36537-2 RREF II-CWC LaQ, LLC - OBR & Released BondsOUTSTANDING BOND REPORT
Tract Number: 36537-2
Development: The Signature at PGA West
Developer/Owner: RREF II-CWC LaQ, LLC
Bond Company: Lexon Insurance Co,
12890 Lebanon Road
Mt. Juliet, TN 37122
Attn: Greg Semrow
Outstanding / Released Bonds:
Bond Type
Bond No.
Amount:
Date Replaced or Released
Performance
(On -site)
110245T
1102552
$2,'^r 03,945
$1,338,239 Rider
Reduced w/rider on 03/09/16
Released 4/17/2024
ta �W
CALIFORNIA
April 17, 2024
M Lake Development
ATTN: Mike Lake
3417 Camino Alegre
Carlsbad, CA 92009
RE: TM 36537-1 and 36537-2 THE SIGNATURE — BOND RELEASE FOR ON -SITE
IMPROVEMENTS
Dear Mr. Lake,
Per authorization of the City of La Quinta Public Works Department, the City Clerk's Office has
hereby released the following bonds and notified Lexon Insurance Company
on 4/17/2024.
Tract Map 36537-1 and 36537-2
Bond Number
Bond Amount
Bond Type
1102156
$3,297,407 rider amount
On -Site Performance
1102552
$1,338,239 (rider amount)
On -Site Performance
The original paper bond is enclosed.
Please do not hesitate to contact me should you have any questions.
Sincerely,
Laurie McGinley, Deputy City Clerk
Email: LMcginley(a_).LaQuintaCA.gov
Tel: (760) 777 - 7123
ta �W
CALIFORNIA
April 17, 2024
Lexon Insurance Company
12890 Lebanon Road
Mt. Juliet, TN 37122
Attention: Greg Semrow
RE: TM 36537-1 and 36537-2 THE SIGNATURE — BOND RELEASE FOR ON -SITE
IMPROVEMENTS
Dear Mr. Semrow,
Per authorization of the City of La Quinta Public Works Department, the City Clerk's Office
hereby releases the following bonds:
Tract Map 36537-1 and 36537-2
Bond Number
Bond Amount
Bond Type
1102156
$3,297,407 (rider amount)
On -Site Performance
1102552
$1,338,239 (rider amount)
On -Site Performance
Copies of the bonds being released are enclosed for your reference.
M Lake Development, the developer, was also notified of the above bond release on 4/17/2024.
Please do not hesitate to contact me should you have any questions.
Sincerely,
Laurie McGinley, Deputy City Clerk
Email: LMcginley(a_).LaQuintaCA.gov
Tel: (760) 777 - 7123
MEMORANDUM
Date: April 17, 2024
ta Quiara
(.AI IFORNIA
To: Monika Radeva, City Clerk
Via: Bryan McKinney, P.E., Public Works Director / City Engineer/
From: Amy Yu, Associate Engineer
Re: TM 36537-1 and -2, The Signature, Bond Release for On -Site Improvements
Please release the following performance bonds held in your files for the above referenced tract.
The on -site improvements were accepted by City Council on April 16, 2024.
The bond amounts and the address to the developer and surety company are as follows:
Tract Map No. 36537-1 and 36537-2
Bond Description
Bond No.
Bond Amount
Performance
1102156
$3,297,407 (rider amount)
Performance
1102552
$1,338,239 (rider amount)
Developer: Mike Lake
M Lake Development
3417 Camino Alegre
Carlsbad, CA 92009
Surety Company: Lexon Insurance Company
12890 Lebanon Road
Mt. Juliet, TN 37122
Attn: Greg Semrow
If you have any questions, please contact me at extension 7047. Thank You.
-s
F a,
r tiC4J
of
To: Susan Maysels, City Clerk
From: Amy Yu, Associate Engineer /
Date: March 9, 2016 I
Re: Reduction Bond Rider to Performance Bond for On -Site
Improvements - Tract Map No. 36537-2, The Signature
Please attach the two bond riders to the existing on -site improvements
performance security bond for TM 36537-2. One rider changes the bond
number from 1102451 to 1102552. The other is a reduction bond rider
reducing the amount to $1,338,239.
The amount and addresses to the developer and the surety company are as
follows:
TRACT No. 36537-2
Performance
Reduced Performance
Bond Number
I
Seci
Amount
1102552
$2,703,945
1 $1,338,239
Developer: Ms. Liz Belloso
RREF II-CWC LaQ, LLC
5927 Priestly Drive, Suite 100
Carlsbad, CA 92008
Surety Company: Lexon Insurance Company
12890 Lebanon Road
Mt. Juliet, TN 37122
Cc: Project File I, Tract Map No. 36537-2
SURETY BOND RIDER Duplicate Original
Issued 3/2/2016
To be attached to and form apart of Bond No. 1102451
Effective: August 28, 2014
Bond Amount: $2,703,945
Executed by: RREF H-CWC Lao, LLC as Principal
and by: Lexon.Insurance Company as Surety
in favor of City of LaQuinta as Obligee
the Surety hereby consents to:
Amending the bond number from 1102451 to 1102552
Nothing herein contained shall vary, alter or extend any provision or condition of this
bond except as herein expressly stated.
