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15-0505_Bond_SUR21000018_Pacific Point Dev_TR 16747 Premium: $814.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000018 Replaces Bond No.SUR20000332 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: Grading (Lots 1,2 & H) 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 One Hundred Eight Thousand Five Hundred Thirty Three Dollars and 00/100 Dollars, ($108,533.00 ) 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 int Development Partners, LLC (NOTARIZATION AND SEAL) By: �� Its: ��1a�r kyr SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: Margar . Ginem , Attorney-in-Fact Surety Phone No. CIO WILLIS or f=LORIDA 42111 W.Boy SCOt1T BLVD,glWo TAMPA, FL 33607 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 ) O before me, l a to He se and Title a fflcer , personal) appeared Y t S Y PP 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 is true and correct. 5�aW. CORDI Commission#2088325 WITNESS my hand and official seal. Notary Public-California z Orange County ' Mv Comm.Expires Oct 31,2018 Signatures 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: �� i 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 ANET7 CARDINALE E - This Commission#FF 138482 qExpires July 28,2018 ', Aiti-Vv' 9ond®d ThN Troy Fdn Inrurence M385.7olo area for Official Notarial Seal Sedate Bi11 1050 �tids-:Secti6fig -:189 amid: 195:4"6e:CIVI�.�c°cle cud S. .i $�Q2 of fh$ ram .Cade;. eYatin #ty nodes_p , lie:.IU lieI0V Physical formatoff` o:,rievV cli :elos-are x�rvi�c�. s;axz example, £or pt�r�ases o�i�[�ustxatirn�: Y1000.public of A&61.tb coitip]O ng this, cerfifzcate verifies only the identity ofthe individual who.signed the db�uinerit-tti wh&-_d- . certifioato.is attached,and not the trtithfulness, acc�ir�Cy,o'r validity t3f#hat.tiocu�itcx��. .81'att ofWiforimia County.of before me, .. 66 ,i5sert name ani�-title oft�fficer5,')personally 4ppmed Who. ry evidr nce tct E�e'tli ersori fi i�++hose banie(s) slaxe su crjbr6atp: gfioWed;ESS l��pt}-t�fe t?a51S of'satisfacto p ( ) t&e wMri 4ristrument,and acknowledged to rne° than hr)shelthey executed the same hi .h Aer/their aptY�taltizcfi ,�a acitjt ies�, okad qh Ivy.]iis/Iier/dieft`SI *Te( 0.6P '14s&uthoDt 66 fsbn(S),.-o the ;ofxtiky,rti.pon behalf ofwhich'tlieperso>i acted,ekecutedthe instrtuu®xtt 1..�qxti#`j!'urider PENAL'I ' (QI � It1E]Ifi�( tinder Ili law s pf te.Stafd Qf' alifornla tho the f0itgoirig, paragraph is true and corre t WINESS itiy Band and official seaL Signattfre Sea] POWER OF ATTORNEY Ironshore Indemnity Inc. III- 21000018 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 Attorneydn-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. �! BEAL 7919 � y F By: panaL.Suss 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.Aw n MY L TAYLOR _ _ Notary Pubilc-Slate of Tennessee Davidson County My Commission Epi—01-09-16 Amy L.Ta 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 19th Day of MayZp 15 9LAL ' 791v Paul s.Gi dart 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 SNDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140.947 Losse $63,582,066 Preferred stocks p Relnsurante payable on gold losses and Inas adjustment expenses 0 Common stocks 31,840,141 Loss adjustment expenses $10,384,957 Mortgage loans on real estate.Pmt 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(excluding taxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,licenses and fees(excluding federal and foreign Income taxes) $2,383j909 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 $29,156,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of coding commissions) $58,222187 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 t!loated Aggregate write-Ins forinvested assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and tabliltles due to foreign exchange rates Title plants less$..,Charged off 0 Drafts outstanding Investment income due and accrued $990„560 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected prem;ums and agents'balances in the course of collection $73,567,547 Derivatives a Deferred premiums,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 recoverable from reinsurers $33,586,257 Liability for amounts held under uninsured plans 0 Funds held by or deposited with relnsured companies 0 Aggregate write-Ins