLVD,#1000 TAMPA, FL 33607 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 California ) County f On before me, Dat He Inseil e and Title f the Officer personally appeared lifo - 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. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph W.CORDI is true and correct. r' Commission#2088325 _ ' Notary Public-Czll}ornia WITNESS my hand and official seal. 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(lies) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s):_ El 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 $ejftate 13M 050, eiids:gectiotis x 189 bhi3 .1 M 'Of"Ofe dyiModc and Sedii U 9 Ol-of'the Goxeut, oe;.i� laing to notices.ptt# i die belCv physical format of tie ri+ r disclosure notice,�s,�n exat�aple,�for pw�ca�s,a�` Xus�ai�rn: A rioti� ffec public of other naohjpllstiiti th#s certifibate vetifies.only the identity of the individual w'ho,signed the do;�utnchtra whichs certificateis attached,and not'the trutWnessi z � IpOrAdy;0 Validity of that'doqurtterrt,. State i�f(:alifornia C.bunty.of 4ii _ ;before ine, iiassert name and'title oftfficer),persowdly 4ppwed Who.. prov.f4 to ftkotl'fh'o'basis-of Otisfacgpty evidence to bM`* ,fiersori(6 Wl os iianie(s)xsJ4r sul scrj&ea to, the Vvithiri..i`iistrument and acknowledged to -me- that h0she/they exeouted the same .in His/her/their utl 4V. P,-.. Opacity(io), anal that by his/lien/tFietr-slghatttt'e(q) ' .:fine. istruin�nf a rson(s),:"off t#te _entity._eAtity. Opon behalf of which the pefsofi(t).acted, ekecuted.thi`i kstrurnent, I; eit%fy'iilider ]°ENA:LTl?. P�:12;1�URX under:lie )avi%s 'of be. t;t pf CAfomia fat the forgoing paragraph is true and carred WrMESS i*,hftnd aii .Oicial seal'. afore — (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 affix d my official seal on the date in this certificate first above written. Signature Anett Cardinale q ANETT CARDINALE *= Commission#FF 138482 ?;• EXPIres July 28,2018 r < ` Bonded Thru Troy Fein Insurance 800.3857019 This area for Official Notarial Seal POWER OF ATTOFNEY Ironshore Indemnity Inc. III- 21000005 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 Attorneys)-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: Resofved,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 $7,500,000 dollars,which the Company might execute through its duly elected officers,and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-In-Fact shall be as binding upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company,Any Attorney-In-Fact,so appointed,may be removed for good cause and the authority so granted may be revoked as specified in the Power of Attorney. Resolved,that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted,and the signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company.Any such power so executed and sealed and certificate so executed and sealed shall,with respect to any bond of undertaking to which it is attached,continue to be valid and binding on the Company, IN WITNESS THEREOF,IRONSHORE INDEMNITY INC. has caused this instrument to be signed by its Director,and its Corporate Seal to be affixed this 7th day of August,2013 IRONSHORE INDEMNITY INC. SEAL 1919 !i • 4�yyY�£. F., By: !]art a Lr$us " 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. AMY L TAYLOR s Nolery Public-State of Tennessee � i• ^ = Davidson County Commission Expires 01-09-1S Amy L.7-A Notary Pu611C 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 Y9F! ! Paul S.GI dan o 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 IHC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140.947 Losses $63,582,066 Preferred stocks pReinsurance payable on paid bases and loss adjustment expenses p Common stocks 31,840,141 Loss adjustment expenses $10,384,957 Mortgage loans on real estate:First kens 0 Commissions payable,oontIngent commissions and other similar charges $1,020,805 Mortgage loans on reel estate;Other than first liens 0 Other expenses(excluding taxes.licenses and fees) $5,435,125 Properties occupied by the company 0 Taxes,licenses and fees(exdudmg federal and foreign Income taxes) $2,383,909 Properties heli for the production of intone 0 Current federal and foreign Income taxes $2,434,392 Properties held for We 0 Net deferred tax liability 0 Cash.rash equivalents and short-term investments $15,632,951 Unearned premiums $29,158,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of ceding commissions) $58,222,187 Other invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities 0 Amounts withheld or retained by company for account ofothers Securities lending reinvested collateral