17-0803_TAYLOR MORRISON_Transmittal Warranty Bonds Release 32400
SAN JUAN CAPISTRANO,C MEMBERSOFi ECITYCWNCIL
(94 )4911PISTBANO,CA 926%5 ILf ,WJ
(949149311'11
(949)493-1053 Fwz W 9ER010 FARIAS
B1 76 1961 KERRY K. .MARY ON
TT
wwwSaajuancapistrano.Oig 1J$ � BRIAN L.MARYOTT
• PAM PATERE
DEREK
R REEVEVE
August 3, 2017
Taylor Morrison
Attn: Wendy Lewis
100 Spectrum Center Drive, Suite 1450
Irvine, CA 92618
Re: Release of Warranty Bonds — Campanilla. Tract 13436
Dear Ms. Lewis:
The City of San Juan Capistrano hereby fully and forever releases and discharges the Lexon
Insurance from any and all liability for the warranty bonds associated with the construction of
on-site and off-site improvements associated with Tract 13436 Campanilla (Taylor Morrison of
California, LLC). The following bonds are officially released as of July 10, 2017:
BOND NO. PURPOSE AMOUNT
1134557 Warranty Bond — Common Area Offsite Landscaping $ 6,500.00
1134558 Warranty Bond— Grading Improvements $ 24,000.00
1134559 Warranty Bond — In-Tract Landscaping Improvements $ 65,000.00
1134560 Warranty Bond — Monumentation $ 1650.00
1134561 Warranty Bond — Storm Drain $ 58,675.00
1134562 Warranty Bond —Water and Related Appurtenances $ 38,452.00
1134563 Warranty Bond — Sanitary Sewer Area $ 31,082.00
1134564 Warranty Bond — Public Streets $ 1,960.00
1134565 Warranty Bond — Private Streets $ 79,464.00
The released documents are enclosed. If you have any questions, please do not hesitate to
call me at (949) 443-6310.
Sincerely,Chns�Ja
Assistant City Clerk
Enclosures as noted
cc: Steve May, Public Works and Utilities Director
George Alvarez, City Engineer
Joe Mankawich, Association Engineer
}� San Juan Capistrano: Preserving the Past to Enhance the Future
`' Pnnw w IW%,a pace,
Pennium'$235
MAINTENANCE Bone N3J55]
KNOW ALL BY T}acc PXESENR,Tmtvc. TaWw kbrr¢on NCalddny.LLC
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Sevum Eill 1050,amrnds Sections I lfl9 and 1195 of Ne Civil Code and Section 6202 of Ne
Govemmem Codc,relating m troLariCS public.The below physical faemat of Ghe new diulosuc
mti«is an exantplc,far pugous of illusLzation.
A noisry publrc ar oNcrol!<a completing Nis
cenifim¢verilice only dm idemiryofNe
indivitlwl whn signetl Ned«umm[a xMich Lhis
ceni0utc i5 mmched,a,W wt Newdifvincss.
auuracy,m valWip of Nm d«umcn5.
Sm¢of Glifu
Cwnry of `,x/ `!I,�1
On � � before ma yy�w A��✓�i+an9f�.�lf�_Owry<
'nxn name ask litlen oR rl.persoiwllyappzmd_ A ]]ISS, who
provM�n me on the bnaix ofsaLishmmy evidence]n be the punxds)wlmx Swnc(*)dare wbwibnl ro
the xiihin im5mmem mut«knowle9gM ro me Nai hdslrNwy cxecuxa the samc in hiaR,erAheh
mnhnnml Uryciry(iesh aM NeL by hislherhheir sigiuwYIXi)on Ne i55mum<nt Ne permn(sl,m Lhe
rnliry upas hehalfofwhieh Ne persoNs)arced ex«md,lw imuumm�i.
I eenify undo PENALTY OF PERIURY eller the laws of the Su¢of L:alifamie Naz She foeegoing
wngmMi is nuc and m,mc]
wllTaltss any Wane ane oR<i,l«nl.
SignaSUR_ _ _ (SUI)
w Ltll6
Cgnnnlm n 10BB]SS
WIaY PUMI[�t WInNa
OnnGecwnry
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ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 20 day of September, 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 Lexon Insurance Company, 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 &kX, 44"
Gloria Robb
GMA Ra88
K Oo WiUbe R FF 196062
E*ft JMM 26 2019
w,r pw Inp r r Ir,loOirFRO
This area for Official Notarial Sea!
POWER OF ATTORNEY Lx-251924
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation,with its principal office in
Louisville.Kentucky,does hereby constitute and appoint:Oavid H Carr.Anetl Cardmale.IAaraaret A Gin-em.Brhnv L Balch its true and lawful
Attomey(s}In-Fact to make,execute,seal and defiver for,and on its behalf as surety,any and atl bards,undertakings or other writings obligatory
in nature of a band.
This authority is made under and by the authority of a resolution which was passed by the Board of Dl OCM of LEXON INSURANCE
COMPANY on the I"day of July.2003 as follows:
Resolved,that the President of the Company is hereby authwf¢ed to appNrd and empower any representative of the Company or other
person or persons as Attorney ln•Fact to exeaAe on behalf of the Company any bonds.undertakings,topes.contracts of Indemnity or other
writings obligatory in nature of a band not to exceed$2.500.000.00.Two kfillmn Five Hundred Thousand dollars,which the Comparry might
execute through its duty elected officers,and aft the seal of the Company thereto.Any said execution of such documents by an Aaanay-bh•Fact
shall be as bin?rg upon the Company as If they had been duty executed and acknowledged by The regularly elected officers of Ute Company.Any
Attomey-fn•Fad.so appofnled,may be removed for good cause and the authority so granted may be revoked as specked at gte Power of
Attorney.
Resolved,that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted,
and the signature of the Assistant Secretary,and the seal of the Company may be alfixed 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 bin tg on the Company.Any such power so executed
and sealed and certificate so executed and sealed shalt,with respect to any bond of underta"to which it is allached.continue to be valid and
binding on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this Instmmard to be signed by its President,and ifs Corporate
Seal to be affixed gds 9th day of July,2015.
LEXON INSURANCE COMPANY
SEAL" By D C=pball-
...�• President
�i�err rv,►
ACKNOWLEDGEMENT
On ids 0th day of July.2015.before me.pereanaly came David E.Campbell to me known.who be duty swam,did depose and say that
he is the President of LEXON INSURANCE COMPANY,the corporation dosabod in and which exec ted am above lnsbumeM:that he executed
said Instrument an behalf of the corporation by authority of his office under the By4aws of said corporation.
AW LTAKOR BY
2 = Notary PuOac•Sm»of Toa essee Am T ytor
% oa mm Camry
Mvaemmmt=E,a.m01-0416 Not Public
CERTIFICATE
I,tho undersigned.Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company.DO HEREBY CERTIFY the
the original Pourer of AUomey of which the forgoing Is a true and correct copy,is in full force and ofact and has not been revoked and the
rosokrttans as set forth are now in force.
