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15-0505_Bond_SUR21000008_Pacific Point Dev_TR 15609
Premium: $345.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000008 Replaces Bond No. SUR20000318 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: Storm Drain 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 Forty Six Thousand Fifes Dollars and 00/100 Dollars, ($46,050.00 ) 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) By: Cis r Its: c S SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: Ad. Margaret/4 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 of ) On before me, . Card U1 iG Date I e Ins N e and Title of the Officer personally appeared Name(s)of Signer(s) 3 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/shelthey 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 0 2088325 WITNESS my hand and official seal. �� Notary Public-California z - Orange County ,„, r Comm. lras 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(ies) 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 f Si 6 te.Dill 1.05.0, Mefi :'Sectiori5:I1$9 abd 11955-9i;the:Civil Core Arad Sectiob 92,2 of'lie �xavem t.Code,-relat ag tp ngf fi pu�ili6 Tlie,i el `c r'l ?rs cal format of the hew-dis.cl'osure -notice, s-am example, £or pnr ayse c 'iIlustrat rm A botwy public of othdr off,bel Grip etingth3s;. cert reate verifies.only the id6nt4-6f the in4v8uaT vrho:sigae the do' cutnesit.to W ceoificate.is attached,and not the irdthfulness, acciiraty,tai•V4dity of that.d0miWA, Sfate of aliforhia County.of Oil before rhe, ...- ano -ihsert name an&title cif officer),personally appeared Who [ ott't#re basis of-a 9facto y.eyiderice to he°tla�::'�rs©ri 9 ►phase same s stare sial scdbedto grouei t P ( 16' within.I istrument.and acknowledged trne: o me! that;helshelthey executed the.sa .in hislherltheari 4,utb iZed .capacity(i'cs), aad tliat;hy..�is/l erltf*`s�g�atuMW 'on the iristru�ozit � o'Vorson(s),:of the �04tity ti.pcn.behalf of whtcli'tfie per'W i(t).acted,eicecuted th&II tstrurnent I:.,*tfly-oder PmOLT- (Qll.p RJ[IRS(iirider the ]a�vs o£ e. # ,gf Galiforiiia that the foregoing paragraph i"s true anddcarrer+ WITNESS:rii Band and.official seRL r Signawre _ 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 n ten. Signature Anett Cardinale ANETT CARDINALE 4 Commission#FF 138482 Expires July 28,2018 %A,-,gg`, Bonded Thm Troy Fein Ineurenoe 800.305.7010 This area for Official Notarial Seal POWER OF ATTORNEY Ironshore Indemnity Inc. III- 21000008 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 facslm"rte 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 itis 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. ;�aaPOR�f _ SEAL ' - 1919 s. By: lane 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. l AMY L TAYLOR Notary Public-Stale of Tennessee °- ' x Dsvid—County ,.. My Cammisslon Expires 01-09-16 1 fr1Y L.1 41 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 farce. Signed and Sealed at this 19th Day of May 20 15 o° vory x•. BFAL 4 47919 I Paul 5.Gi dana 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 MDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABIUTIES Bonds $179,140,947 Losses $63,582,066 Preferred stocks 0 Reinsurance payable on paid losses and loss adjustment expenses a Common stocks 31,840,141 loss adjustment expenses $10,394,957 Mortgage loans on real estate.First kens 0 Commissions payable,contingent commissions and other similar charges $1,020,805 Mortgage Irons on real estate;Other than first Bens 0 Other expenses(exciudng taxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,licenses and fees(exdudmg federal and foreign Income taxes) $2,383,909 Properties held for the production of Iricome 0 Current federal and foreign Income taxes $2,434,392 Properties held for save 0 Nat deferred sa%Iiab[l" 0 Cash.cash equivalents and short-term Investments 515,632,951 Unearned premiums $29,158,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance Premiums payable(net of ceding commiss cans) SS8,222,187 Other invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities D Amounts withheld or retained by company for amount of others Securities lending reinvested collates.