Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
15-0505_Bond_SUR21000016_Pacific Point Dev_TR 16752
Premium: $772.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000016 Replaces Bond No. SUR20000345 KNOW ALL MEN BY THESE PRESENTS, that Pacific Paint 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: Water subdivision improvements within Tract 16752 within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract 16752 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 Two Thousand Nine Hundred Nineteen Dollars and 00/100 Dollars, ($102,919.00 ) 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: v� oc SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: _ .. ",argaret . Ginem , Attorney-ill-Fact 6/0 VALLIS OF FLORIDA Surety Phone No. 4211W BOY SCOUT BLVD,#1Io TAMPA, FL 33607 INQUIRIE&(813)281-2095 Page 2 of 3 APPROVED AS TO FORM: By: NOTE: Please attach Acknowledgement and Power of Attorney Page 3 of 3 CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT 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, I G Date r He�re Inse Nam and Title th Officer personally appeared V Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose names) €s/are 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#F 2088325 WITNESS my hand and official seal. Notary Public-California z 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 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 ANETT CARDINALE Commission 4 FF 138482 .:7 Expires July 28,20J8 8"4W TW rY Fdn IMAOMKr aaoass•rn�� This area for Oficial Notarial Seal % I0 0, ch(Is.Se rig. 0 Sections: '1189 bbd. 1195 of CIA. C. &=d SeCtim 910Z of the orb. e notWes.pAbIfe;,nY6:bCiov.*,,ygicat formatW , o'f$e,Iie. disclosure potic9is-mexample,for purposes ofillugl mtpc L. , both*.Public of A&06dof do4jjting6fs- cerdfimte verifies onlythe id6ntity of the ivaigodtfiedoor indi,vt d. ,iwha S piwit.to wh3 It .certificate.is attached,and not,the tnithUness, �qcftty,ot validity Of th4tdoe.umept .Stag of 4 iliforhid' ,Q¢unty.of O _--beford ino, �ihsctname ante-title of-efftcer),per-sonally 'appwi34 t the WiO66,•i`4strment,and acknowledged -to me� that:he/sheithqy"executed the same:in,.ffiAerhbeir authori El capacity esj, Ano 1$4i by)ijOhq/6iejr ijpg t4 ' els) o .:tIfi�. bt trufRDt tiy,upoi �6halfof �hirhA6 e�soi(),40ed,e�ec atedteinsb=ent, 1�ftify**r PF14LW. -OF' HOMY iih der Ae I.ai*'§ of tk ftte of c4fom� 4�.0the 'parajyraph is true and correcf WITNESS y.lz'and a-hi'd.officiM seal POWER OF A7TORNEy Ironshore Indemnity Inc. III- 21000016 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 behaif 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. -ik4in,`f, 5 SEAL 7 Big �P By: {tan a L.Suss n Director ACKNOWLEDGEMENT On this 7l"Day of August,2013,before me,personally casae 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. Y TA AMY L TAY QR ! Notary Public-Slate of Tennessee _ ' •' aZZ DavlasonWmpy y ,� lily Commission Eraaeo C1-09-15 Amy L.Ta ,'r%„ �;;•"'c` Notary Public CERTIFICATE I, the undersigned,Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy,is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 191h Day of May Zp 15 .Ao=4 S. EEAI I 1A7i Paul S.G dagp r y~ 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 tNDEMNFTY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140,947 Lassa $63,582,065 Preferred stocks 0 Reinsurance payable on paid losses and loss adjustment expense 0 Common stacks 31,840,141 Loss adjustment expenses $10,384,957 Mortgage loans on real estate,.first kens 0 Commissions payable,contingent commissions and other similar charges $1,020,805 Mortgage loans on real estate;Other than Ont liens 0 Other expenses(axdsrding taxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,Ncenses and fees(excludirsg federal and foreign Income taxes) $2,383,909 Properties held for the production of inoome O Current federal and foreign Income taxes $2,434,392 Properties hcld for is e 0 Not deferred tax liability 0 Cash.cash equivalents and short-term investments $15,632,951 Untamed premiums $29,158,576 Contract loans 0 Advance premium Derivatives D Ceded reinsurance Premiums Payable(neto(cedingcommissions) $58,222,187 Other invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities 0 Amounts vAthheld or retalned by company for aecountof others Securities tending reinvested collateral assets 0 Remittances and Items not allocated Aggregate writeans forinvested assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and labilltie due to foreign exchange rates Title plants less S-Charged off 0 Drafts