Signed and Soul at Mount Jufie6 Tennessee ids Day of, U&dg&lllj��-.
t BY Andrew Smith
• Assistant Secretary
-WARNING:Army parson vfio knowingly and with Intent to defraud any Insurance company or other person.files and 9pp0atlon for Insurence of claim
containing any materially false Information,or conceals for the purpose of mislartifirtS Information concerning any fad mat*"thereto,commits a
fraudulent Ineurance act.which is a crime and subjects such person to criminal and civil penitis"
vrem m-szzs
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02400 P AtlPI No B n J an Catisbano CA 926]5
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w;n ro fiat or any xrmxac �mmriah of wonmaaallry wean xoama apPum m:nng Ik puwd N w
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ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 24G' day of September, 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 Lexon Insurance Company, 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
Gloria Robb
GLORIA ROBB
e
Cwrabsim#FFf9M
Eq*u January 29.2919
r.rr�rAraee�m�ren
This mea for Official Notarial Seal
Senate Bill 1050, amends Smuons 1199 and 1195 of the Civil Cate and Sretion 9202 of the
GnvcmmwT Cod,relating to notaries public. The Inelow physieal format of the new dimlosuse
sinowe is an example.foe purposes of it usvmiun.
A salary public m otlmr o/fim cwn pletin6 tLis
cenifnte vedGes only The idmtiry oftlu
individwl also si,W do daumrn[to xTich This
cmifieute is attached,and not Ne oafl,fulwss,
mcy,or validity ofllTas document.
Sevle ofealifwpp
Cowry of —1V1
a. N Pen.., �[_�X-�Vl`7 O�LL them
insert.1-1vaM one o�puwnelly appearcJ _ � n
pined m ne on The basis of eatufacTMy cvWcncc le be The perw , x amcO i sabscrilad m
the xnha inslmmem and asknmvledged m me Thm hdslsvM, execurcd The -en hisO'd1li r
aulhonu<I copauty(es), and Thu by bls/huhheif si,nmurePi) on the inslrumunl the pe—(v, or We
emir,npnn behalf of xhi6 the persenls)aanJ,eaecnled the inmmment.
1 anifi under PENAI'1'Y (11PERJURY once(the laws of the Stale of Califomia that the fom9ain9
paraeraph is true and rune,
WlN1SS my hand end omeial seal.
$isnalale V1�1 i li,i-li __ (S-11
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Cqm C Ltiat.2016
POWER OF ATTORNEY Lx-251925
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporatron,with its principal office in
Louisville.Kentucky.does hereby constitute and appctnt David H.Cart.Area Cardilate.Margaret A Ginem.[spiv L.Balch Its true and 13
Attumhoy{s}In-Fad to make.execute,seal and delrvor for.and on ft behalf as suarty.any and a7 bonds.undertakings or other writings obligatory
in nature of a bond.
This authority is mado under and by the outhe ity of a resolution which was passed by the Board of Directors of LEXON INSURANCE
COMPANY on One t°day of July.2003 as follows:
Resolved,that the Premdent of the Company is hereby authorized to appoad and empower any feprosentativa of the Company or other
Person or persons as Attomeytn-Fad to execute on behad of the Company any bonds,undertakings.policies.contracts of indearAy or other
rings obligatory in nature of a bond not to emceed$2,500.000.00,Two Million Five HumM Thousand dollars.which Ore Company oftht
execute Ukrough is duly elected officers,and affix the seal of the Company Oseroto.Any said execution of such documents by an Attarney-WFact
shall be as binding upon the Company as O they had boon duty executed and acknowledged by the regularly elected officers of the Company.Any
ey-In-Fact.so appointed.may be removed for good cause and the awry so granted may be revoked as speefred in be Power of
Attorney.
Resolved.that the signature of the President and the seat of the Company maybe affixed by facsimile on any power of attorney granted.
and the signature of the Assistant Secretary.and the seal of the Company may be affixed by facsnrilo to any certificate of any such power and
any such power or cedifcate beadrg such facsimile signature and seal shall be valid and binding on the Company.Any such power so executer
and sealed and certificate so executed and sealed shall.with respect to any bond of undertaking to which t is alladmd,continue to be valid and
banding on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused Oris instrument to be signed by its President,and its Corporal
Seal to be affixed this gth day of Juty,2015.
LEXON INSURANCE COMPANY
* SEAL BY��Campbett
... +� President
.Qa,o
ACKNOWLEDGEMENT
On On Oth day of July,2015,before me.personally came David E.Campbell to me known,who be duty sworn,did depose and say Uw
he is the President of LEXON INSURANCE COMPANY,the corporation described in and which executed the above Instrument:that he axocuted
said instrument on behalf of the corporation by authority of his air=under the By-laws of said corporation.
a";i^u' MLTAVL"
e `: Natin vitro-Still err Tam ecsse BY _
Davkkrh Couny Am ylor
` ..�% Mvew�Msua.Ixweeotaa+e N ryPublio
CERTIFICATE
1,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company.DO HEREBY CERTIFY that
the original Power of Attorney of which the forgoing Is a tnue and torted copy.is In fuer force and effect and has not been revoked and the
resolutions as sot forth are now in force.
Signed and Seat at Mount Juliet,Tennessee Osis .2LI71, Day q&& 20�.
BY ✓
S E A Andrew Smith
Assistant Secretary
"WARNING:Any person who knowlnpty and with Intal to defraud any Insurance company or other person,fees and apptleafkhn for Insurance of claim
conlatntng any materially false Information,or conceals for the purpose of mlabadInp,Informadon concerning any fact material thereto,commits a
faudxdent Insurance act,wNeh Is•crime and subjects such person to c"Inal and civil penaltles."
MNNTENANOE RwM 11JC550
KNOW ALL RY TNESE PRESENTS,tlul aw,T I M rr ICa4lpma LLL
u PAmipal.antl
a,�por.uoA oaa,Yina Yae�n�a RW:awasmlea Tx awawYalnmo-ano to aooY9a�ie
�k mYar cA ..asmuY.am lwJa.m rnm7mYmmn cmasaA JYan cavnaaAp
32400 Pa:ap AGN I Sa J C Dist CA 92fi]5
asOdipc in lOcp:rW 3uma f" 1n MOa ON 00
(f 65.000.00 1
m uSrE payinem Wdl ab lrvlYm Sa wJ�we mbind wrsclvu,pnraM ech of our lairs,eaaaubrs,aamininmlors.3uaaasrs
rrd...:TYNinGYaM rnenllY,Nlmyby�e Prsrew.
