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15-0505_Bond_SUR21000027_Pacific Point Dev_TR 16750 Premium: $3,147.00 SUBDIVISION FAITHFUL PERFORMANCE BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000027 Replaces Bond No.SUR20000335 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: Landscape subdivision improvements within Tract 16750 as defined within Amendment#1 and Reinstatement of the Subdivision improvement A reement for Tract 16750 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 Four Hundred Nineteen Thousand Six Hundred Fifty Three Dollars and oo/1oo Dollars, (419,653.00 ) 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. a SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: E Margar A. Ginem , Attorney-in-Fact Surety Phone No. C/O WILLIS OF FLORIDA 4211 W.601 SCOUT BLVD,41000 TAMPA, EL 33607 Page 2 of 3 INQUIRIES:(813)281-2'),[ 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, --mMo �V [Date a Insert Name and T1tle of he Officer personally appeared r L-_W(fl�j_1�'� Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) €s/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#20883 Z WITNESS my hand and official seal. QMy Notary PublicCalifornini aOrange County Comm,Expires Oct 31,2018 Signature Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name: Signer's Name: ❑ Corporate Officer — Title(s):. ___. ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑ Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: _ Signer Is Representing: Signer Is Representing: ©2014 National Notary Association -www.NationalNotary.org - 1-800-US NOTARY(1-800-876-6827) Item#5907 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 t` Ls Comm ssi©n#FE 138482 a = Expires July 28,2418 `* '' Bada6 T1eu Tny Fay IneOV4 9043&rr7019 This area for Official Notarial Seal zrlate:Hill 1050 azftczjd"s:Sections 1189 inid : 19.5; Glvl.lacfe Kacieti $20-of the JQOYerpmA-t.0 040,relafir gtto wthies:pxiblie:.'fbe.bel .-1 bYgical format of fte..hew di ol`osure xtwtice.is;an exa�pplL-,,for pu na s of illustrat.im. 1fidt9ty.public of o#hes afflda coihpl tingthl$: certificate verifies only the identity of the indlvidua liha.'signed.the doeutm'it.to Wvhidh. is certificate is attaohed,and not the tnithfulnessi �.obiir���';e�vatzdity��t�a� lotsu�e]at_ State of California G.unty.of Ufgrd The, ihsert name and title 6foffieer5,personally appeared Who lsrflver3 t ink.piS the basis of'saYisfatbiy evidence t ise#fte,:prsori( )vs+liost3 iiarsoe(s)is/i;re suoscriberte; .t`he within--instrument -and acknowledged to me- that• helshe/they executed the same: in. i s/herltheir au kioa`izefi r- .Vacity(ses'), aiid that f y�is]"f&Ax `MOa..wre:(i 'q the in fnoht the P#t son(s),,or the tentity inh,behalf of-which the person(;)acted,ekect3ted tiie insrurent< f cektijfyiloder PENALT7(-OV� 1IJR 'tiriti$r tlae laws of tbe_Mtgeof Calzforhia i}t the oregairi paragraph i"s true and corre0- V TI'NESS.my Mind and.official seal, 4 t .Sj Matit rI3 (Sea]), POWER QF ATTORNEY Ironshore Indemnity Inc. III- 21000027 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 7,h day of August,2013. IRONSHORE INDEMNITY INC. r��p46afy'y-. pT 1414 � t 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 TAYLOR s — Nolary Public-Slate of Tennessee + .... •' Davidson County Am L Xa My Commission Expires 01-09-16 Y Pu61lc 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 20 15 S°Q9.F Dryp''� 1914 jj Paul s.GI dano r 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 tosses $63,582,066 Preferred stocks p Reinsurance payable on told losses and loss adjustment expenses Common stocks 0 31,840,141 toss adjustment expenses $10,364,957 Mortgage loans on real estate.r,rst I ens 0 Commissions payable,contingent commissions and other similar charges $1,020" Mortgage loans onrealestate;011ierthan first liens 0 Other expenses(excluding taxes.licenses and fees) $5,435,125 Properties occupied by the company 0 Taxes,licenses and fees(exdudmg federal and foreign Income taxes) $2,383,909 Properties held for the production of income 0 Current federal and foreign Income taxes $2,434,392 Properties held for sa'e 0 Net deferred tax liability 0 Cash.cash ewhrolants and short-term Investments $15,632,951 Unearned premiums $29,158,576 Contract loans D Advance premium Derivatives 0 Ceded reinsurance premiums payable(net of ceding commissions) $58,222,187 other invested assets o Funds held by company under relnsurancetreatks 0 RecelvaNes for securities 0 Amts withheld or retained by company for account ofothan Securities lending reinvested collateral assets 0 Remittances and Items not allocated Aggregate wrlte-Insforinvestedassets 0 Provlsionfor mInsurance $1,S45,075 Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and tabllkles due to