outstanding Investment Income due and accrued $99(060 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected prersrums and agents'balances In the course of collection $73,567,547 Derivatives u Deferred premiums,agent:'balances and Installments booked but deferred and not 0 payable for securities 0 yetdu Accrued retrospective premiums 0 Payable for securities tending 0 Amounts recoverabte from reinsurers $33,586,257 UsblRty for amounts held under uninsured plans 0 Funds held by or deposited withreinsured companies 0 Aggregate write-Ira for liabilities $4,185,928 Other amounts rEcehrableunder reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811,131 Amounts remlvWe relating to uninsured plans 0 Protected cog liabilities Current federal and foreign income ax recoverable and interest thereon 0 Net deferred ax asset $5,530,837 Total liabilities $190,811,131 Guaranty funds receivable or on deposit 0 Furniture and equipment,including health care de8very assets 0 POUCYHOLDEWS SURPLUS Net adjustment In assets and liabilities due to foregn exchange rates 0 Aggregate write-Ins for special surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 Health are and other amounts receivable 0 Common aOal stock 5,0D0,000 Aggregate write-los forather than Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat, $347,414,611 Aggregate write ns for other than special surplus 0 Accounts From Separate Accounts.Segregated Accounts and Protected CellAccounts 0 Surplus Notes TOTALS $347,414,511 Gross paid In and contributed surplus $155,938,671 Unaaslgned fundsburplus; ($5,335,190) SurprW as regards policyholders $156,603,481 TOTALS $347,414,611 Si385Cfit$£0 and sworn to me lNs •day of Mycomm,sstnrxpires 7-fUe-/L ' � NoaryPubilc CERTIFICATE Prhted Name ALYSSA TURKOVITZ I certify that the above financial statements to the hestaf my Notary Public,State Of Now York knowledge area true and accurate reflection of the financial ALYSSA TU RXOVf12 No.01 TU6044514 condition oftheCompanyuofDecember 31,2014, - l OU&fftiedinWestchester County Addltionaliy,I certify that the above financial statements are 1 ..ti�� f1r s �y.�.- COMITIJBIAGn Expires July 10,2018 In agreement with the Statutory Financial Statements filed with the Texas Nclwj,7'rubllc,State of New York ti Department of Insurance as of the same date, No.01TU6044514 William 1 Gleason qualified In Westchester County Yn- F- Commission ExplresJuly 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000016 Replaces Bond No. SUR20000345 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: Water subdivision improvements within Tract 16752 within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract 16752 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 Two Thousand Nine Hundred Nineteen Dollars and 00/100 Dollars ($102,919.00 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: � Its: ti ' *mac.xx .A-tt- SURETY: Ironshore Indemnity Inc. / (NOTARIZATION AND SEAL) By: MargareA. Ginem , Attorney-in-Fact Glo VVI1.i.IS of Ro kjDn. Surety Phone No. 4297 W.9UYpCOU78LVD #14011 MPA 1NQtJIR1ES�(f 3 33607 8 p 2095 Page 2of3 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 f On I� before me, Date f In rt Name and 7"i of a Officer personally appeared � � - Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(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.CORDI is true and correct. Commission#2088325 WITNESS m hand and official seal. dc �" Notary Public-California x y z Orange County " M Comm.Ex )res 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: r�^c:cs .�^�- .. c^�- c .w^<<�' •-�-a�=��r =<,^�=��-���.- . . - - �^�c, ,^�^��� -€ern-c�,;,^��:��' _ ©2014 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 i ANETT CARDINALE 4 �1� ' Commission#FF 138487 a a�aw XPIFen rJuly t 28,7018 ��.ggq..O mt' fw"IS GP385aAtB This area for Oficial Notarial Seal ate:B Il 105.0; amehi s;Sections 1189 and :1195'ofihe:Gl 11CP66 and Sept ori V of the Cr i.!e aent.Cn e irelaixaig';tcl n t .,es.pAblib."Me:bOp t�O.ysi cal format o f tie dew disclosure nv#cc:; s anent ple; forpur�.os�s-Of illustm*rna: A riotary,public or other[iffiest`coiholefingtVf cer iftca.