WIIFRFAS.Ihe ititl Primyal<nlvN iMoa CvNmtl wi1611c
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NOW.TF¢REFOIIC,TNE CONDITION OFTHIS OBLIGAITON I6 SLYH,Tpnl if lbc Prircipal Nall guamnlx llYt Gm wort
Hill tr T� e( airy mNane nattnHls or Workmanship which beano appartm Gum�S IN pviotl a
1 Yeer(s)NmWin6 ramplaionaNe Cenvaa lben Wia cbli�5on shall br va6 mhmwveartmain in 'tea
NII rmre AM eRm.gm'itlei banner,am amih0�Ml ammnry ar hwmnle wh4hv yr¢sd Or implieA is uNMa br the Y A
Nipciplw MmnGamammtly.untllk smeY MsmvoroliaNlily rm wcNagnmm:. J .�, wl^
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INWIaIEs IaaRm-mss
Senate Bill 1050.amends Sxrinns 1189 and 1195 pf the Civil Code and SeNon 82D2 of Nc
Govemmcrt Code,relating w rwtaries public The blow physical fommt o!the new disclose¢
wrice is agexample,for purposes of illuttraion.
A nomry public wotlwoRm cmnpluing Nis
renifiwse saiBa only rhe idmsiry of the
individual who aiened shedmumrnlmwbich Shia
vniGnm iz apached,and nm the miNfulnesc
mgr.�*ealieiy ufw�documem.
Sulc ufCalif m e
CWnry/or
On�� � before mc.y�l,�pJl JIS �(herc
i senname and rislep oDicer).pusonelly appeared �. who
proved ra me on do basis of misfagory evidence to be rbc pvason(s7 wlioz mnnc(s)islare wbscrikM m
the wirhin i ant end aeknowleJged ra m<shat hehl/Ihny a arced die a n hia+herM1heir
aurhoriud wpaciry(ies),and shel by hisnc�rnnvir signewrgs)on the insm�m<m Ne puson(s),or the
entity upon bchal(ofwhich the persons)acted,caecmW the insrrvmrnl.
I reniy under PENALTY OP PERJURY under the laws of the Swm of Glifornia dw she foregoing
pmagrapM1 is true mid comci
W I fNE55 my hand and o?cial seal,
Signamrt__�(�p,�,4 (Seal)
® w sJsvn
w.mr.im a marcs
xu.rrwo.cravi.
skay.pwry
earn. mal.m+a
ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I ss.
On this 20 day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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
Gloria Robb
GLON RM
Conphdm/FF 194062
et
E*uJnM26.2019
w�wnrrgrr�r.ueOil4M 11
?his areafor Ofcid Notarial Sea!
POWER OF ATTORNEY Lx-251926
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation,with its principal office in
Louisville,Kentucky,does hereby constitute and appoint:David H Carr Anon Cardinals Mamaret A C�~emElmnght L.Baich its tree and
Ananey(s)-tn-Fad to make.execute.seal and degw for.and on its behalf as surety.any and all bonds.undertakings or other writings ob5gatory
in nature of a bond.
This alNwrity is made under and by the authority at a resolution which was passed by the Board of Directors of LEXON INSURANCE
COMPANY on the 10 day of A4.2003 as foDows:
Resolved.that the President of ti.a Company is hereby authorized to appoint and empower any representative of the Company or other
I:erson or persons as Attartey-haFad to execute on behalf of the Company any beads,undertaki g%polides.contracts of Indemnity or
writings obligatory in nature Of a bond not to exceed E 2.500.000.00.Two Mizen Five Hundred Thousand doaars,whish the Company tush
execute Wmkgh Its duty elected officers,and affix the seal of the Company dareto.Any said execution of such documents by an Anomey-In-F
shall be as binding upon the Company as if they had been duty executed and acknowledged by the regularly elected officers of the Ovary.
In-Fa .so appointed,may be removed for good cause and the authority so granted may be revoked as specified in the Power
d
Resolved,that the sgnaGue of the President and the seal of the Company may be affixed by facsimile on any power of attorney granted.
and the signature of the Assistant Secretary.and the seal of the Company may be eftbked by faesimDo to any certificate of any such power and
any such power or certificate bearing such fansimile signature and seal she be voDd and W dng an the Company.Any such power so executed
and seated and cer0cale so executed and sealed shall.with respect to arty bond of undertaking to which It is attached.continuo to be va0d and
binding on the Company.
IN WITNESS THEREOF.LEXON INSURANCE COMPANY has caused this instrument to be signed by its President,and Its Corporate
Seal to be affixed this 9th day of July.2015.
LEXON INSURANCE COMPANY
�'-
S E A L BYDaW------ E aCampbetl
�...'�. President
ACKNOWLEDGEMENT
On Ibis 9th day of Judy,2015.before rte.personally came David E.Campbell to me known.who be duty sworn.did depose acrd say thal
he is the President of LEXON INSURANCE COMPANY,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.
.ptlIN I11i1 .�
_••���'��� AlIY L TAVIOR BY � I
Notary Pv6ee-Sme of Tennessee
' - Dwazoncwffly Am T ytor
"semy�..,,,,..�A�� Yv Canvntrdon EYeyos 01-00.18
No Public
CERTIFICATE
1,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company,DO HEREBY CERTIFY that
the original Power of Attorney of which the fwgoing is a true and coned copy.is in full farce and effect and has not boon revoked and the
resolutions as sat forth are now in force.
Signed and Seat at Mount Juliet,Tennessee this off?Day of 20 A' /J
BY
Andrew Soft
Assistant Secretary
"WARNING:Any parson who krtowingly and with Intent to defraud any Insurance company or other person.!Ws and application for Insurance of claim
contain[ng mny materially hese Information,or conceals for the purpose of mhhading.Ulormstlon concerning any hd material thereto.commits a
fraudulent Insurance act.which is a crime and subjects such paean to atmtnat and dv0 ponaitlss"
Prem u n Sm 00
MAINTENANCE Shad t13a560
KNOWALLBy31RSEfRESFNIS.Thalwa, Ta Morti not Caiforna LLC
100Sphsa m o Arne Surto 14511 rvirwMe$A 9�1+tR
a mmontioo argaWrsd uMa the Ny of the Salad TX eMdW,.4 hcmiad m lablwinB ip
d.S. r CA .af 5mm'.:;¢Ir1daM 61mly EouM unto City of San Juan Capi54a:w
33400 P Atl lana San Juan Capisuanp CA 92675
:d WliMinlboperelvm o! g H tl iM01 tl001100
t 165000
o wniaA payment WI aM Imly m be maAe as dobintl ourttnca nut aM Ncb of our Ildrs.a.munrs,ahsdWlmlma,..
arylat Mjoindv"mc21ty,LmJybytlw pasNs.
WHEREAS 1b v0lNimgl s.—I mW a a..with Iw
C'ly of San Juan Capslrano &hai
fer CamPanilla-Monammrsduon
WHEREAS.said has bva mv;plmad and war aWp an
day c
NOW.THEREFORE T16 wNo . OF Tws oR1.Ic,ss sam IS d, h s c Ina pnnap,l anal e,.r ow ua w a
E
wm a rma d aPy aaraw.< malmiaB ar wpn�amn;ip wnm baamc apppmd aan, ua pm;otl d q.
t y®rt:l FdlawinS ruPplrLan nrlh Ca,VM wWlbuabllgaYan stall b[ugd.albNrilfNrtmtiau W
ran fat¢a:W eRm.p—a hmma.any addiliaaal wamnry or guasa.. .pial ts aa1aMM by 8e
M.,,l a Mandapmmaoly,atl,he Smdyasmmam liabiliq for ba5wmlx. ^
5iRNd and vlad this 24th dayof Seplem4x 2015 A
t��� dN
T br NrFl wn 8Ca8brlb LL� (SaH J NU O
Iy/LFp}tg,.�SNl W/ N
OI .�.