°assets 0 Remittances and Items not allocated Aggregate write-ins forinvasted assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,614;039 Net adjustments In assets and tabiiltles due to foreign exchange rates Title plants less$...Charged off 0 Draf s outstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and afRllates $12,458,110 Uncollected prem umsand agents'bolanceslnthe course ofcollection $73,567.547 Derivatives 0 Deferred premlums,agents'balances and Installments booked but deferred and not 0 yet due Payable for securities 0 Accrued retrospective premiums 0 Payable for securities lending 0 Amounts recoverabtefrom reinsurers $33,586,257 Liability for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-lice;for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811,131 Amounts receivab�e 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 Total liabilities $190,812,131 0 Guarantyfunds receivable or on deposit Furniture and equipment,including healthcare delivery assets 0 POLICYHOLDERSS SURPLUS Netadjustment In assets and liabilities due toforegn exchange rates 0 Aggregate wnte-Ins forspecial surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common captal stock 51000,000 Aggregate wrttrinsfor other than Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat $347,414,611Aggregate wdtr ns for other than special surplus p Accounts From Separate Accounts,Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS $3+77,41a,G11 Gross paid In and contributed surplus $155,938,671 Unassigned funds(surplai ($5,33S,190) Sugius as regards policyholders $156,603,481 TOTALSnry/� $347,414,611 ;UBSCRIBED andswom tome this�fday of Mjqy,_ My comngsk n expires; NotaryPublic CERTIFICATE Printed Name ALYSSA TURKQVITZ No4fuyr Public,State of New York I certify that the above financial statements to the bestof my NO.U1TUfi044514 knowledge are a true and accurate reflection of the nnar+clal ALYSSATURlU7V1TI condition of the Company as of December 31,20K �'a / QualifledinWestchester(`mrity Additionally,I certify that the above financial statements aro ; [ 1!°. !fwi}y y` nIrB&July Z[}+ 0tt M agreement with the Statutory Financial Statements filed with the Texa< NobatfAlublir,Stats of New York Department of Insurance as of the same date, No.01TU6044514 WMUam J Gleason Qualified In Westchester County CFO.bP A Trea5vrer Commission Expires July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No.SUR21000008 Replaces Bond No. SUR20000318 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: Storm Drain subdivision im rovements 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 Forty Six Thousand Fifty Dollars and 00/100 Dollars ($46,050.00 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: ��• a�� � vary SURETY: Ironshore Indemnity Inc. 01 (NOTARIZATION AND SEAL) By: Margare . Ginem , Attorney-in-Fact Surety Phone No, C/O WILLIS OF FLORIDA 4211 W.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 ) County of On before me, Date Hem Insqrt Name and Title of the Officer personally appeared U Name(s)of Signer(s) r who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) Islare 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. Notary Public-California � 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: ©2014 National Notary Association -www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 -SoiatdAMIT 10% oheilds gectio* rig- 89 aind- 1195;'Ofthe:UVAICQ& and SeCtiot 9M-of-the uHR Ilid: ao #Y- sic al format of tic-hew di§ bsure -,O,oticq,js.P.e)MnpIc,,..for pW_ose4p.f iUu*atjmL. hb%wy p0lic of Other officer completing this. certificate vetifies.only the id6ntitybf the indiv' dual vnhcy.signed the dbt,=, ctitjb ku , W"A - mrtfflcata-is attached,,and not the trtithUness, Ap P*a 0-Y Y.Ot v0t4ty of t�4t.4 o�u pi eut -()f Caj i forb Cbljnty_of oil ..,befo.re"mte, insert name,and'fitle of-officer},personally appeared Wha )v,4.oh Aho'basjs ofsa sfidtbry vvjdeji?�e to fU.wftniihstrment and acknoNviedged to -me.- that he/shelthey exezuted the,.same: in hiAer/tbeir, 4uftj�ed ryapa6ky(J'O),.Agd tbat.by )iiONT/ '!