This rider is effective August 2& 2014
Signed and Sealed: November 4, 2014
Lexon Insurance CgMpany
Surety
By: L AyCj,i IL
Kelly) A.I ardner, Attorney -in -Fact
POWER OF ATTORNEY
I_x- 269821
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 James I Moore, Bonnie Kruse, Stephen T. Kazmer, Dawn L. Morgan, Kelly A.
Gardner. Elaine Marcus, Jennifer J. McComb, Melissa Schmidt, Tariese M. Pisciotto, Diane Rubright, Tiffany Cunniff 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 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 1st 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 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 $8,000,000 Eight Million 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 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 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, LEXON INSURANCE COMPANY has caused this instrument to be signed by its President, and its Corporate
Seal to be affixed this 5th day of August, 2015.
LEXON INSURANCE COMPANY
BY
David E"Campbe#i
President
ACKNOWLEDGEMENT
On this 5th day of August, 2015, before me, personally came David E. Campbell to me known, who be duly sworn, did 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.
`rY.TAII
..... r ' AMY TAYLOR
= Notary Public- State of Tennessee
= Davidson County
`= My Commission Exoires 07-08-19
CERTIFICATE
BY J4(14jw�
Amy ylor
Notart
Public ti
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 full force 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 4 Day of November, 2014
SEAL * BY
e
Andrew Smith
Assistant Secretary
rC o► �{
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance 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."
STATE OF ILLINOIS }
COUNTY OF DU PAGE}
On November 4, 2014 before me, a Notary Public in and for said County and State, duly
commissioned and sworn, personally appeared Kelly A. Gardner known to me to be Attorney -
in -Fact of Lexon Insurance Com2anythe corporation described in and that executed the within
and foregoing instrument, and known to me to be the person who executed the said
instrument on behalf of the said corporation., and he duly acknowledged to me that such
corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and
year stated in this certificate above.
My Commission Expires March 23, 2019
01
�—�
L 1y�
Tiffs , otary '
Commission No. 816980
TIFFANY CUNNIFF
OFFICIAL SEAL
° Notary Public, Slate of Illinois
My Commission LxImes
�IJ•_
March 23, 2019
SURETY BOND RIDER
To be attached to and forma part of Bond No. 1102552
Effective: August 28, 2014
Bond Amount: $2,703,945.00
Executed by: RREF II-CWC LaQ, LLC as Principal
and by: Lexon Insurance Comp an as Surety
in favor of. City of LaQuinta as Obligee
in consideration of the mutual agreements herein contained, the Principal and Surety
hereby consent to:
Reducing the penal sum of the bond from $2,703,945.00 to $1,338,239.00
Nothing herein contained shall vary, alter or extend any provision or condition of this
bond except as herein expressly stated.
This rider is effective: February 25, 2016
Signed and Sealed: February 26, 2016
RREF II-CWC LaQ, LLC
Principal
By: "See attached signature page}_
Lexon Insurance Company
Surety, - ,
By: i5 cu,w�K, ant. .
Dawn L. Morgan, Attorney -id Fact
Signature Page to Surety Bond Rider No. 1102552
Effective February 25, 2016
RREF II-CWC LAQ, LLC,
a California limited liability company
By: California West Construction, Inc.,
a California Corporation
Its Authorized Agent
By:
Name: Donald W. ntana
Title: President
POWER OF ATTORNEY
Lx- 269815
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 James I Moore, Bonnie Kruse, Stephen T. Kazmer, Dawn L. Morgan, Kelly A.
Gardner. Elaine Marcus, Jennifer J. McComb, Melissa Schmidt, Tariese M. Pisciotto, Diane Rubright, Tiffany Cunniff 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 LEXON INSURANCE
COMPANY on the 1 st 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 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 $8,000,000 Eight Million 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 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 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, LEXON INSURANCE COMPANY has caused this instrument to be signed by its President, and its Corporate
Seal to be affixed this 5th day of August, 2015.
LEXON INSURANCE COMPANY
BY
David E.'Campbel}
President
ACKNOWLEDGEMENT
On this 5th day of August, 2015, before me, personally came David E. Campbell to me known, who be duly sworn, did 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
a AMY TAYLOR
ya. j4/lAaaaw
a+e - Notary Public- State of Tennessee BY
- _ Davidson County Amy ylOr
' My Commission Expires 07-08-19 Nota Public
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 full force 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 26 Day of February, 2016
SEAL t BY
Andrew Smith
r Assistant Secretary
7} Et
trp� Y
"WARNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance 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."
STATE OF ILLINOIS }
COUNTY OF DU PAGE}
On February 26, 2016 before me, a Notary Public in and for said County and State, duly
commissioned and sworn,,personally appeared Dawn L. Morgan known to me to be Attorney -
in -Fact of Lexon Insurance Company the corporation described in and that executed the within
and foregoing instrument, and known to me to be the person who executed the said
instrument on behalf of the said corporation, and he duly acknowledged to me that such
corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and
year stated in this certificate above.