Amuu
Lenon finsss/rt�a�/ CompanyUs
"�r1z� r;em AIIa111eynefad
CO YAWS OF FLONW
RII WofsaWM ..
TPNPA,FL3.t8W
INW RIES:(813)291-
Senate[fill 1050,amends Sections 1189 and 1195 of the Civil Code and Section 8202 of the
Governtncrht Code,relating 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,
aceumcy,or validity of that document.
State ofCalifo na
County
�of}��,,,, 7j
On before me, V_! .LAC- '�L (here
insert name and title o officer),personally appeared "f '"1 whn
proved to me an the basis of satisfactory evidence to be the person(s)whose name(s)islare subscribed to
the within instrument and acknowledged to me that helshelthcy executed the same in histhedtheir
authorized capacity(ies),and that by his/her/their signature(s)on the instrument the persan(s),or lite
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
W"ESS my hand and official seal.
Signature- -- --- (Seal)
--------------------
w.LEWM
CouhuNttlon�20!l32S
"my Public•camort"
ortnpe County
Clltthat ret Od�t
ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 24th day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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 AUU-11 +-'
Gloria Robb
MOM Rom
�
( �
A \MIg[iUWM 8 T{t9M
E�hoa Jamary2B,2019
r.snw ar r+.....aanau
This area for Official Nofwwl Seal
POWER OF ATTORNEY ix-251927
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that LEXON INSURANCE COMPANY,a Texas Corporation,with its principal office in
Louisville,Kentudry,does hereby constitute and appoint:David H.Carr,Anelt Cardinale.Mmmarot A.Ginem.Brandy L.Balch Its true and lawful
AxornMs}In•Fact to make,execute,seal and deliver for,and on its behalf as surety,any and all bands,undertakings or other writings obligatory
in nature of a bond.
This authority is made under and by the authonty of a resokd en wt"h was passed by the Board of Directors of LEXON INSURANCE
COMPANY on the td day of Juy,2003 as follows:
Resolved,that the President 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 bohalf of the Company any bonds,undertakings,policies,contracts of Indemnity or other
wntings obligatory In nature of a bond not to exceed$2.5411.000.00,Two Million Five Hundred Thousand dollars,vdtkh the Company might
erecuto through its duly elected officers.and affix the seal of the Company thereto.Any said execution of such documents by an Aftorneyin-Fact
sig be as binding upon the Company as if they had been duty executed and acknowledged by the regularly elected officers of the Company.Any
A=nvy-In-Fact,so appointed,may be removed for good cause and the authority so granted may be revoked as specified in the Power of
A—nay.
Rosofved,that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granled,
and the signature of the Assistant Secretary,and the soul of the Company may be affixed by facsimile to any oariifiwfo of any such paver an
any such power or certificate bearing such facsimile slgnahue and seal shag be valid and binding on the Company.Any such power so executed
and seated and ceniftcato so executed and seated shall,with respect to any bond of undertaking to which It is attached,continue to be valid and
trading on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this Instrument to be signed by its President,and its Corporal
Seal to be affixed this lite day of July.2015.
LEXON INSURANCE COMPANY
�
SEAL A BY
David
••�ie President
�•e a.�6a
ACKNOWI EMENT
On this 911%day of July.2015,before me,personally came David E.Campbell to me known,who be duly swum.(Rd depose and say that
he is the President of LEXON INSURANCE COMPANY,the corporation described In and which executed the above instrument;that he executed
said Instrument on behalf of the corporation by authority of his office under the By-laws of said corporation.
;•`` Y* AMY L TAYLOR BY 1 w"
n' OMT PubEt smear Tenne90ee
o Davkwn Caimy /tin r.T ylor
`r W Coxre+xas.oer Euaea 01-08.56 Nal ry PubGe
CERTIFICATE
I,the urdersirined,AssistmA Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company,00 HEREBY CERTIFY that
the original Power of Attorney of which the forgoing Is a trite and correct copy,Is in fug force and efkxt and has not been revoked and the
resoluth s as set forth are now in farce.
Signed and Seal at Mount Juliet.Tennessee 4eis -70 Day of, 20-Lg:—.
dam--
By
Andrew Smith
O Assistant Secretary
'WARIMG:Any person who Ixnowbgty and will Intent to defraud any insurance cemparry or other person,files and applteauen for tnwra c@ of eWm
containing any materially false Inforri ark or conceals for the purpose of misfeaft96 Information concerning any fact material thersto.commks a
fraudulent Insurance ad,which Is a aline and subjects such penim to ertmhW aW Wit penahias
_ Prem
MAINTENANCE B9ntl H34661
KNOW ALL RYTHESE P6ESFM3.Tbal xc.T M M fC If lLC
I INI CMrtnim t@va C lP 1450 emna fp 9) 8
as Pri�KiFal.and m neyPwnPc_fmrmm
am9nnlon PryniavluNmlklausdlk Sulcd TX and dvh'mNiumNmdOLuli^w in
du.Smw of CA .m6mtp',am MtluM Ormty Eweaunw CM INSan Juan CapisUaw
02400 P Atl I I Sa J Ca�I o CA 926]5
as Cblig([,in lkpcnal wm or 5 H dretl6 F' D011am and 001100
(f 50.6]500 )
w u-0m8 paPvmt udl W hub w fic wdc xc ao biml g95cIrR wrW wcM1 d we Aur;cmvlma,aamini9mlam suamna
aba®gnsjdndy ab c+cmlty,GrmNey Ncu pr®Is
W112NFA5.Ik aN Mrcpl exlaet iow u Caxrw vilh We
CiN IN San Juan Capcbano �
ra campanula-smmlom�n
vfHEPEAS.aid Cuwa M1r ban wmplaml,ab xu appmveAav
na,yr � d
c
NOW.IHEREFOPE,THE CONDITION OF'IHIS0BLIGATIDN MSUCN,'ITal if 0w Pnropal thnllgunnl¢Ilwl tlmxmt Q
win x rme d any a<rmia mwrids w x9lxm.mnip xdam esavc appmol avr�vy Ik puiod d
1 rmrar ralv..;xemmplm4vadx;cmmauw mi:mliFalNv.mu6:wle.aemw'a.ly mvmvw W.,
NII f ab eRm.povidN Iwxnv.my addiwnY xamanty a gwmnlc xktkr capmuil or uupliel a uwMm Ny Ik
Pn�opalur MamdaumimaY.aW dm Svmn azmmcs w IM1NIil2 h mcha yaunis. u
n
SiFpcdaMwk4lhu 241h tlryd $egember 2015 � e
_ 1 �W
T rto OI CaIf�- LLC (So0 J OIC
y �U a
I HY: —�-�bE�, � 1..L O VI U U
— Ivk c� �AA�E'`' S: sdu
Lexon Insurance CanpanV
Igare Clem .MmmL}�mF+m
aiNYIBDtSr/JNBURtI®
TW.1P0.0.iSar
IHDNRIE6.(af]pel�2aa5
Senate Bill 1050,amends Sections 1189 and 1195 of the Civil Code and Section 8202 of the
Government Code,relating 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 malidity of that document.
