15-0505_Bond_SUR21000032_Pacific Point Dev TR 16751 Premium: $1,768.00
SUBDIVISION FAITHFUL PERFORMANCE BOND
(GOVERNMENT CODE 66499.2)
Bond No. SUR21000032
Replaces Bond No. SUR20000329
KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Development Partners, LLC
(hereafter designated as "Principal"), and Jronshore 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 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
Two Hundred Thirty Five Thousand Seven Hundred Fifty Three Dollars and 00/100 Dollars, ($236,753.00 ) 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 P int development Partners, LLC
(NOTARIZATION AND SEAL)
By: �
Its: � *��"
SURETY:
Ironshore Indemnity Inc.
(NOTARIZATION AND SEAL)
By: 2 i
Marga tA. Ginem Attorney-in-Fact
Surety Phone No.
C/O WILLIS OF FLORIDA
4211 W.BOY SCOUT BLVD,#1000
TAMPA, FL 33607
INQUIRIES:(813)281-2095 Page 2 of 3
APPROVED AS TO FORM:
By:
NOTE: Please attach Acknowledgement and Power of Attorney
Page 3 of 3
Senate Bill 1050, amends Sections 1189 and 1195 of the Civil Code and Section UO2 of the
Government Code, rclating to notaries public. The below physical format of the new disclosure
notice is an example; for purposes of illustration.
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 M&AA t Al t 2A21!5before me, 6ir?x&. here
insert name and title of officer), personally appeared Who
proved to me on the basis of satisfactory evidence to be the persons)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.
1 certify udder PENALTY OF PERJURY under the laws of the State of California that the foregoing
paragraph is true and correct
WITNESS my hand and official seal.
Signature_ (Seal)
GRACE S.ANDERSON
Commission* 1991524
U�COMM-
Notary Public-California z
Orange Countyz
Expires Se 17.2016;
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 ai7L
Anett Cardinale
ANETT CARDINALE
r = Commission#FF 138482
=,. Expires July 28,2018
•1 "'I" Bonded Thru Troy Fain Ineurence 800-395.7019
This area for Official Notarial Seal
POWER (3F ATTORNEY
III- SUR21000032
Ironshore Indemnity Inc.
KNOW ALL MEN BY THESE PRESENTS,that IRONSHORE INDEMNITY INC.,a Minnesota Corporation, with its principal office in New York, NY does
hereby constitute and appoint: David H.Carr,Anett Cardinale,Margaret A.Ginem its true and lawful Attorney(s)-In-Fact to make,execute,seal and
deliver for,and on its behalf as surety,any and all bonds,undertakings or other writings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC. on the
22nd day of April,2013 as follows:
Resolved, that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or
persons as Attorney-In-Fact to execute on behalf of the Company any bonds,undertakings,policies,contracts of indemnity or other writings obligatory
in nature of a bond not to exceed $7,500,000 dollars, which.the Company might execute through its duly elected officers, and affix the seal of the
Company thereto. Any said execution of such documents by an Attorney-In-Fact shall be as binding upon the Company as if they had been duly
executed and acknowledged by the regularly elected officers of the Company.Any Attorney-In-Fact,so appointed,may be removed for good cause and
the authority so granted may be revoked as specified in the Power of Attorney.
Resolved,that the signature of the Director and the seal of the Company may be affixed by facsimile on any power of attorney granted, and the
signature of the Secretary, and the seal of the Company may be affixed by facsimile to any certificate of any such power and any such power or
certificate bearing such facsimile signature and seal shall be valid and binding on the Company.Any such power so executed and sealed and certificate
so executed and sealed shall,with respect to any bond of undertaking to which it is attached,continue to be valid and binding on the Company.
IN WITNESS THEREOF, IRONSHORE INDEMNITY INC. has caused this instrument to be signed by its Director, and its Corporate Seal to be affixed this
7th day of August,2013
IRONSHORE INDEMNITY INC.
,r pYPk*
4 p�+
5F.Al.