for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total Bablllties excluding protected cel liabilities $190,811,131 Amounts recehrab:e relating to uninsured plaits 0 Protected cell liabilities Current federal and foreign Income tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 TotalBabilitles $190,831,131 Guaranty funds receivable or on deposit 0 Furniture and equipment,including health are delivery asset 0 POUCMMDERY55URPLUS Net adjustment In assets and liabilities due to fdme gn exchange rates 0 Aggregate wnte-lns for special surplus funds 0 Receivables from parent,subsidiaries and affiliates 0 ttealth care and other amounts recclvable 0 Common capital stock S,lx)0,000 Aggregate write-ins for other than Invested assets $7,124,971 Preferred appal stack Total assets excluding Separate Accounts,Segregated Accounts and Protected Cet $347,414,511 Aggregate untie;its for other than apolar surplus p Accounts from Separate Accounts.Segregated Accounts and Protected Cell Amounts 0 Surplus Notes TOTALS $3,17,414,611 Gross paid In and contributed surplus _ $156,938,671 Unassigned funds fsurplus,' ($5,335,190) Surp us as regards policyholders $156,603,481 TOTALS $347,414,611 SUBSCRIBED and swomtome tHs?_rdayof/�J�Y Mycomatisknexpires -7-/4)—/S- CERTIFICATE Printed Name ALYSSA TURKOVITZ I certify that the above financial statements to the bestaf my Notary Public,State of New York NO.t)1TUsoaa514 knowledge are a true and accurate reflection of the financial ALYSSA TURKOVUZ condition of the Company as M December 31,2014, r Qualified In Westchester County Additionally,I certify that the above financial statements am 4, :.'` ��. �� ��..-, :• Commissim Expires July 1.A 2018 h1 agreement with the Statutory Flnandal Statements filed with thr Texas Notate bll4 Stat*of FfawYork Department of insurance as of the same date, € No.O1TU6044514 willlam J oesson Ctuafifled In Westchester County V-Q v T.RBlivaL Commission Explres July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No.SUR21000018 Replaces Bond No. SUR20000332 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: Gradin (Lots 1,2 & H) 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 One Hundred Eight Thousand Five Hundred Thirty Three Dollars and 00/100 Dollars ($108.533.00 ) 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: r'% r SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: Margaret . Ginem , Attorney-in-Fact Surety Phone No. 0/O WILLIS OF FLORIDA 4211 K BOY SCOUT BLVD,#1000 'VAMPA, FL 33607 Page 2 of 3 fNQUIRIESS:(813)281-2005 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 CaDa ) Coun ofOn before me, x 'h1 ni A,ere Insert N e and Title of th Q Icer 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(ies),and that by his/her/their signature(s)on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph W. CORDI is true and correct. Commission#2088325 WITNESS my hand and official seal. z "# Notary Public-California x , Z Orange County ' My Comm.Expires Oct 31,2018 J 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.NationaiNotary.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 . COMM is$ion#FF 138482 Expires P' xis MY 18,2018 yFen Ineww"9W385.71Y19 This area for Official Notarial Seal Sea te.kill. IQ$:0, ameii4:Sections 1.184 ani :11 5 of°tfia:Gzv l coir ci eGtlou $ Q of'the C oYe t e ode;,te�ating#a nq`tMes,pdbli,6.•Tlie,belgw.-Physical format of tiwdi" lsurer ,co xwexa ple,,,fRr parratses off°allustra#lt��; A Yiotaty.public of other cruder 6aiijplctinb this cexfificate verifies.only the identity ref the individual who'signed the do _ Motto whidh. l certificate is attac}med�and not the lxirthfulnesss -1ecyracy,OT valzclity Of that:docuDicv_ Matte ofCalifo_rimia County.of Oh_ befcice ine, , TF�e>e "insert frame andItitle ofofficerjj,personally appeared - Who 'prOVO to °tit 00,1;k4lasis of'satisfacwyevidencd to lie the:persori(s)Whose iianae(s}Is/x6 sutzswbeatQ; t'be.vrithiii it§s umea.and acknowledged -to me- that: heJshefthey executed the same:irm-.kislher/their, artthetri ed -apacsty(ies , end .Haat by liisihor/6,eir'szg lat e�s� -on:Yh lostrafn fie V,6rsaa(s),,i 1lie .c-�Atity-�Oh-behalfofvrhich'the pefsorj('s)acted,.ekdcute'd tlic:ittstruineut 1;cc ify'iiiider PENAIr.T `QF Pl1R 1l iRY VTider Ibe laws of thie fwd of Cal'oriiia}lr. the fvirl±go%t paws raph is true and'.correct WITNESS my Band and offrc ak scaih: Slgx}ature (Seal), POWIcFi DF ATfDIiIV Y nI- 21000018 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 22°d day of April,2013 as follows: Resolved,that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or persons as Attorney-In-Fact to execute on behalf of the Company any bonds,undertakings,policies,contracts of indemnity or other writings obligatory in nature of a bond not to exceed $7,500,000 dollars,which the Company might execute through its duly elected officers, and affix the 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. 