Statta�t
CouOrr before me._. _ * _(here
insert name and title of off icer),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 helshe/they executed the same in his/her/their
authorized capacity(ics),and that by his/her/their signature(s)an the instrument the person(s),or the
entity upon behalf of which the person(s)acted,executed the instrument.
1 certify under PENALTY OF PERJURY under the lass of the Stale of California that the foregoing
paragraph is true and correct
WITNESS my hand and official seal.
Signature �— --- (tel)
W.LEWIS
Coeaabuan 120!10325
Mowry Pu00ee-Catftft
C es ltd 11.2010
ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH
I SS-
On this 24`h day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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
Gloria Robb
GLOR141i0�
Ca M*ft i rf 19=
Eames daxwy 2!,2019
e.ra,r.,.r�veess+ee
77as arra jor official Notarial Seal
POWER OF ATTORNEY u(-251928
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation,with its principal office in
Louisville,Kentucky,does hereby constitute and appoint:David H.Carr.Anett Cardfnele.Maroaml A.Ginem.Brandy L,Baich Its true and lawful
Allorrtey(s}to-Fact to make.execute,seal and doliver for,and on its behalf as surety,any and an bands,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 LEXON INSURANCE
COMPANY on the 1"day of July,2003 as follows:
Resolved,that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other
person of persons as Adomeydn-Fad to execute on behalf of the Company any bonds,underlakirgs,policies,contracts of i ule+mdty or other
wrWrigs obligatory in nature of a bond not to exceed E 2,500,000.00.Two Milton Fire Hundred Thousand dollars,which the Company might
execute tfhrough'kts duly elected officers,and aft the seal of the Company thereto.Any said execution of such documents by an Allamay-In-Fact
shall be as binding upon the Company as if they had been duty executed and acknowlodgod by the regularly elected officers of the Company.Any
Aterney-In-Fad.so appointed,may be removed for good cause and the authority so granted may be revoked as specified In the Power of
Resolved,that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attomay granted,
and the signature of the Assistant Secretary,and the seal of the Company may be affixed by facslmile to any certificate of any such power and
any such power or certificate bearing such facsimile signature and seal shah be valid and binding on the Company.Any such power so exeartod
and sealed and certificate so exoarted and sealed shall,with respect to any bond of undertaking to which it is attached,continuo to be valid and
binding on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this instrument to be signed by its President,and its Corporate
Seal to be affixed this 9th day of A y,2015.
LEXON INSURANCE COMPANY
,SEAL, BY OaCid f-A-6g
President
ACKNOWLEDGEMENT
On Oft gth day of July,2015,before an.personally came David E.Campbell to me known,who be duly swum,dxl depose and say that
he is the President of LEXON INSURANCE COMPANY,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.
>r!-`-"•^qts cur L TAYLOR
No"Paaoc.Scree of Tettresaee BY .
DaV*§fflCounty Am .T ytor
' �..% w Canv yaeron Emros OtC4te "Ac
M1IHr�
CERTIFICATE
I,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Tom Insurance Company,DO HEREBY CERTIFY that
the original Power of Attorney of which the forgoing is a was and coned copy,is in full force and effect and has not been revoked and the
resolutions as set forth are new in force.
Signed and Seal at Mount Juliet,Tennessee this 24 Day Of.�0 16.
g p BY
Frew Smith
Assistant Secretary
'WARNING:Arty parson wlho khgaingfy and whh Intent to defraud any insurance company or odw porsm fibs and application for insurance of ctalm
contaadng any mater any false Information,or conceals for the purpose of adabadiog,Information Concerning any fad matertal thence.oanmtts a
fraudulent Insurance ad,which Is a ohne and subjects such person to criminal and civil panties.'
Prr m SQ
MAINTENANCE OonY 11]a562
KNOW AIL OY TkffSE PIffiSPMS,Thal w[. Tavlor Monson Of Calibma.LLL
s Pnxipel.and :xrF m
a wpnmwnarpw�iam mm�n:e law,orine suwa Tx and amymdhmia lombaainm bl
du Sae v( CA .aa SLmy,vml¢W aM Grmlybwmd nmo City of San Juan Caeist2no
324fx1 S J CanisO CP 926]5
as Oblig[,in lheycvl wm of 10[Th HmMrerlF Ilars and 6UI100
6 3fl 45200 1
1[wbrh ryymeM xW:md IrulY w tr maie xe dpgnd ourRhei mu aM wL akwt heir;esealwrs,admiwalmlw;.m¢[amre
and assipu NilNy and menllY,fmdaq U1�e prtxr0a
WHEREAS.rK said PrirSryl woal inw a C®ma wnb Ik
C Iy o15an Juen Cal:isyano dalW
fcr Camyanilla,Trac41343fi-Water an0 reWle0 appurlelances t[WY
WHFJIEAS,said Comral M1as btn amyitlM.ao1 xaappfossdm \`�
davQ _
NOW.T16REPOPE.THE CONURION OFTHIS GBpGAtkGN M SUCK Tbm J Bu Prinopal sM1lal Nanmm 16n IM xprk
will M frte oy s:ry Mfmn[ melcrials o wrkmaoship whirA bsa:nc appertnl dmi:�p rhe pniod of P
1 y[ar(sl fNlogi�mmPleuw:ofUUCmwav then J:is abli8alian shall be roil pWmviuwwma:n in Q xaS
NII Ga¢aM[ttm.pwvNd 11mrcm.any etldiliwul rrenanN ar guxrama xlulher V:amd m impllyd is wemm q Ilu q�q
Priavryla bbmJaswus omy.avd lbe 5uxry asweo np liabiliry fa mcha Baarudm. W U
SiglN aM wkd Wis 2401 tla>of Sepl0mber 2015
T br Morti nol Cal6o'nia (Smp YN
u
�(So0 �A U O
/'< LEST c•.Y S�15b11 W m�'__
N QLIIUV
Leann I��njjs��urance Canpany��l1 ,//
BY /nl(.cf�2/(LY�Y.
r9a AllmlleJ�mfitl
GOWLYS OF FLOftIpP
I111WBtt5CpIlI&'A.INL
TP4GA FL]aWi
INpUIgIES.(8131301-dA5
Senam Bill 1050,emends Bnlinns I IS9 anJ 1195 of Ne Ciril Codc anJ Swoon 8202 of the
Government Code,reletvg:o no0flb public.The bdow physical formm of da new diuloswe
rmliw is en example,foe pUgmus o(ilhuxratiprt
A nUmry peble or mha oRccr wmpluing Ihis
cenifiwe vcrifio YYIy We dmlily Yfdm
individual who signed rhe docmnem mwhkh Ihis
eMlfrcate i5 alln<heQ vld nYl d¢IrUNlulne54
wurncY.ar ealidib ofWldncunmm.
