Loading...
15-0505_Bond_SUR21000024_Pacific Point Dev_Off-Site Circ Premium: $19,283.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000024 Replaces Bond No. SUR20000348 KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Development Partners. LLC (hereafter designated as "Principal"), and Eronshore 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: Off-Site Circ. subdivision improvements within Tract N/A as defined within Amendment#1 and Reinstatement of the Subdivision Improvement Agreement for Tract N/A 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 Two Million Five Hundred Seventy One Thousand Dollars and 00/100 Dollars, ($2,571,000.00 ) 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 dayof 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: SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: aaw_'_�C -teal Margaret . Ginem , Attorney-in-Fact Surety Phone No. C�/O WILLIS OF FLORIDA 4211 W OOY SCOUT BLVD,#1000 TAMPA, FL 33607 !NQUIRIEv:(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 L ) On � before me, � i a ere Insert ame and T �ofthe Officer PP personallyappeared &1/1j) v 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(#es),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 s WITNESS my hand and official seal. a -M Notary Public-California z Z * Orange County a ' 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 tistey�,. ANETT CARDINALE Commission#FF 138482 •,. 'a Expires July 28,2018 %grf1 ' Bonded Thru Troy Fdn Ineurence 800.355.7010 This area for Oficial Notarial Seal �SeMfOl VU 10$0, Arfteb0s'.-Sec.O iig.1-:189 alai 1195;'Of.*6 UV4 torte-anti Seaf()-U 8202,of Ifid' es:pblfe.'Te bCWW-'*siCA format of the hew disclosure upOesia- n example,for pu-.P ones of iflusirat kiOW* other lhf : ..Ublicor her6ffidof6oMO ing certificate Vetifies only the identity-©f the Jnd�i'iduai v�ho.signed,the he dkqqtnetit-ro WIdefi.t . yt--- . , _hi;s .certificate.is attached,and not,the truthfulness, OT Valf t. 4peftey, Wity dha rdo4umexit. Beate of Ca]i forii i.a. ,C.�i nty.of Qin 'insert name and-title ofofficerj,'personlalfy appe�ed o�v,I!O)Vgo�-tho'basi' of who pr J!� '�548fdotot),evidexi0oto U,ptrso (tyw�osei nw#�(j)1's&re subscribed ,the withifi'-ftikrment and acknowledged to me, thati h0shelthey executed the samein hiarr/their 41JAWW OpacliY(JP4), "d .16 tult( tru no 6 .At by.)iWfief/ffieir MA on t� iq� )4t -Vcrso (S),Ur the ;4tfty Opofl-li6hAlf ofwhiPh'tho p6ft*),acfed,ekecdted tfi&.Instrs ent 1 eqil. iry.40d6r. PTRO LTkl Or,P'F�WAY u.fi&r T,b*e laws 0t tkbA 5tao Ubma-tho the rw*frf� paragraph-is true and'carred WITNESS air" hAnJ and 6064,seal, WrA, P�7WER OF ATTORNEY Ironshore Indemnity Inc. III- 21000024 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 revolted 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 r 1919 By: Daniel 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. _`,ty�� AMY L TAYLOR A - _ Notary Publlc-Slale or Tennessee IN -' Davidson County R111p L..Ts 0. ...",¢� My Commission Ezpirse 01-09-10 --y L Ta Not Publk— 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 May20 15 .ndn f� a� I,4 SEAL�el 19 St 1 Paul s.Gi 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." IRONSHORE rNDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31,2014 ASSETS LIABILmEs Bonds $179,140,947 lasses $63,582,066 Preferred stocks p Reinsurance payable on paid bases and Inns axiJusAnent expenses Common stocks 0 31,840,141 Lois adjustment expenses $10,384,957 Mortgage loans on real estate.Arlt tens 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 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 $2,434,392 Properties held for sa!e 0 Net deferred tax 0ablilty 0 Cash.cash equivalent$and short-term Investments $15,632,.951 Unearnedpremlums $29,158,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of coding commissions) $58,22;187 Other invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities 0 Amounts withheld or retained by company for amount of others Securities lending reinvested collateral assets 0 Remittances and Items not allocated Aggregate wrlteans forinvested assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,6144039 Net adjustments In assets and liabilities due toforeign exchange rates Tide plants less$6.,Charged off 0 Drafts outstanding Investment Income due and aoWed $990.960 Payable to parent,subsidiaries and ofRpates $12,458,110 Uncollected prom umsand agents'balancesInthe 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 Payable for securities lending 0 Amounts recovenb€efrom reinsurers $33,586,257 Liabllty for amounts held under uninsured plans 0 Funds held by or deposited with reinsured companies 0 Aggregate write-Iris for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cel liabilities $190,811,131 Amounts receivalke relating to uninsured plans 0 Protected cel liabilities Current federal end foreign income tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 Total labilitles $190,811,131 0 Guaranty funds receivable or on deposit Furniture and equipment Including health care defveryassets 0 POLICYHOLDERS`SSURPLUS Net adjustment In assets and liabilities due to fowgn exchange rates 0 Aggregate wnte-Ins for special surplus funds 0 Receivables from parent subsidiaries and affiliates 0 Health care 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 Cat, $347,414,611 Aggregate wrkrhn 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 Unasslgned funds(surplus; ($5,335,190) Surp us as regards policyhoiders $156,603,481 TOTALS $347,414,611 SUBSCRIBED ami sworn to me thisyd of r' lJsl MycommlfaCnexpires- 7 rri)ri1S '- r` fi..,-s-. �✓��'' — __ NotaryPubllc CERTIFICATE printed Name ALYSSA TURKOVITZ I certify that the above financial statements to the bestof my Notary Public,State of NOW York No.01TU6044514 knowledge are a true and accurate reflection of the Einar clai ALY55ATURKOVITI QUalIff d in WeatcbBf er C.a1 Inty condition of the Company as of December 31,2014, y. �Expires July for 2018 financialAdditionally,I certify that the above financial statements are Z,y f `I in agreement with the Statutory Financial Statements filed with the Texas Nota /u blit,State of New York Department of insurance as of the same date r - No.01TU6044514 WRIlam1 Gleason QuaOfled In Westchester County GF4 Vp 8i 7fxi13ls[. Commission Exielres July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000024 Replaces Bond No. SUR20000348 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: Off-Site Circ. subdivision improvements within Tract N/A as defined within Amendment#1 and Reinstatement of the Subdivision improve nent Agreement for Tract N/A 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 Two Million Five Hundred Seventy One Thousand Dollars and 00/100 Dollars ($2, 71,000.00 ) 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) Its: 1' SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) Margare A. Ginem , Attorney-in-Fact 0/0 WILLIS OF FLORIDA Surety Phone No. A,211 W.BOY SCOUT BLVD,#1000 TAMPA, FL 33607 sNQUIRIES:(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 ) Court of ) On before me, 'Date, Here se a m and 7i the Officer personally appeared Name(s)of Signer(s) r 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#2086325 WITNESS my hand and official seal. z . Notary Public-California x Orange County a �NIComm.Expires Oct 31 2016 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.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 writte . Signature Anett Cardinale a " •• ANETT CARDINALE "kCQmmissbn#FF 138482 Expires July 28,2018 •�AA"', ®widad Thry Prcy f elei pnwanw 90tl36S•TUs9 This area for Oficial Notarial Seal `;Sete;13M 105.0, ame0s-Sections : -189 Wla :i 195:'of;the:Civil CD)k.ad Seo#ism 9, of't$s JQONIefprnen#.Code,,f6lafing-tt! nt) es'pjt(sji:the b jovv�hysicai format of ttip-hew disclosiire notice is; exa�tnplq, #or pusses of iiusixatirni: 1 ne.ta y polic of other officer doiiipletin this: certif iieate vetifies.only the identity of the individual who:signe4the do ?inGrit.ta vwbi l� 3s certificate.is atfa�hed,and not the trethfulness, agt3ur�y,as valz�ity t���h��:daeu>�ienti- State of California Giunty of Urt °_.:before r�ae, eta insert name and title o f'of 'icer, personally 4ppmeq Who pxQwed t¢1xf :oti tht basis of"satisfactory e� dance#a l # pex5ori )ivlips aiarne(s}isl re stili .6bbatp: alae. wifhira -instrument.and acknowledged Io me, that:helshelthgy executed the sama in his/her/their, auLEtoize+ capaeity(ies), d .that by his/her iq uq`sjghgu�e(�) -on the-itistrunne�t ate rsat�(s},:dr tie esitity upon.6ah41f of--whiph the peffi(O acted,ekecutedthe.:znstruruent, I:. ert% 'iiriderPENAI;TY OF ' It1EIRY wider die ]ad✓s ofte. tte of"Galifnriaiath.at the forego>ci paz�aBpph'i"s true and',correct W UNESS-iiiy hAnd a- seat..,sear: �ig�nafure �Seal�. POWER OF ATTORNEY III- 21000024 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$7,50D,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 revolted 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- 14 SEAL k', 141G By: Dan a 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. % _ AMY L'LAYLOR p� Notary Public-Stale of Tennessee N- z "' = Davidson County Am L.Ta , My CaffWLU n F kes 01-M-10my Y �'"•.