Loading...
15-0505_Bond_SUR21000011_Pacific Point Dev_TR 16747 Premium: $225.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000011 Replaces Bond No. SUR20000330 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: Monument subdivision improvements within Tract 16747 as defined within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract 16747 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 Eighteen Thousand Five Hundred Dollars and 00/100 Dollars, ($18,500.00 ) 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: Its: sv' b�'� r SURETY: Ironshore Indemnity Inc. ® (NOTARIZATION AND SEAL) By: G . Margare 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:(613)261-2095 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 { ) h On f before me Date Here Insert a and Thle o 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) Ware 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(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 ]7 W.CORDI is true and correct. Commission#r 2088325 i �� Notary Public-California WITNESS my hand and official seal. Orange County My Comm.Expires Oct 31,2018 Signature — lu 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): _ _ ❑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 I 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 7".alta. ANETT CARDINALE i. Conrlssion#FF 138482 ,� Expires July 28,2019 Bonded Thru Troy Fern Insurance eD0.3B5-7018 This area for Official Notarial Seal -Wiate..B';il 1050, efi$s.Sections a 1$- twa 1195:oft Gau 1,Cade - 4 ge(#i n 002-of the roe t.Code; reiat ng to t t rie :pu}�]i_' Te,l eXoVv hys cagy format of.ihe.bevy diwosure Ttptice:§:�M,Cxarnpleq, for pwpases ofWusfratipp L. A hop"public of other officer cainipleting th#s certificate verifies only the identity flf the individual oo_6gned thedpet� ent.10 WbAt cerfificate is attached and not-the Mitlffulness, aoour 0cy;or vw4ty of thaf.dacuntent. :Stgtd of California. .Qbtinty.of Q7[ . . ,,;before arse, 'insert name and title 0f`officef5,pemnally Oppeared Who proved To tg oo the basis of4atis'Factory.evidence to�3e�'tfw,person(�] vlaase names is! .• st'bAC6bedxta -) the within, instrument and ackaxo4edged -to me-'that.:helshelthey executed the.same :in .hislher/their authatiaeii gaort}+�suo3 a d that by.'�Wherltfiefr`444.4ure(s) 'od. #be-uistru�eiat be'V.erson(s),,at tf- �Zdtlfy upon-beh.Wof.whicli'ifie persofi('s)acted,ekecutedthe nstruinent, t_ erti 'iliider PENi4L T F l� R i 7) Y"tinder alae laws of t e.Statd Of,trMworn a fat.th, f0ep$oane paragap'h is true and',correO W]TNESS hiy Band ai d.offic a"t seal;• ;' Sgnafdre. Sea] • POWER OF ATTORNEY III- 21000011 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 deliverfor,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 goad 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 ytwig 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. L- —i ARTY TRYECVt Q, Public-Stale of Tennessee `• ^ + - Davloson County My cuanna,l t E.O.,al-09,la *AmyL •�'•:;Rvarra?;:•`��� - 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 setforth are now in force. Signed and Sealed at this 19th Day of May 20 15 L oN BEAT 191a Paul S.GI darty µ — 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 losses $63,582,066 Preferred stock p Reinsurance payable on paid losses and loss aa)ustment expenses p Common stocks 31,840,101 Loss adjustment expenses $10,384,957 Mortgage loans on real estate.£firat tens 0 Cammisslons payable,contingent commissions and other similar charges $1,020,805 Mortgage Ion ns on reel estate;Other than tint liens 0 Other expens as(e*Kt ng taxes.llcenses and fess) $5,435,126 Properties Occupied by the company 0 Taxes,licenses and fees(exdudtrg federal and foreign Income taxes) $2,383,909 Properties held for the production of income O Current federal and foreign income taxes $2,434,392 Properties held for sa:s 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 ceding commissions) $50,222,197 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 wrlteansforinvestedassets 0 Provision for reinsurance $1,545,075 Subtotals.cash and invested assets $226,614,039 Net adjustments In assets and tabiittles due to foreign exchange rates Tide plants less$..,Charged off 0 Drafts outstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected premumsand agents'botanceslnthe course ofcollection $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 