Scale efCalifa
Caunl//Y,lolLf,.�,U�'����� ,/s1�p���
On l.fJlJnwa hforc me,_u v 4K1[,f��L, �yy���"f�yi_(here
i�srn name and title pfaR r).personaltyappearcd �f. (R'�--_, wno
pmvYd tome on the basis of sarisfauoD evidenec to be rhe p�xsm�(s)whose�wnc(s)islom su0.uibcd lU
Inc wiWin inurvmenr nq xknpwledged ro me tM he/shWley exeeutr4 the same in his'Im/Ineir
amhm'vN apaciry(ics),eM Ilial by hisMmMheir signemrc(s)on ilia innmmem inc persoMs),or the
cntiry upon bdlel(pf wnicn rhe pclsonlz)u¢d,cw'uwd the inswment
I aeaify under plNALTV DP PflRJURV under Ina laws Yf rhe Swm of California Ilial Ne rorcgoin5
pmagnph iz we and cmrect
MJTNLSg my hand a 1M/�o�clm1i s1c1e1.1 f,
Signemre Y Vim___.._ (Seal)
w cams
mmYlrbn a 1MBII5
swylwr.daem
immv:ole
ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 24th day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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 k
rianella 13amola
1AARIMaLA DMCLA
A• 3 ormnispon#EE 170165
Expes May 5.M16
�(a� (pygp,�gire¢aw WU.tSS+=J
This area for ficial Notarial Seal
POWER OF ATTORNEY Lx-251929
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation.with its pdndpa!office M
Louissvilia,Kentucky,does hereby Constitute and appoint:David H.Carr,Anon Cgrdinnde Margaret A Ginem Brandy L Balch its true and lawful
Attorneys)-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 bend
This authority Is made under and by the authority of a resolution which was passed by the Board of Directors of LEXON INSURANCE
COMPANY an the 1n day of Juty.2003 as fo`ows:
Resolved,that the President of the Company Is hereby authorized to appoint and empower any representative of the Company or other
person or persons as Attomoy-In•Fact to execute an behalf of the Company any bonds,undertakings,policies,contracts of indemnity or other
writings obligatory in nature of a band not to exceed E 2,500,000.00,Two Million Five Hundred Thousand dollars.which the Company might
execute&=Gh as duty elected officers.and aft the seal of the Company thereto.Any said execution of such doCumems by an AComey-M-F
shall be as bb Kling upon the Company as if they had been duty executed and acknowledged by the regularly dectod officers of the Company.Any
Attorney-Irl-Fad,so appointed.may be removed for good cause and the authority so granted may be revoked as spedfied in the Power of
Allorngy.
Resolved.that the signature of the President and the seal of the Company may be affixed by facsimile on any power of anomaly granted,
and the signature of the Assistant Secretary.and the seal of the Company may be affixed by facsines to any cenifeare of any such power and
any such power or certificate bearing sivah tacsWle signattae and seal shall be valid and binding on the Company.Any such power so executed
and seated and certificate so executed and sealed shad.with respect to any bond of undertaking to which it is attached.ixinHmio to be valid and
binding on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this inskumertl to be signed by its President,and its Corporate
Seat to be afixad this gth day of July,2015.
LEXON INSURANCE COMPANY
EA ��i�
SEAL BY David F--Campbell
•�`b«• Prosident
ACKNOWLEDGEMENT
On this gth day of July.WIS.before me,personally came David E.Campbell to me known,who be duly swum,did depose and say the
the is the Presidait of LEXON INSURANCE COMPANY,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-taws of said corporat on
�,��.•••�4� AW l TAYLOR BY
PAW
Notary Pu40e•Stue of Torm ss"
D&Viftm CaMnly Am .7 ytaf
�q y_ rr� MvCortarostar Eaokes0»SI.70 PubEc
•gym"n"a'"m'„� CERTIFICATE
I,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company.DO HEREBY CERTIFY”
the original Power of Attorney of which the forgoing is a tree and correct copy,Is in full force and erect and has not been revolved and the
resolutions as set forth are now in face.
i
Signed and Seal at Meunt Juliet,Tennessee this Day of o�fl 20/:> 3
BY
Andrew Smith
Assistant Seaetary
'%YARNING:Ary parson who knoMngty and with Intent to defraud any insurer=company or other person,files and appiteadon for Insurance of claim
containing any m tertally false ledonnaton,or eonooats for it*purpose of misleading.Information concerning ing any fad material lhsreW commits a
fraudulent Insurance ad,which is a crime and subjoets such person to criminal and coil panaldes.'
V emu
MAINTENANCE eontl 1134563
KNOW ALL OY TlffSE PRE6GNIS,Tbal uc.T b M wn of California LLC
m0 cu.n..�m r a,n,i.,� fila tern J^+..�r A
:u Pnrcipal.ane
aum.umnnel„maea nnaer ll.la.sornw smle o<Tx .w anlr a�nnoaambaodawsl
it<6mc of_, CA .u6ortry,am hMaM6rmry NUM unm GN of San Juan GpsVuw
32400 Pa Aeelenlo San Juan Ca 'sVam CA 926>5 _
as oaleAc mlM vew wm at Tn�r one Tn urmE hrvr o II rs ane oonoo
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ane ampa ja nlh�am a+mny,6muy Nr uK,e vltsmtl.
WHPJIEAS.Ih<saia Peiripal eolnal info a fumxtwilh the
CiN of San Joan GlNsnano datm
k�Lampamlla,Tran 13436-Sanidry Sewer Nea
WII6RFAS,miJ Comrlu Wsnm�mmpklce.advssapysovNon
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NOW.THEREFORE.TIR:CONOrttOH OF TIISOBLIGATION LS Sl/CIL inv if the YrindpN slug 6larmas 14AVewak �J e
w;n a 6rc nr .m aum:.< matniatt u aorkmawav mam � alga�ml a�mne � pvioe a "" e
t ruticl ralow;nq mmpbbnawe cu�aa<I wm mumugarm shallxwie.anm.i:<mmawnlA Q
mn r sitl<1Yw.pmviad Imsma.am aeeh'oval wertanry ar gmmnlce teMhm uyremi.ar iinpliM is extrMM M IIK
Prirapa or ManWavurtl aNv.aiW the 6ueety ammem INElliry W such aglm(mllf<
6i8nm aM solei Ws 241A darts September � 2015
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Lexm Inwmnea Company
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Marg to Gislem AnomgJmFNa
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INOUIPoES:Ie136813UY
Senate Bill 1050,amends Sections 1139 and 1195 of the Civil Code and Section 8202 of the
Government Code,relating 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 orcarf II
County of
on before me. _1l I a/'KM_J_'�n-& (hero
insert name and title of offtccr).personally appeared T who
proved to me on the basis of satisfactory evidence to be the pe:rson(s)whose names)is/are subscribed to
the within instrument and acknowledged to me that he/shc/they executed the sane in his/her/Their
authorized capacity(icsl and that by his/her/their signaturc(s)on the instrument the person(s),or the
entity upon bchalfof which the person(s)acted,executed the instrument.