5454
By:
Dane L.Suss n
Director
ACKNOWLEDGEMENT
On this 7th Day of August,2013,before me,personally came Daniel L.Sussman to me known,who being duly sworn,did depose and say that he is the
Director of Ironshore Indemnity, Inc. ,the corporation described in and which executed the above instrument; that he executed said instrument on
behalf of the corporation by authority of his office under the By-laws of said corporation.
- .�I
AMV L TAYLOR
NotaryPublic-Stateol Tennessee
ao
Expires 01
Davids _'& A
on Caunty Amy L.Tay.
My Commission -09-16
NolaryPubac
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 correctt 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 M.4y 2015
0
— 8FM
1414
Paul S.G Qano 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."
IRONSHORE;NDEMNITY INC
FINANCIAL STATEMENT SUMMARY
As of December 31,2014
ASSETS LIABILITIES
Bonds
$179,140,947 bsef $63,582,066
Preferred stocks 0 Reinsurance payable on paid losses and loss adjustment expenses 0
Canmonstocks 31,840,141 Loss adjustment expenses $10,384,957
Mortgage lows on real estaW A rst it ens 0 Commis3ionspayable,rontlngentcommissions;and othersimilarcharges $1,020,805
Mortgage Irons 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(exdudrng federal and foreign income taxes) $1,383 909
Properties held for the production of mane 0 rurrmt federal and fofelgn Income tarn $7.435.372
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
Derivatives 0 Ceded reinsurance premiums payable(net of ceding commisslons) $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 tending reinvested collateral assets 0 Remittances and items not allocated
Aggregate write-Ins forinvestedassets 0 Provision for reinsurance $1,545,075
Subtotals.cash and Invested assets $226,614,039 Net adjustments In assets and tabllltles due to foreign exchange rates
Title plants less S.•,Charged off 0 Drafts outstanding
Investment Income due and accrued $990,960 Payable to parent,subsidiaries and affiliates $12,458,110
Uncollected premums and writs'batances in the course of collection $73,567,547 Derivatives
D
Deferred premiums,agents'balances and Installments booked but deferred and not 0
yet due Payable for securkles 0
Accrued retrospective Premiums 0 Payable for securities lending 0
Amounts recoventWe from reinsurers $33,586,257 LlsbUity for amounts held under uninsured plans 0
Funds held by or deposited with reinsured companies 0 Aggregate write-Iris for liabilities $4185,928
Other amounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell flabllhies $M,811,131
Amounts receivab:erelatingtouninsured plans 0 Protected cell liabilities
Current federal and foreign Income tax recoverable and interest thereon 0
Net deferred tax asset $5,530,837 Total liabilities
$190,811,131
0
Guaranty funds receivableor on deposit
Furniture and equipment,including health are delivery assets 0 POVCYHOLDMSSURPLUS
Net adjustment in assets and liabilities due toforegnexchange rates 0 Aggregate wntrlnsfor speclalsurplus funds
0
Receivables from paren%subsidiaries and affiliates 0
Health are and other amounts receivable 0 Common caotal stock 5 000 0DO
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 wrlte;ns for other than special surplus
Accounts 0
From Separate Accounts.Segregated Accounts and Protected Cell Accounts 0 Surplus Notes
TOTALS $341,414,611. Gross paid In and contributed surplus
$156,938,671
Ormslgned funds is urplus,+ ($5,335,190)
Surp us as regards policyholders $156,603,481
TOTALS $347,414,611
SUBSCRISEDand swomtome tNs iavol
Mycommiss;cnexpires
1411
Notarypubllc
CERTIFICATE PP ted Name ALYSSA TURKOVITZ
Notwy piJblic,Stats of New York
I certHy that the above financial statements to the bestof my NO.U7TU60445t�
kn waledge are a true and accurate reflection of the finrnciel ALYSSATURKOVTTZ
condition of the Company as of December 31,2Q14, Y Qualified in Westchester C 3urdy
Additionally,Icertify that the above financial statements:re t _1-�..;. y_<" Ca4TJli"tIE1F3tCJf3EK�,7maJuly 10,2018
In agreement with the Statutory Anandal Statements filed with thr Trxax Nctatfvoblic,9tsto of New York
Department of Insurance as of the same date
No.01TU6044514
William J Gleason Qualified In Westchester County
CEV,YP.iD1l113Iys1_ Commission Expires Jury 10,2014
SUBDIVISION LABOR AND MATERIAL BOND
(GOVERNMENT CODE 66499.2)
Bond No. SUR21000032
Replaces Bond No. SUR20000329
KNOW ALL MEN BY THESE PRESENTS, that Pacific Point Devela rnent Partners LLC
(hereafter designated as "Principal"), and Ironshore Indemnity Inc. y
as Surety (hereinafter called "Surety') agree to install and complete certain designated
public improvements as conditioned by City Council Resolution No's. 92-6-164 and
03-09-16-06.