assets 0 Remittances and items not Notated Aggregate wrlte-Insforinvestedassets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and Labillties due to foreign exchange rates Title plants less$--,Charged off 0 Draftsoutstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and afhllahs $12,458,110 Uncollected prad ums and agents'balances in the course of collection $73,567,547 Derivatives 0 Deferred premiums,agents'balances and Installments booked but deferred and not 0 yet due Payable for securities 0 Accrued retrospective prernlums 0 Payable for securities lending 0 Amounts recoveralto from reinsurers $33,586,257 Liability for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-Ins for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities exdudng protected ce0 fiabifides $190811,131 Amounts recelvabce relating to uninsured plans 0 Protected cell liabilities Current federal and foreign income tax recoverable and Interest thereon 0 Net deferred tax asset $5,530,837 Totallabilities $190,81):131 0 Guaranty funds receivableor on deposit Furniture and equipment,Including health care delivery assets 0 POUCYNOLDEFWS SURPLUS Net adjustment In assets and liabilities due to foreign exchange rates 0 Aggregate wnte-Ins for special surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 Health are and other a mounts receivable 0 Common capital stock 5 000 000 Aggregate witte-Insfor other than Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat $347,414,611 Aggregate wri[e rsfwotherthanspecialsurplus p Accounts From Separate Accounts_Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS 5347 416 631 Gross paid in and contributed surplus $156,936,671 Unassigned funds(surplus;. ($5,335,190) Surp us as regards policyholders $156,603,481 TOTALS $347,414,611 SUBSCA18EO and sworn to me thislLrdaY of H-*', ,e-vs My cementizen empires: fNotary public CERTIFICATE ^^^ �. Printed Name ALYSSA TURKOVITZWptery public,State Of New York I certify that the above financial statements to the bestof my knowledge are a true and accurate reflection of the financial ALYSSA TURKOVrrz No,Ut TU6044.514 condition of the Company as of December 31,2014, '" w Qualified In Westchester GCllli7tk" C..ort'Lml gJLtn Additionally,I certify that the above financial statements arc Expires JtII 10,2011 B I v { r— J/ 'moi.' '. In agreement with the Statutory Flnandal Statements filed with tine Texas Nota. bile State of New York Department of Insurance as of the same date NO.O1TU6044514 wgiiam 1 Gleason Qualified In Westchester County M.VP&Treasurer Coramisslon Expires July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000005 Replaces Bond No. SUR20000317 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: Street subdivision improvements within Tract 15609 as defined within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract 15609 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 Four Hundred Fifty One Thousand Five Hundred Fifty Four Dollars and 00/100 Dollars ($451,554.00 ) 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: � 1 Its: v .Qc, o [1Ci+ C SURETY: Ironshore Indemnity Inc. �� ,.-� (NOTARIZATION AND SEAL) By: J 6 Margar, A. Ginem , Attorney-in-Fact Surety Phone No, C/O WILLIS OF FLORIDA 4211 W.BOY SCOUT p v0,#low 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 ). County of On before me, j Dat Here sert ame and Title f he Officer personally appeared i 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(les),and that by his/her/their signature($)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 MyComm.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: �"t 4 :�G C^ t c C z Ga✓3 tib.. �uK W�10 4 CiY L C {i"h4�riq�f 'kN 02014 National Notary Association -www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 . . ` te:Dill 10 .0, ari wsc Sections 1:189 ani. 1195.6f°tho:OVIR CQ& Wa SeOiOti 990-of the Obyeramwt.cede.relating nQ Vis:pit li 'I"tYe,bel W Aysi cal format of the tiew disclosure xtvtice.•�s;�.ur��anple,for:ptu��cs5es��il�ustr..a�i�sn, city,pti6lic at o#her afftct coitpl #ins certificate vedfaes.onlythe identity 6f the ndiv[ . e�nco;signets the dacnime it;to w.bichf .certificate.is attached,and not the lrrithfulnessk acctir�ey;vii't�alzdty��'�?��do�uAr[c�#_ Std bf(C iforhia .county of Oki before mg,= a �ibsert name anis title of officer),persmd ork4ly?ppea - -0 proV.ezi t¢l aii the basis.vf'satisf airy evir3erice to be;`tlie liexsori(s .Whose iianie(s) Who aslare subscribeatp. &6yr thiti instrument and acknowledged 4o mer that;he?she/they executed the.same:.in•_hisiherftheir i� jcapaetiy(ies), �qo that:by)ii0orftlick'Oghaa e(s) -oil "instruater�t �e�urson�(A.'lot ti e ;rAtity ti beh,idf of whiicfi-&,persori(�),aced,eit&glei d tWinstruruent, Z, rtify'iirider PENA :T 'OR )? URX i.ridcr. ae laws'of te. taf Qf Califotnia at tE focegozri paragraph is true and'.correc WITNESS racy hAnd and.,o#ficid seal, � gna .. 