#e verifies only. the identity of the individual who:signe(i thedoisutnerit rti vhlCh .certificate,is attached,and not the trd fulness ae_ftM oir va)Aj.ty oftb#do�arjicnT. .8iia#e afCaliforiaia. Ciiunty.of 'ibsert name and'title of officer},personally+appeared who prayed M ffi, of 'the basis.of-satisfactory eyiderice to be# e_'peXsori(z)'WhosO iiarn°ies) s/Or subscribed:to, f%6 Wiffik�iristrument and acknowledged -to me�lhav bel'shefthey exeDuted the same- in .hiAerltheir au, pri l "pactty(ies), avid .that by)tis/h r/thpjr'srgha i>re D 'On the"listruf in#lre prson(s),.Qt'ttie, .e,0it�+tiph behalf of"which the pefsoii(s)arEed,.executed t] .instruraertt, 1; ciki y'urider PENAL,T "pl? l�k:RJl7RX iirider.tlae Jaws of stald o�"Galli�ft�mia that the fQxegoiri� par Amph is true and'.correc} WITNESS iijy hand and..Off jcla"l-seal, ig tut a (Sea] r POWER OF ATTORNEY Ironshore Indemnity Inc. III- 21000016 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 duty 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 band 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. :'.1'4hP9A�T: rL SEAL y 1019 By.( y Dan e 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. _ — AhSY L.tAYL4R p _ LN,,,.aryPubllc-SlaTennesseeDII's7om ,>lon enyvesUtaF-teAmy L.Tay. •,,''�.,,,',,,i•''• 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 arid the resolutions as set forth are now in force. Signed and Sealed at this 191h Day of May Zp 15 rGN<1n .F cin �.•c SFAL 1910 • 1 Paul s.Gi darla w 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 $179,140,947 tosses $63,582,066 Preferred Stocks 0 Reinsurance a gable on paid losses and Inns adluspnent expenses p Common stocks 31,840,141 Loss adjustment expenses $10,384,957 Mortgage loans on real estate:first it ens 0 Commissions payable,contingent commissions and other similar charges $1,020,80S Mortgage loans on real estate,,Other than first liens 0 Other expenses(excluding taxes.licenses and fen) $5,435,126 Properties occupied by the company 0 Taxes,licansas and few(excluding 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 We 0 Net deferred tax liability 0 Cash,cash eclulvalents and short-term Investments $IS,632,9% Unearned premiums $29,158,576 Contract loans 0 Advance premium Derivatim 0 Ceded reinsurance premiums payable(net of ceding commisslons) $58,222,187 Other invested assets O Funds held by company under reinsurance trestles 0 Receivables for securities 0 Amounts withheld or retained by company for account ofothen Securities lending reinvested collatesa',assets 0 Remittances and Items not allocated Aggregate wrlteansfcrinves6edassets 0 Provisionforreinsurance $1,S45,07S Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and tabilNles due to foreign exchange rates Title plants less$..,Charged off 0 Draftsoutstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected Front umsand atients'balancesinthe course ofcollection $73,567,547 Derivatives 0 Deferred premiums,agents'balances and Installments booked but deferred and not 0 yetdue Payable for securities 0. Accrued retrospective premiums 0 Payable for securities lending 0 Amounts recoverable from reinsurers $33,586,257Liability for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-Inas for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811,131 Amountsrecelvatgerelating touninsured plans 0 Prottttedcell liabllitles Current federal and rorelgn Income ax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 TotalNabrlities $190,811,131 Guaranty funds receivable or on deposit 0 Furniture and equipment,Including health rare de6vwy assets 0 POUCYHOLDERSS SURPLUS Net adjustment M assets and 0abi0ties due to fortgn 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 capital stock S000,000 Aggregate write-Ins for otherthanInvested assets $7,124,971 Preferred capital stock 611414 $347, , Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat. Aggregate written for other than special surplus p Accounts From Separate Accounts,Segregated Accounts and Protected Call Accounts 0 Surplus Notes TOTALS $347 Gross Gross paid In andwntnbutedsurplus $156,938,671 Onasrlgned fundsourplus, ($5,335,190) Surp'us as regards pollcyWders $156,603,481 TOTALS $347A14,611 SUWCPABED and sworn to me thisV day of l j)' Mycamm9sscnexpires 7,/0 NoaryPubllc ' CERTIFICATEPiiwua Name ALYSSA TURKOVITZ Notary Public,Slate of NOW Yost( 1 certify thaattthe above financial statements to the bestaf my NO.O1TUt1044514 knowledge are a true and accurate reflection of the financial ALYSSATURKOViTZ condition of the Cwnpany as of December 31,2014, Ouallfied In WeStchlmter Gout*lp Additionally,I certify that the above financial statements are 4{ � �1 .7. Commission EOMS JUlY 10,2018 In agreement with the Statutory Finwclal Statements filed with the Texas kotapg. hrl4lc State of ttew York _ Department of Insurance as of the some date, No.01TU6044514 HRlllam 1 Gleason Qualified In Westchester County t51 .I[48fYSfi. Coramissfon Expires July 10,2014