premiums 0 Payableforsecurities lending 0 Amounts recoveroWe from reinsurers $33,586,257 Liability for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-lrss for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,111,131 Amounts recelvaKe 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 Tont liabilities $190,811,131 Guaranty funds receivable w on deposit 0 Furniture and equipmerst,Including healthcare delivery assets 0 POUCYNOLDERS"SSURPLUS Net adjustment In assets and liabilities due to foreign exchange rates 0 Aggregate vinte•Ins for special surplus funds 0 Receivables from parent subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common a0tal stock 5 000 000 Aggregate write-Ins for other than invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Amounts and Protected Cat $347,414,611 Aggregate writes ro for other than special surplus p Accounts From Separate Accounts,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 pollcyholders $156,603,481 TOTALS s^� $347,414,611 .UBSCRIBFDand sworn tomotMsyday ofH'q4 "'O/s .7 My Comrrdls.•.nexpires ] 10-/S NotaryPubllc CERTIFICATE Printed Name ALYSSA TURKOVITZ I certify that the above fl nanclal statements to the best of my Notary Public,State of NOW YankNO.��Tt16U445�4 knowledge are atrueandaccurate relecdonofthefinandal ALYSSATUAKGVM Q{Ig� lid .01TU6044514ter 1 niy Addicondtionally, the Company as of Decemberial tate � �I Expires July 1� 2Dt8 AddlUonally,I certify that the above financial statement are y{: y?rte- , r In agreement vdth the Statutory Financial Statements filed with the.Texas Notacf,''iibblra.Sulioof Newyork Department of Insurance as of the same date, r No.O1TU6044514 William 1 Gleason Quallfled In Westchester County 9D VP reasu3L Conamisslon Expires July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000011 Replaces Bond No.SUR20000330 KNOW ALL MEN BY THESE PRESENTS, that Pacific Paint Develsa mens 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. 92-6-164 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: Monument subdivision improvements within Tract 16747 as defined within Amendment#1 and Reinstatement of the Subdivision improvement Agreement for Tract 16747 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 Eighteen Thousand Five Hundred Dollars and 001100 Dollars ($18,500.x0 ) 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 T, 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: a� I SURETY: Ironshore Indemnity Inc. _j4 -If", I (NOTARIZATION AND SEAL) MargaredK Ginem , Attorney-In-Fact Surety Phone No. C;K)VVILLIS OF FLORIDA 4211 W Boy SCOUT BLVD#100 TAMPA, Fl-3360'7 Page 2 of 3 WOUIRIFS:(843)267-200,5 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 �� ) Coun of On 1 . before me, ML Dater 5, Here In rt Name and VTof e Officer personally appeared l( " 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/shelthey executed the same in his/her/their authorized capacity(les),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.CORGI is true and correct. Commission#E 2088325 WITNESS my hand and official seal. z Notary Public-Cellfornla Orange County MY Comm.Exp fres Oct 31,2018 Signature —ut, 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: ©2014 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 written. r Signature Anett Cardinale ANETT GDINALE omm ss on#IFF 138482 a Expires July 28,2418 '+npf��,`,`.�' Bonded Thor Troy Fein Insurance 800.385-7018 This area for Oficial Notarial Seal ` e�iate kill 1`050; mCrids Sections :1189 aba.I lq$'of"Pube:Girl.C06e,W14 SeCtiOli 910-of'tlie �'xo. mem .Cac e; jaiing:tp Uq PS.PlA jfb 'Tie:bel# ysical format-oftfio Aew cii5olosure nPOCe s p eXampleC for purposes:of Wuwaoop, A lid.Wy ptii tc of other a�ce� doft*lefin this certificate verifies only the identity'of the individual who:signed,the dc)5W;nga.tO wlaicthU certificate,is attached,and not the triAl falnessi AcogrAdy;off'validity Of thal',do6u.went Mate ofC-aliforiria C.bunty.of Qii :before rne, tZere i xsert name and#title o'--o ficer),perso anally oppeared_ _^ who,.. proved t¢)tg oil-thebasis of ptisketory-evidence to *the p6imonts).whose aiamie�s)isles siz�scrilbe4 to %6-wfti,si�-ihstrument,and acknowledged -to m& that helshelthey executed the saute:',in-Nislherltheir apt6orizefi pacity(ies , cl .than;ly laisller/theiir siatute(s) :fihe itistraim. Y�t alae fit rson(s),: t the �ritity kapott.