1 certify under PENALTY OF PERJURY under the laws or the State of California that the foregoing
paragraph is true and correct
WITNESS my hand and official seal.
Signature - (Seal)
W.LEWIS
Cathebtlon 12Q=5
mmy hbk-Cal;t nus
Ceen�Od31.2GI0r
ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA SS.
COUNTY OF HILLSBOROUGH
On this 20 day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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 AL .'.K &"'t r s�
arianella Bamola
,C ;Caimftsim#EE 17WG5
EW=M3y5,M10
�(,�'�}jN bw<cllinigfrlrrsnfd37i►Y..q
my area jor Officia!Notarial Seal
POWER OF ATTORNEY Lx-251930
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation.with its principal office in
Louisville,Kentucky,does hereby constitute and appoint:David H Cart Arad Cardinal% Manhare A Ginem Brandy L.Balch its true and lawful
Attomey(s)•ImFad 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 authmity Is made under and by the authority of a resolution which was passed by the Board of Directors of LEXON INSURANCE
COMPANY on the is day of July,2003 as(egows:
Resolved,that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other
person or persons as Altomoy-Ir►Fed to execute on behalf of the Company any bonds.undertakings,poEcies.contracts of lindmnmty or other
writings obligatory in nature of a bond not to exceed E 2.500.000.00.Two W5on Five Hundred Thousand doMM which the Company might
execute through its duty elected officers,and affix the seal of the Company thereto.Any said execution of such documents by an Attorney-in-Fact
shag be as binding upon tte Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company,Any
Altomeyln-Fad,so appoinW,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 President aunt the seal of the Company may be affixed by facsimile on any power of attorney granted,
and the signature of the Assistant Secretary,and the seal of the Company may be affixed by facsimile to any cortificate of any such power and
wry such power or certificate bearing such%csirrdlo signature and seal shell be valid and binding on fine Company.Any such power so executed
and sealed and certificate so executed and sealed shall,with respect to any bond of undertaking to which d is attached.continue to be valid and
binding an the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this instniment to be signed by its President,and its Corporate
Seat to be affixed this Oth day of July,2015.
LEXON INSURANCE COMPANY
b EA L
J S E A L BY a David E.-Campbell
..'or r President
�14 M`01
ACKNOWLEDGEMENT
On this 9th day of July,2015,before me.personally came David E.Campbell to me known.who be duty swum.died depose and say that
he is Ute President of LFIXON INSURANCE COMPANY,the corporation described in and which executed the above instrument;that he executed
said instrument on behalf of the corporalfon by authority of his office under the Bylaws of said corporation.
bV4
AW L TAYLOR BY
T t , Naary Putrses Sato or Temessee
Amn.T ybr
- Davidson County
Notbly Pub5e
\~ WCommc�nE+nuet Ot-04te
Air CERTIFICATE
I,the undersigned.Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company,DO HEREBY CERTIFY that
the original Power of Attorney of which the forgoing is a true and correct copy.is in fug force and eHed and has not been revoked and the
resotvlions as set forth are now In force.
Signed and Seal at Mount Jufhet.Tennessee thsoZ�Day of&hL,&t206
BY
o S E A L n Andrew Smith
Assistant Secretary
`WARNING:Any paean who knowingly and whh IMem to deraud any Insurance cornpaay or other person,run and application for insurance of claim
ooee,,, Ing any matarlagy false hdornutlon,or conceals for the purpose of adskailift information eonumtnp any fad mataral tlara110.commits a
(raudutad Irtwranee ad,which is a dtmo and subjaets such person to criminal and civil penafthm"
Prem
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NOW.T1ffRFtllMT MN0MMON0FTMS0BLIGATIONI56UCN. Tha if Inc Pnmilal shall gu.nva lbl Be xwt w io
will h fcc of any defmhc anscriuls or workman, which hma:m appmvl d:ur;S Ilse Ivied of � ll11
i1 yarwwoBmiogmnrylnien ofNe forbaomita: ns(hor rcxissad owidaMwiMtowxaiolb VI q
full fare aM Afm.pawidal sumo.my nwcwx l xbrob.or—h. ,w xlelhcr a yrmN a unPtiW is ealvWN q the
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5igad aM seaW this 24th dayof September 2015 J .. N W
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IRIES 10llp8UX95
Berate BiB 1050,amends Sediotss 1189 and 1195 of the Civil CNe and Section S2lQ of dte
Govcmmmt CMq relating to notoria public.The below physical formal e(the new diulosurz
smtim is an example,for purposes of Blustmtion.
A remry Wblic orotiwr nllittr comPkrin&this
rmifmm•efiBes unly the idemity ufthv
individual who signed tlm documem m which this
emifiuw"a azmchod and mt dw truthfulness,
umry,or nlitliry of rMs tl«umrnt.
Smaaf Glif
Cou�n�ty�nn�(��tt,,,,��� _ 1 -� ,
On1aAV!aL�a �b<fac mc.w.LEW��fSf""pp���� IL (h<m
m nemeeM sial<afoR a).pen'ormllY^pP�i�l�— oho
pmral w me an rhe bash ofvnsf tory widen¢m be drc pmroa(il wbox wnMz)idare subwribd ro
the within inarwnent and ack�mwlMgN to me dma Fe!sbathq exavted the same m hisMoltbor
amhorrzd capaeitytics),xnd thvt by his!hedtheir signewMs7 un tFe instrun.m the persmis),or the
mtiry upon bdwlfaf which da persons)acted,exwated she inswmens.
1 e<ni(y undo PBNALfY OI PF.RIUBY ands the laws of the$wle d Calif is dw Bm foregoing
remsmnn is w<.tM soma
wRN(:8$my hath aM oRcial seal.
Sipnamrt �_ (S®B
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ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 20 day of September, 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 Attomey-In-Fact
on behalf of Lexon Insurance Company, 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
adanella Bamola
61ARINtEUABAR►dxXA
found w N EE 170165
%+t -E1#1 Mal 5,2016
`;4;�� eweam.r+sse...imasrre
This area for Officio!Notarial Sea!
POWER OF ATTORNEY (,x_2519:fts
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation,witrincipal office in
LouisvilleKentucky.does hereby constitute and appoint:pavid H Carr Amit Cardinale Mamarol A.Cin Brmdv L& s true and
Altornoy(s)-in-Fact to make.execute.seal and deriver for.and on its behalf as surely.any and ag bonds,undertakings or Other writings obr:gat
in nature of a bond.
This authority is made under and by the authority of a resolutim which was passed by the Board of Directors of LEXON INSURANCE
COMPANY on the 1a day of July,2003 as follows:
Resolved.that the President of the Company is hereby authorized to appoint arta empower any representative of the Company or
othei
person or persons as Altomeyln-Fac 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 S 2.500.000.00.Two filfion Five Hundred Thousand dollars.which the Company might
execute through Its duly elected officers,and affix the seal of the Company thereto.Any sold execution of such documents by an Attomeyln-Fa
cl
shall be as hinting upon the Company as if they had been duly executed and acknowledged by the regularly elected officers of the Company.Arty
Attanurt4n-Fad,so appointed.may be removed for good causo and the authority so granted may be revoked as specified in the Power 01
Attorney.