4f:pRR*t�'i SEAL/ 1 0ft o1119', t - - 'J syc Dan a 1.Sus 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 Nolary Pu611c-Slate or Tennessee Davitlson County Amy L.Tn y q,"..,,,..•''„��: .yCommission Expires obo31S Notary Public #u# 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 MayZp 15 ha.^ V• ^o SEAL doll Paul 5.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;NDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILITIES Bonds $179,140.947 losses $63,582,066 Preferred stocks p Reinsurance payable on paid losses and loss adjustment expenses 0 Common stocks 31,840,141 loss adjustment expenses $10,394,957 Mortgage loans on real estate.first Lens 0 Commissions payable,contingent commissions and otherslmilar charges $1,020,805 Mortgage loans on real estate;Other than first Ivens 0 Other expenses(excluding taxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,kenses 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 Not deferred tax liability 0 Cash.cash equhralentsand short-term Investments $15,6329S1 Unearned premiums $29,158,576 Contract loans 0 Advance premium Dedvatives 0 Ceded reinsurance premiums payable(net of coding commissions) $58,222,187 Other invested assets 0 Funds held by company under relnsurancetreatles 0 Receivables for securitles 0 Amounts withheld or retained by company foraccountof others Securities lending reinvested collateral assets 0 Remittances and iterm not allocated Aggregate write-Insforinvestedassets 0 Provision for reinsurance $1,545,075 Subtotals.cash and lnvested assets $226,614,039 Netadjustnents In assets and labilkles due to foreign exchange rates Tide plants less$.-,Charged off 0 Drafty outstanding Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected premums and agents'balancesin the course of collection $73,567,547 Derivatives 4 Deferred premiums,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 recoverable from reinsurers $33,586,257 Liability foramounts 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 Mobilities excluding protected cell flablfltles $190,811,131 Amounts receWab:e relating to uninsured plans 0 Protected cell liabilities Current federal and foreignincome tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 Total liabilities $190,611,131 Guarantyfunds receivableor on deposit 0 Furniture and equipment,indudlng health are delivery asset 0 POUCYNOLDERTSSURPLUS Net adjustment In assets and liabilities due toforegnexchange 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 capital stock 5,0D0,000 Aggregate write-Ins for other than Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and protected Cot $347,414,611Aggregatewrltt4rs for other than special surplus p Accounts From Separate Accounts,Segregated Accounts and Protected Cell Accounts 0 Surplus Notes TOTALS $547,e 14,{,11 Gross paid In sod contributed surplus $156,938,671 Unassigned funds jsurplusj ($5,335,190) Surplus as regards policyholders $156,603,481 TOTALS { $347,414,611 SUBSCRLRED andsvrom to me Ndsy"day of/yf} / My commiisFcn 4xpnres_ 7=/o)F iS Notarypublic CERTIFICATE s Printed Name ALYSSA TURKOVITZ I certify that the above financial Public,State of New York nanclal statements to thebestof my NO.01TITUfi044514 knowledge are adaccurate reflection ofthefinancial ALYSSATLIRKOVTZ { U®tjfjDidry1� tGtTl@F('itltJCit condition of the Company as of December 31,2014, �' ., / Additionally,I certify that the above financial statements are {,, / }' CUfTTmisslOfl Expires July 10,2{)1$ In agreement with the Statutory Financial Statements filed with the•Texan No"PLrblIS St►la of Hew York _L- Department of Insurance as of the same date, - r No.OITU6044514 WRIlam1 Beason QuaBRed In Westchester County CFO.VP&IlemNrtr Commission Expires July 10,2014