&h,alfof which the perso►i(s)acted,pxecatted ftinstrsnbent+ I.ccrkify-Oder PENALTY O PMURX'Oder the Jaws 'of t1ie. 'oriaia:that tb.e-twpgDi t paragt'aph is true and.correct WITNESS riiy.h6md and.offic 4l.seal, t Sgtafure, (Seal) r POWER OF ATTORNEY III- 21000011 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. ,;;.IearMry Z$49Rrp�r eEAL r 1919 By: Dane i.Suss n '9� Director ACKNOWLEDGEMENT On this 7th Clay 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. ��>• AMYL TAYLOR Notary Public-Stale of Tennessee Davieson counry 2�,._ ,� My Commission Fxplres 01-0946 Amy L.T 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 1 9t Day of May ZD 15 tiny, sEAt l lana Paul S.Gi dater 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." IRONSWAE INDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140,947 Lnssa $63,582,066 Preferred stacks 0 Reinsurance payable on paid losses and loss adjustment expenses 0 Common storks 31,B4Q141 Loss sdJusbnmt expenses $10,384,957 Mortgage loans on real estate:First tens 0 Cpmmisslons payable,contingent commissions and other similar charges $1,020,805 Mortgage bans on real estate;Other than first liens 0 Other expenses(eacjudlrgtaxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,Ncenses and fees(exdudmg 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 Propertles held for sate 0 Net deferred tax liability 0 (ash.cash equlvalentsand short-term Investments $15,632,951 Unearned premiums $29,158,576 Contract loans D Advance premium Derivatives 0 Ceded reinsurance premiums payable(ret of ceding commissions) $58,222,187 Other invested assets 0 Funds held by company under reinsurame treaties 0 Receivables for securides 0 Amounts Withheld orretained bycomperryfor amount ofothers Securities lending reinvested collateral assets 0 Remittances and Items not allocated Aggregate wrlte-Insforinvestedassets 0 Provisionforreinwrance $1,545,075 Subtotals.cash and invested assets $226,614,039 Net adjustments in assets and labilltlesdue to foreign exchange rates Title plants less$_Charged off 0 Drafts outstanding investment ImOrrie due and accrued $M960 Payable to parent,subsidiaries and offillates $12,458,110 Uncollected prom 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 s«urkles 0 Accrued retrospective premiums 0 Payable for securities lending 0 Amounts recoverabt a from reinsurers $33,586,257 Liabllity,for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate wrlte-Ins for liabilities $4,185,928 other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell flabintles $190,811,131 Amounts receivataerelating touninsured plans 0 Protected cell liabilities Current federal and foreign income tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 TotalNabilitles $190,811,131 0 Guaranty funds receivable or on deposit Furniture and equipment,including health care delivery as" 0 POLILYHOLDERYSSURPLUS Net adjustment In assets and IlablOtles due to foregn exchange rates 0 Aggregate wnte-ins for special surplus funds 0 Recelvables from parent,subsidiaries and affiliates 0 Health care and other amounts receivable 0 Common capital stock S 000 000 Aggregate write-Ins for other than Invested assets $7,124971 preferred capital stock Total assets excluding Separate Accounts,Segregated Amounts and Protected Cat, $347,414,611Aggregate wrlteim for other than special surplus D Amounts From Separate Accounts.Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS $347,414,611 Gross paid In and contrAbuted surplus $156,936,671 Vnetrllined funds jiurplust,, ($5,335,190) Surp us as regards policyholders $156,603,481 TOTALS $347,414,611 SU&SCRIBEDand swomtomethisy_054ofjy/�y. ?GrjS Mytrmmisi cnespnes- 7- Notary Public CERTIFICATE TURKOVIIZoaaE +� Printed Name Notivy Public,State of New York 1 certify that the above financial statements to the bestof my NO.U1 TU6044514 knowledge are a true and accurate reflection of the nnandal AL75SATURXOVIR condition ofthe Company esofDecember 11,,2014, / OuelifEedinWestchester Caurty Additlonally,I certify that the above financial statements areL 3 fl i ti ✓��/Ff.fir}` GOTT LITIiHii]F7 EKOM dilly 10,201C S In agreement with the Statutory Financial Statements fled with thi Texas 'Ntr[al f11po°bac.state of New York �y Department of insurance as of the same date, r No.01YU6044514 William J Gleason Qualified In Westchester County C[q ui�&TMRsVrCL Commission Expires July 10,2014