foreign exchange rates Title plants less$..Charged off 0 Drags outstanding Investment Income due and aocrued $99Q960 Payable to parent,subsidiaries andoffidales $12,158,111) Uncollected prem ums and agents'balances in the course of conection $73,567,547 Derivatives D Deferred premiums,agents'balances and Installments booked but deferred and not 0 payable for securkles yetdue 0 Accrued retrospective premiums D Payable for securities lending 0 Amounts recoverable from reinsurers $33,586,257 UablRty for amounts held under uninsured plans 0 Funds held by or deposited wkhreinsured companies 0 Aggregate wrlte-Imfor liabilities $4,185,928 Other amounts receivable under reinsurance contracts D Total oablliUes excluding protected cell liabilities $190,811131 Amounts receivab:e relating to uninsured plans D Protected cell liabilities Current federal and foreign Income tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 Totaillabilitles $190,813,131 Guaranty funds receivable or on deposit D Furniture and equipment,including healthcare delivery assets 0 POl1CYNOLDE S SURPLUS Net adjustment In assets and nabl0ties due to for6in exchange rates 0 Aggregate vette-Ins for special surplus funds 0 Receivables from parent,subsidiaries and al0liates 0 Health are and other smountr receivable 0 Common capital stock 51000,000 Aggregate write-Ins for other than Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cel: $347,414,611 Aggregate white m for other than special surplus 0 Accounts From Separate Accounts,Segregated Accounts and Protected cell Accounts 0 Surplus Notes TOTALS 347 414 511 Gross paid In and contributed surplus bd l _• _ _ P $156,938,671 Unassigned funds b urplus; ($5,335,190) Surp'ur as regards policyholders $156,603,481 TOTALS �/ $347,414,611 SUBSCRIBED and swum to me thlsy-'day of HY,, j?„rI S f7 '" Mycommsscnexpires_ 7-lo-IT * .r^a- Notary Public CERTIFICATE Printed Name ALYSSA TURKOVM I certify that the above flnanclal statements[o the bNct�Public,State of New York estof my knowledge area true and accurate renection of the financial ALYSSA Tl1RX041T2 No.01TU6044514 condition of the Company as of December 31,2914, Oualllled In Westchester(;wmy Additionally,I certify that the above financial statements are ; 4{...Z/.+.� ,. /,44 }' Xslon Expxlhsf>July 10,2018 in agreement with the Statutory Financial Statements filed with the Texah •NOlap�f'hrWl�Scat=of fYtw York \''� Department of Insurance as of the same date NO.OITU6044514 WRllem.1 Gleason Quanfled In Westchester County YP 8 Treasurer Commission Expires July 10,2014 SUBDIVISION LABOR AND MATERIAL BOND (GOVERNMENT CODE 66499.2) Bond No. SUR21000027 Replaces Bond No. SUR20000335 KNOW ALL MEN BY THESE PRESENTS, that Pacific Paint Develo ment 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: Landscape subdivision improvements within Tract 16750 as defined within Amendment#1 and Reinstatement of the Subdivision improvement Agreement for Tract 16750 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 Four Hundred Nineteen Thousand Six Hundred Fifty Three Dollars and 00/100 Dollars ($419,653.00 ) 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, shat 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: SURETY: Ironshore Indemnity Inc. (NOTARIZATION AND SEAL) By: Margar A. Ginem , Attorney-in-Fact Surety Phone No. C/O WILLIS OF FLORIDA 4211 W.BOY SCOUR`BLVD,#1oo(E TAMPA, FL 33607 Page 2 of 3 INQUIRIES.-(813)261-20QS 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, *ns,?prf Date re me and Tit the Officer personally appeared Ph f Names)of Signer(s) k 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. a Notary Public-California z Z Orange County 11,01 My Comm.- ares Oct 31.2018 Signature 6 6' 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: T_ — 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 ANE-TT CZANALE `+ Commission#FF 138482 aa *r Expires July 28,2018 Baled Thiu Troy Fdn Ineurence M385.7019 This area for Official Notarial Seal ` eate:$t11 I0 .0, ametid's:Sections f l$9 aai : 19 'of the:Oy 1.Cocke-and seaioi 00 of'the G enf.Code;rola'laj�to note;ries.publfe,"Mb.'Wo*w--Pb.ys cal format of the-new diselosiire 1�00ce:is_44 example;,-fprpu cr es o 'iqustratizsn: A,WfAty public of other officer coiiipll ng flus certificate verifies only the ideptity'of the indi;viduaI who.signed,the doNtnmt.kd zvliich' certificate is attached,and not the truthfulness, aee*aCy,of validity o khat.do�uyient S afC-alifornia. County of .Word rne, h3sert naris and,title of officerj,personally aped Wht3'. proved to irig otl Il,Ogiis.of satisf4toiyeviderioe to bgftpersgii(fi):Whosa haauis/tyre suti crihe t .the vrithin -i�istrument and acknowledged Io me, than beYsheltheY executed jhen.samc,in .his/herAbeir, wbOT-0capacIt, (tes), grid