WHEREAS, said Principal is required to furnish a bond pursuant to Municipal
Code Section 9-5.101 and 9-5.109 et seq., for the faithful performance to guarantee
certain work, more particularly described as follows:
Water subdivision im rovements 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
Two Hundred Thirty Five Thousand Seven Hundred Fifty Three Dollars and 00/100 Dollars ($235.753.00 ) 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:
SURETY:
Ironshore Indemnity Inc.
(NOTARIZATION AND SEAL)
By: �' d-,
Mar ret A. Ginem , Attorney-in-Fact
Surety Phone No.
C/O WILDS OF FLORIDA
4211 W.BOY SCOUT Bl110,#1006
TAMPA, FL 336107 Page 2 of 3
INQUIRIES:(813)281-2095
APPROVED AS TO FORM:
By:
NOTE: Please attach Acknowledgement and Power of Attorney
Page 3 of 3
Senate Bill 1050, amends Sections 1189 and 1195 of the Civil Code and Section 8202 of the
-Government Code,.gelatin to-notaries-public--. The below
p physical format of the new disclosure
notice is an example; for purposes of illustration.
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
OnI _ t5 before me, (here
insert name and title of officer),personally appeared who
proved to me on the basis of satisfactory evidence to be the persons)whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he/shc/they executed the same in his/her/their
authorized capacity(ies), and that by Itis/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
WITNESS my hand and official seal.
Signature (Seal)
:. GRACE S.ANDERSON
Commission #t 1991524
zn Notary Public- California
Orange County '
My Comm.i xaires Sep 17, —
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
Comrnissirrr+#FF 13$482
Expires July 28,2018
flawkdlMvi,,VknlmwamO10" -7019
This area for Official Notarial Seal
-- POWER OF ATTORNEY
III- SUR21000032
Ironshore Indemnity Inc.
KNOW ALL MEN BY THESE PRESENTS,that IRONSHORE INDEMNITY INC.,a Minnesota Corporation, with its principal office in New York, NY does
hereby constitute and appoint:David H.Carr,Anett Cardinale,Margaret A.Ginem its true and lawful Attorney(s)-In-Fact to make,execute,seal and
deliver for,and on its behalf as surety,any and all bonds,undertakings or other writings obligatory in nature of a bond.
This authority is made under and by the authority of a resolution which was passed by the Board of Directors of IRONSHORE INDEMNITY INC.on the
22nd day of April,2013 as follows:
Resolved,that the Director of the Company is hereby authorized to appoint and empower any representative of the company or other person or
persons as Attorney-In-Fact to execute on behalf of the Company any bonds,undertakings,policies,contracts of indemnity or other writings obligatory
in nature of a bond not to exceed $7,500,000 dollars, which the Company might execute through its cluly..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 facsimi I e on any power of attorney granted, and the
signature of the Secretary, and the seat 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 seat 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,2,013
IRONSHORE INDEMNITY INC.
MAL
1919 d
By y
Dane C.Suss in
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.TAVLOR Public-SlateofTennessee
Davidson County Aia;4�My Commission Expires 01-09-16
Notary Public
CERTIFICATE
1, 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 2015
..E."0.
4w1919�
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."