�Orr�;+•�� 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 May _L 20_15 to d" M 4 9EAL 55�b Pauls.G' lane r v— 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 LIMUTIES Bonds $179,140,947 lasses $63,582,066 Preferred stacks p Reinsurance payable on paid losses and loss adJustrnent expenses Common stacks 0 31,840,141 lass adjustment expenses $10,384,957 Mortgage loans on real estate;Forst tens 0 Commissions payable,contingent commissions and other similar charges $1,020,805 Mortgage loans on real estate;Other than first liens 0 Other expenses(excludingtaxes.licenses and fess) $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 sale 0 Net deferred tax liability 0 Cash.cash eclulvalentsand shad-term lmestments $15,632,951 Unearned premiums $29,158,576 Contract loans 0 Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of ceding commissions) $58,224187 Other Invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities 0Amounts withheld or retained by company for aecountofothers Securities lending reinvested collateral assets 0 Remittances and items not allocated Aggregate write-ins forinvestrd assets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $225,614,039 Net adjustments Massets and tabilltles due to foreign exchange rates Title plants less$..,Charged off 0 Drafts outstanding Investment Income due and accrued $M960 Payable to parent,subsidiaries and affiliates $12,458,110 Uncollected premumsand agents'balancesinthe course ofcollection $73,567,547 Derivatives 0 Deferred premiums,slants'balances and installments booked but deferred and not 0 yet due Payable for securities 0 Accrued retrospectiveprem7ums 0 Payable for securities lending 0 Amounts recoverabfe from reinsurers $33,586,257 UatiRlty foramounis held under uninsured pians 0 Funds held by or deposited with reinsured companies 0 Afigregate write-ins for liabilities $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811,131 Amounts reeeivab:e relating to uninsured plans 0 Protected cell liabilities Current federal and foreign income tax recoverable and interest thereon 0 Ntt de 1e"ed tax s s sH $5,530,837 Total Nobilities $190,811,131 Guaranty funds receivable or on deposit 0 Furniture and equipment,including health care de8veryassets 0 POLICYHOLDElMSSURPLUS Net adjustment In assets and liabilities due to fore.gn exchange rates 0 Aggregate wnte-Ins for special surplus funds 0 Receivables from parent,subaidtaries and affiliates 0 Health are and other amounts receivable 0 Common cap2tal stock 5000000 Aggregate write-Ins for other than Invested assets $7,124971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat. $347,414,611 Aggregate write;arts for other than special surplus p Accounts From Separate Accounts.Segregated Accounts and Protected Cell Amounts 0 Surplus Notes TOTALS _ $347414,611 Gross paid In and contributed surplus _ $156,938,671 Unassigned funds(;urpiust ($5,335,190) Surp us as regards policyholders $156,603,481 TOTALS $347,414,611 SU85CR18FDandsvnorntomDlhls�rdayofMf�y, Myco+nrrussen expires /'''lrV°•l'k Notary Public CERTIFICATE NItad Name ALYSSA TURKOVITZ 1 certify sites the above flnanclal statements to the best of my Notary Public,State Of New YorkNO.��TU6044514 knowledge are a true and accurate reflection of the financial ALYSSA TURxOITI V condition of the Company as of December 31,2014, ' , Clualitied in Westchester County Additionally,I certify that the above financial statements are i r�:. �, .�i✓1 c.:-�r `' CoiQl Exoms July,10,20115 In agreement with the Statutory Financial Statements filed with tho TexaiIf044%blk[State of New York _ Department of insurance as of the same state; r No.01TU6044514 William 1 Gleason qualified In Westchester County Q9.!l,P�IFS11ML Cornmisslon Expires July 10,2014