*a4re(s) -01 7 tfiP' 1Astrt'fTkO)pt tO tprson(s),:or jhq ejitity bpoit,bthaff of wbjch'ths 06fsoii(s)acted,-executed the.1�nsbijin6nt _Y. CAliforniii the the gpin Pamsmph is true and correct WTMES,S.-*y'.hAnd6fficiM- a.nd. sr,.al', 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. 5� - Signature Anett Cardinale 4 ' : ANETT CARDINALE °. Commission#FF 138482 Expires July 28,2018 Bended Am Troy Fain Insurance 800-385.7019 This area for Official Notarial Seal I POWER OF ATTORNEY III- 21000008 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 porter 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. '3P aiaiy�g, - i' 1414 By: Dan a L.Suss n Director ACKNOWLEDGEMENT On this 7`I'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. to + AMY L TAYLOR r t7nlary PuC%k-'Sisal of T,nnesyctl _ Davidson County - .� My Commission Expires 01.09-16 Amy L.Ta % 4 Notary Publle 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 Zp 15 YnA,p e G A REAL 4 1Yf4 f y Pauls.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." IRONSNORE MDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140,947 tosses $63,582,066 Preferred stocks p Reinsurance payable on paid losses and loss adjustment expenses Com mon stocks 0 31,840,141 loss adjustment expenses $10,384,957 Mortgage loans on real estate:first tans 0 Commissions payable,contingent commissions and other similar charges $1,020,805 Mortgage loans on real estate,,Other than first liens 0 Other expenses(excluding 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 $2,434,392 Properties held for We 0 Net deferred tax liability 0 Cash,cash equIvalents and short-term 1nvesdnents $15,632,951 Unearned premiums $29,158,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of cedingcommisslons) $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 of others Securities lending reinvested collateral assets 0 Remittances and items not allocated Aggregate write-Ins forinvested assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,6145039 Net adjustments In assets and labilltles due to foreign exchange rates Tdie plants less$_Charged off 0 Drafts outstandkN Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected prem urns and agents'balances to the course of collection $73,567,547 Derivatives 0 Deferred premlums,agents'balances and Installments booked but deferred and not 0 yet due Payable for securities 0 Accrued retrospective prerniums 0 Payable for securities lending 0 Amounts recoverobie 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 Cnher amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell Robllldes $190,811131 Amounts receivalte 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 TotalRalulkles $190,811,131 Guaranty funds receivable or an deposit D Furniture and equipment,Including health are delivery assets 0 POUCYHOLDERTS SURPLUS Net adjustment In assets and liabilities due to fore gn exchange rates 0 Aggregate waste-Ins for special surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common capital stock 5 000 000 Aggregate write-Ins for other than Invested assets $7,124,971 preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cot, $347,414,611 Aggregate write?ns for other than special surplus p Accounts From Separate Amounts,Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS $347,414,611 Gross paid In and contributed surplus $156,938,671 Unassigned funds(surplus,' ($5,335,190) Surp`us as regards pollcyhoiders $156,603,481 TOTALS $347,414,611 5UB6C1u8ED and swom Us ma thlIf way of H,9 �f 5 z MYoommiswerexpires 7-/O—/S' r� NotaryPubllc CERTIFICATE T ^� Printed Name NotaryLYS C,State O ITZ York certify that the above flnanclal statements to the b �/estof my NO.01. f N knowtedge are a true and accurate reflection of the financial ALY55A TURKOyRi condition of the Company as of December 31,2014, ! QusllHied In WestchesterGoin y Additionally,1 certify that the above financial statements are Comm elusion E*ms July 1p���,� s-.- I f �w.�-�' s 2018 in agreement with the Statutory Financial Statements filed with the Texae NotocIAOu Mir,State of New York Department of insurance as of the same date, No.01TU6044514 W81lom 1 Gleason Qualified In Westchester County C21?�ifSft3f1S� Commission Expires July 30,2014