IRONSNORE',NDEMNITY INC ,
FINANCIAL STATEM ENT SU MMARY
As of December 31,2014
ASSETS u siLmES
Bonds
$179,140,947 Losses
$63,582,066
Preferred stocks 0 Reinsurance payable on paid losses and loss adjustment expenses 0
Common stocks 31,840,141 Low adjustment expenses $10,384,957
Mortgage loans on reel estate•.first tens 0 Commissions payable,contingent commissions and other similar charges $1,020,805
Morligage loans on real estate;DOW than first liens 0 Other expenses(exciudIngtakes.licenses and fees) $5,435,126
Properties occupied by the company 0 Taxes,licenses and fees(excluding federal and foreign income taxes( $2,9B3,9D9
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:oashequhraientsandshort-term Investments $15,632,951 Unearnedpresnlums $29,158,576
Contract bans 0 Advance premium
DerlvafWes: D Ceded reinsurance premiums payable(net of ceding commissions( $58,222,187
other invested assets D Funds held by company under reinsurance treaties 0
Receivables For securities 0 Amounts withheld or retained by company for accountofothers
Securities lending reinvested collateral assets D Remittances and items not allocated
Aggregate write-InsforInvestel assets D Provision for reinsurance $1,545,075
Subtotals.cash and Invested assets $226,614,039 Net adjustments M assets and labllitles Out to foreign exchange rates
Ttieplantsless$-chargedoff 0 Drafts outstanding
Investment Income due end accrued $990,960 Payable to parent,subsidiaries and affiliates
$12,,158,130Uncollectedpre*;umsandagents'balancesInthecourseofcollection $73,567,547 Derivatives
0
Deferred premiums,agerrts'balances and Installments booked but deferred and not 0
yet due Payable for securities 0
Accrued retrospectiveprersuums 0 Payable for securities lending 0
Amountsrecoverable from reinsurers $33,586,257 Uabliltyfor amounts held under uninsured plans 0
Funds held by or deposited vdthrelrssuredcompanies 0 Aggregate write-Ins for llablllties
$4,185,928
` Othetamounts receivable under reinsurance contracts 0 Total liabilities excluding protected cell liabilities $190,811,131
Amounts receivabte relating to uninsured plans 0 Protected cell liabilities
Current federal and foreign Income tax recoverable and,interest thereon 0
Net deferred tax asset $5,530,837 Total liabilities
$190,811,131
Guaranty"funds receivable or out deposit D
Furrutureand equipment Including health care de6veryassets D POUCYNOLDERSSSU,RPLUS
Net adjustment In assets and liabilities due tofort gnexchangerates 0 Aggregate vmte-lnsfor speclaIsurplus funds 0
Receivables from parent,subsldiarles and affiliates 0
Health are and other amounts receivable 0 Common ca#1al stock 5,000,000
` Aggregate wrfte4ns for other than Invested assets $7,124,971 Preferred capital stock
Total assets exdudlrig Separate Accounts,Segregated $347,414,611
Accounts and Protected Cel: Aggregate writr'm for other than specWl surplus 0
Accounts
From Separate Accounts,Segregated Accounts and Protected Cell Accoun Ls 0 Surplus Notes
TOTALS 5347414,611 Gross paid In and oontnbuted surplus $155,938,671
iJnessigned funds(s urpius; ($5,335,190(
Surp:us as regards policyholders $156,603,481
TOTALS ��. $347,414,611
it1BSCRIMand sworn tometh}sed4.,of�/lf ?Uf5
MYcommissonexprres� /'�•ICI wJV
Notarylhubilc
CERTIFICATE Printed Name ALYSSA TURKOVITZ
I certNy that[he above financial statements to the bestaf my __ �Public,State of New York
knowledge are a true and accurate reflection of the financial ALYSSA TURKC V172 No.01 TUti044,514
_
condition of the Company asof December 31,2014, ,�).T , " _ Qualified in WestcheGter Courttty
gddhlonelly,I certify that the above financial statements are s , ,�,• � r .-7,�- Comniisst EVims juiy 1 o,201 a.
In agreement with the Statutory Financial Statements filed with the Trxa. `No } Wit;Stall of tlkwycrk_ -
Department of insurance as of the same date, �-_ .
No.O1TU6044$14
WBIIamJ Gleason Quallfled In Westchester County
M. 4sw1✓M Commission Expires July 30,2014