that;by,. islfigrhheii Aghature(s) 'Qn.the 14`strufnont fbe terson(s),:Of the ;entity,upon behalf of w}itcli#lie person(;),acted, ekeouted the4instrument, 1; �rt%if+ under PENAI:TS('Ol; PE URY under tlae Jaws -of ate.Sta d vf"dAiworuia fih4t the fai�goko g. p aph-i's true an&correO WU NESS itiy Band and official shah, Sgnafiate (Sea)) k POWER OF ATTi7fZNEY Ironshore Indemnity Inc. III- 21000027 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-ln-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. SFA spa P 19 9 1 � 1919 By. Dan @.LSus n -`" Director ACKNOWLEDGEMENT On this 7 1 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. AhtY LYY11 w ' - Davitlson{pnwb' qq,, �. My ComMsabn FsfitRs 0149-10 ftmr L.Tay CERTIFICATE I, the undersigned, Secretary of IRONSHORE INDEMNITY INC., a Minnesota Company, DO HEREBY CERTIFY that the original Power of Attorney of which the foregoing is a true and correct copy,is in full force and effect and has not been revoked and the resolutions as set forth are now in force. Signed and Sealed at this 19th Day of MaY Zp 15 µPe yrs .�Y'..Al f7t9 1 Paul 5.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 INDEMNITY INC FINANCIAL STATEMENT SUMMARY As of December 31.2014 ASSETS LIABILITIES Bonds $179,140,947 Losse $63,582,066 Preferred stocks p Reinsurance payable on paid losses and loss asdjustment expenses Common stocla 0 31,840,111 Loss adjustment expenses $10,384,957 Mortgage loans on real estate.First tors 0 Commissions payable,contingent eommlssiorss and other similar charges $1,020,805 Mortgage loans on real estate;Other than first Hens 0 Other expenses(excIudingtaxes.licenses and fees) $5,435,126 Properties occupied by the company 0 Taxes,licenses and fees(excluding federal and foreign Income taxes) $2�383 909 Properties held for the production of income 0 Current federal and foreign Income taxes $2,434,392 Properties held for We 0 Net deferred tax liability 0 Cash.cash equivalents and short-term investments $15,632,951 Unearned premiums $29,158,576 Contract loans 0 Advance premium DerivatWa o Ceded reinsurance premiums payable(net of ceding commissions) $58,222,187 Other Invested assets 0 Funds held by company under reinsurance treaties 0 Receivables for securities 0 Amounts withheld or retained by company for account of others Securities lending reinvested collateral assets 0 Remlttancesand itemsnot anocated Aggregate wrlte-Insforinvestedassets 0 Provision for reinsurance $1,545,075 Subtotals.cash and Invested assets $226,611,039 Nat adjustments In assets and liabilities due to forelgn exdmnge rates Title plants less$_Charged off 0 Draftsoubtanding Investment Income due and accrued $990,960 Payable toparent subsidiaries and affiliates $12,158,110 Uncollected prom umsand agents'balances;lnthe course ofcollection $73,567,547 Derivatives O Deferred premiums,agenb'balances and Installments booked but deferred and not 0 payable for yet due 0 Accrued retrospective premiums 0 Payable for securities 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-Ins for Ilabllttles $4,185,928 Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell tlabllides $190,811,131 Amounts recehrab;e relating to uninsured plain; 0 Protected cell liabilities Current federal and foreign Income tax recoverable and interest thereon 0 Net deferred tax asset $5,530,837 TotalNab]litles $190,811,131 Guaranty funds receivable or on deposit 0 Furniture and equipment,including health care de8very assets 0 POUCYHOLDVWS SURPLUS Net adjustment In assets and liabilities due to foregn 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 captlal stock 5 ODO 000 Aggregate wrlte-lnsforatherthan Invested assets $7,124,971 Preferred capital stock Total assets excluding Separate Accounts,Segregated Accounts and Protected Cat, $347,414,611 Aggregate write-;m for other than sp«lei 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; ($5335,190) Burp us as regards policyholders $156,603,481 TOTALS $347,414,611 SUBSON89Dandsworn tome thls1„dayofHq . .IOjS Mycommiss-exores: 7-/O—/S' Notary Public CERTIFICATE Panted Name ALYSSA TURKOVITZ d I certify that the above Onanclal statements to the besta�f my Notary Public.State of Now York knowledge are a true and accurate reflection of the financial ALy$SA7URROVM No.OITUB044514 condition of the Company as of December 31,2014, s'f ,+ Auall(led In Westchester cfJunly Additionally,I certifythat the above financial statemersts are /r /,4Z, Cf]TTtfi`LjPf Cin Expirea July 10.201156 In agreement with the Statutory Financial Statements filed with the Trxae plotap� bllG Suta of Newyork Department of Insurance as of the same date. No-OITU6044514 WNIIamJ peason Ouanfled In Westchester County CTO.VP.&Trees urc - L Cammisslon Expires July 10,2014