Resolved.that the signature of the President and the seal of the Company may be affixed by facsimile on any power of attorney granter
and the signature of the Assistant Secretary,and the seal of the Company may be affixed by facsimile to any certificate of any such power and
any such power of coMfleate bearing such facsimile signature and seal shall be valid arid binding on the Company.Any such power so executed
and sealed and certificate so executed and sealed shag,wtth respect to any bond of undertaking to which it Is aftac hed.continue to be vatic and
binding on the Company.
IN WITNESS THEREOF.LEXON INSURANCE COMPANY has mused this instrument to be signed by its President and its Corporate
Seal to be affixed this Oth day of July,2015.
LEXON INSURANCE COMPANY
e'S{E A L BY —D3vW E.Camptell �—
.. President
•• •
e«ser
ACKNOWLEDGEMENT
On this Sth day of July.2015.before me.persahaty came David E.Campbell to ma known.who be duly sworn.did depose and say that
he is the President of LDION INSURANCE COMPANY,the corporation described In ad which executed the above ir>sburnent:that he executed
said instrument on behalf of the corporation by authority of his Office under the By-laws of said corporation.
mow.
AW L TAYLOR
WararrPua4rSemarTdxraree BY
- Am rTdVib,
Oavreson Not ry Pubto
WCemmnsnsn Ffmires dret 01-09-16
CERTIFICATE
1,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company.DO HEREBY CERTIFY the
the original Power of Attorney of which the forgoing is a tree and correct copy,is in full farm and effect and has not been revoked and the
resolutions as set forth are now In force.
Signed and Seal at Mount Juliet.Tennessee this ayf- Day
BY
Andrew Smith
• Assistant Secretary
'WARHM:Airy parson who knowbhpy and wM Odom to defraud any insurance company ar other person,flan and application for Insurance of claim
containing any materially false information,or conceals for the purpose of misboading,Information eoneeminp any fad materiel theroto,eamahlts a
fraudulent Insurance ad,vddoh Is a of ne and subjects such person to edmind and"penat§
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INOVIPES.IaI]RB1-AW
Smut Bill 1050,ametMs Sxtians 1189 end 1195 of the Cidl Code and Sx(ion 8202 0l the
Govenmlmt Code,retatin6 Lo nolanes public.The below physical fo(mat of the Imw d'wlosure
msice isane.<ample,for purposes of illurtra(ion.
A:mlmy publro m tuber oRa+.�omPlc(iny This
mrifiwm vcnfcs only Js idenliry urinc
inJiviJunl wlrosi6ucJ lLc docwnem so wbiAi(his
emifiute is mmcned,aM ml me Iwmrvleesc
reey,or aandity ormm eaeameaL
svm of carrg�yq
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oa[ l� TOf befmc me���.UIS�1�dG(U �11��1(/ O:�m
n:,<,t aam<aad enc arorc«r)_p«,r�::all:appearaJ� —.�_�llrCS who
prorLd m me an the basis afsahsfadop miJcna l0 4 Ne perwMs) hose wogs)Nam wbcmibeJ to
Inc widlin Nswnwd anJ acknowlodgN lu me that hJabcMry enecutN tM same in hismvM1hcir
audwnzeJ capecitgies),end that by nis'hcrAheir signalum(s)on dm inslramen(the perwn(s),or(be
cmty upon bchelf ofwhieh the persoMs)actN,executN the inswnanl.
1 ceniry wee.PENALLY OF PERJURY undo We laws or Nc Sam of(]lirnmix that Nc foreNoing
pemgmph is true and coned
W rST:ESS my haM end oRcul senl.
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ACKNOWLEDGEMENT BY SURETY
STATE OF FLORIDA
COUNTY OF HILLSBOROUGH I SS.
On this 24th day of September, 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 Aftomey-In-Fad
on behalf of Lexon Insurance Company, 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
,r
114anella Samola
~MMIAM MNOIA
Conwdsom 0 E 170166
•�o Expiim May 5,2(116
1 + lzdlRnT4Rad/icDfO�ffi:QD
This area for Official Notarial Seal
POWER OF ATTORNEY Lx-251932
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS,that LEXON INSURANCE COMPANY,a Texas Corporation,with its principal office In
Loukw0e.Kenhulry,does hereby constitute and appoomt:David H.Carr,Anel Cardinale.Maroaret A Cirtem.Brandy L.Baich its tree and lawht
Attomey(s)-in-Facl 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 mado under and by the authority of a resolution which was passed by the Board of Directors of LEXON INSURANCE
COMPANY on the 1"day of July.2003 as fWh;ws:
Resolved,that the President of the Company is hereby authorized to appoint and empower any representative of the Company or other
person or persons as AllomeyIn-Fact to execute on behalf of the Company any bonds,undertakings,policies,contracts of indemnily or other
writings obligatory in nature of a bond not to exceed$2,500.000.00.Two FAMon Five Hundred Thousand dollars,which the Company might
execuite through its duly elected officers.and alio the seal of the Company thereto.Any said execution d such documents by an Aaomoy-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.An
Attorney-to-FacL 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 President and tho seal of the Company may be affixed by facsimile on any power of attorney granted,
and the signature of the Assistant 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 cortificate so executed and soared shall,with respect to any bond of undertaking to which it Is altadmd.continue to be valid and
bindirg on the Company.
IN WITNESS THEREOF,LEXON INSURANCE COMPANY has caused this instrument to be signed by its President,and its Corporate
Seal to be affixed this 9th day of July,2015.
LEXON INSURANCE COMPANY
�AJ
SEAL* BY C DaMd VCampbeflt- —`
�...�: President
ACKNOWLEDGEMENT
On this 9th day of July.2015.before me,personally came David E.Campbell to me known.who be duly swan.did depose and say that
he is the President of LEXON INSURANCE COMPANY.the corporation described in and which executed the above instrument dot he executed
said instrument on behalf of(ho corporation by authority of his office under the By-laws of said corporation. J
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a• CERTIFICATE
I,the undersigned,Assistant Secretary of LEXON INSURANCE COMPANY,A Texas Insurance Company,DO HEREBY CERTIFY that
the original Power of Affomey of which the forgoing is a true and correct copy,Is In lug force and effect and has not been revoked and the
resolu9ans as set faith are now In force.
Signed and Seal at Mount Juliet,Tennessee this,!(jjX. Day of 201iib
S E A L P BY Andrew Smith
•� f
.••d je. Assistant Secretary
-WARNING:Any parson will krwwlitoy and with hRertt to defraud am Insunutce any or other pensorb foss and appOestlan for Insurance of elthn
coaWMnp arty materially false Information,or conceals for the purpose of mbleading,Information concerning any fad matartat thereto,eornmits a
haudWant Insurance ad,which Is a crime and subjects such person to criminal and civil penalties.'