4Seal�. 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 ANETTCARDINALE ;.r Commission#FF 138482 • Expires July 28,2018 Bonded Thru Troy Feln Ineurence 500385.7018 This area for Official Notarial Seal POWER OF ATTORNEY III- 21000005 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 1 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. s' SEAL H14 1 b4Raa`r By: Dane 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.94 AMYL TAYLOR LL . Notary Public-Stale of Tennessee =. :` DavidsonCounty dson cnty AmY L.7e �`.C,+'........:���` kH Crmaxiscn FrWres atk9.1B NotaryPubbc 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 e apra.�trt REA .. rg• 1911 e 19f4 Paul S.GI dalm ` 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." IRONS14ORE;NDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIMILFTIES Bonds $179,140,947 losses $63,582,066 Preferred stocks 0 Reinsurance payable on paid losses and loss adgus"ent expenses o Common stocks 31,840,141 Loss Wjusbnent expenses $10,384,957 Mortgage loans on real estate;First kens 0 Commissions payable,contingent commissions and other similar charges $1,020,805 Mortgage foanson real estate;Other than first Bens 0 other expenses(excluding taxes.11canses and fees) $5,435,126 Properties occupied by the company 0 Taxes,licenses and fees(excluding federal and foreign income taxes) $2,383,9D9 Properties held for the production of income 0 Current federal and foreign income taxes $2,434,392 Properties held for We 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 premiums payable(net of codingcommissbns) $58,222,187 Other invested assets o Funds held by company under reinsurance treaties 0 Receivables for securities 0 Amounts wlthheldorretained bycompany for amount ofothers Securities lending reinvested collateral,assets 0Remittances and items not ailoated Aggregate write-Ins forinvested assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and invested assets $226,614,039 Net adjustments in assets and lablittles due to foreign exchange rates Title plants less$..,Charged off 0 Drafts outstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110 uncollected prey ums and agents'balances In the course of collection $73,567,547 Derivatives 0 Deferred premiums,ager&balances and installments booked but deferred and not 0 yet due Payable for securities 0 Accrued retrospective prerrqums 0 Payable for securities lending 0 Amounts recoverabiefromreinsurers $33,586,257 Liability for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-ins for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected ce0 tlabifhies $190,811131 Amoums rerrNab;e relating to uninsured plans 0 Protected cell liabilities Current federal and foreign income ax recoverable and interest thereon 0 Net deferred ax asset $5,530,837 Total Rabilitles $190,81],131 Guaranty funds receivableoren deposit D Furniture and equipment,including healthcare delivery assets 0 POIICYMDER S SURPLUS Net adjustment In assets and liabilities due to foWgn exchange rates 0 Aggregate wnte-Ins for special surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common notal stock 5.000,000 Aggregate wrttrins for other than Invested assets $7.124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cel $347,414,511 Accounts Aggregate vwlte,ns for other than special surplus 0 From Separate Accounts.Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS Gross paid In and oontrrbuted surplus _ $3a7,414�611 $156,938,671 Unassigned funds(surplus; ($5,335,190) Surpr in as regards policyholders $156,603,481 TOTALS $347,414,611 SUBSCR18ED and sworn tome WAY-day of H"y1V "'('j s Mycornnvisctoessprres; 7•/L)-� . NouryPubfic CERTIFICATE Printed Name ALYSSA TURKOVTTZ I certify that the above financial statements to the bestaf my Notary Public,State of New YorkNO.04TU6044.514 knowledge area true and accurate reflection of the Rnwiclal. p1yr�TV RKOVffZ condition of the Company as of December 31,2014, Qualified in Westchester CiOilrlty Addlbonafly,Icertify that the above financial statements are ti. :.;�� p., ��.s. r,-.,ti' ComWb$IOIiExpires July 10,2018 In agreement with the Statutory Financial Statements filed with the Tekas NDtstbile.State of New York Department of Insurance as of the same date. No.01TU6044514 William Gleason Quallfied In Westchester County SFR YP$IfaaltefJ 1 Commission Expires MY 10,2014