My Commission Expires March 23, 2019
Tiffany ry Public
Commission No. 816980
TIFFANY CUNNIFF
OFFICIAL SEAL
!'I Nolmy Public, Slate of Illinois
� My Commission Expires
r'' March 23, 2019
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 San Diego
On _March 1, 2016 before me, M K puh1 i r- -
Date Here Insert Name and Title of the Officer
personally appeared _ Donald W. Fontana _
Name(s) of Signer(s)
who proved to me on the basis of satisfactory evidence to be the person( whose name(* islarkt
subscribed to the within instrument and acknowledged to me that helsk(elt y executed the same in
hislh /thr authorized capacity(i* and that by his/Nr/ffli it signature on the instrument the person(,
or the ent ty upon behalf of which the person) acted, executed the instrument.
M K STUCKEY
Commisslon #t 2107610
Notary Public - CalHornla
San Oispo County -�
Comm. Ex rss May 16, 2019
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
Signature of N tary 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: -
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Signer's Name: —
❑ Corporate Officer — Title(s):
❑ Partner — ❑ Limited ❑ General
❑ Individual ❑ Attorney in Fact
❑ Trustee ❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
. _�•,��,_ _ - - - - - - --.'�4-5;:'-_l,=-,. ��zxc�rt.`��t::rsc�zr,;c{:r�_�=^':rbq:�'�r��.?
02014 National Notary Association - www.NationalNotary.org - 1-800-US NOTARY (1-800-876-6827) Item #5907
SUBDIVISION IMPROVEMENTS
Tract Map No. 36537-2
PERFORMANCE BOND
Bond # 1102451
KNOW ALL MEN BY THESE PRESENTS:
THAT, the City Council of the City of La Quinta has approved the final map for Tract Map No.
36537-2 , prior to installation of certain designated public improvements required by the Conditions of
Approval for the subject map, in accordance with the California Map Act (Government Code Section 66462)
WHEREAS, the City Council of the City of La Quinta, State of California, and
RREF II-CWC LaQ LLC hereinafter designated as ("principal") have entered into an agreement whereby
principal agrees to install and complete certain designated public improvements, which said agreement, dated
Se temiaer 4 20__1 zL, and identified as Tract Map No. 36537-2, is hereby referred to
and made a part hereof; and
WHEREAS, said principal is required under the terms of said agreement to furnish a bond for the
faithful performance of said agreement.
NOW, THEREFORE, we, the principal and Lexon Insurance Company , as surety, are held and
firmly bound unto the City of La Quinta hereinafter called ("City"), in the penal sum of
Two Million Seven Hundred Three Thousand Nine Hundred Foqy Five an No/100 DOLLARS
($2,703,945.00] 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.
The condition of this obligation is such that if the above bounded principal, his or its heirs, executors,
administrators, successors or assigns, shall in all things stand to and abide by, and well and truly keep and
perform the covenants, conditions and provisions in the said agreement and any alteration thereof made as
therein provided, 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 officers, agents and employees, as therein stipulated, then this obligation shall become null and void;
otherwise it shall be and remain in full force and effect.
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.
The surety hereby stipulates and agrees that no change, extension of time, alteration or addition to the
terms of the agreement or to the work to be performed hereunder or the specifications accompanying the
same shall in any manner affect its obligations on this bond, and it does hereby waive notice of any such
change, extension of time, alteration or addition to the terms of the agreement or to the work or to the
specifications.
In witness whereof, this instrument has been duly executed by the principal and surety above named,
on 28i'' of August 2014.
RREF II-CWC LaQ, LLC, a California limited liability company
5927 Priestly Drive, Suite 110
Carlsbad, CA 92008
By: California West Construction, Inc., a California Corporation
Its: Authorized Agent
By:
Donald W. ontana
Title: President
Lexon Insurance Company
Sur ty
a �
Kell A G dner
Attornev-in-Fact
Title
12890 Lebanon Road
Mt. Juliet, TN 37122
Address of Surety
615-553-9500
Phone # of Surety
Bond Department
Contact Person for Surety
CALIFORNIA ALL-PURPOSE .ACKNOWLEDGMENT
State of California
County of San Diego
On 9/4/14 before me,
Date
M.K. Stuckey, notary public
Mere insert Name and Title of the Oftar
personally appeared Donald W. Fontana
Name(s) of Signer(s)
CML CODE § 1189
who proved to me on the basis of satisfactory
evidence to be the personW whose name(,0 is/aid
subscribed to the within instrument and acknowledged
M. K. STUCKEY to me that he/sXeltP {y executed the same in
Commission � 1933217 his/h r/t it authorized capacity(iq�), and that by
z "' Notary Public - California n San i]iega County hi51h rltlr signature( on the instrument the
My Comm, Expires May 16. 2015 pe nh,4 or the entity upon behalf of which the
person( 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.
�p Signature: Place Notary Seel Above _ OPTIONAL
I®�tld�i� ignature of 11 ry P Ilo
Though the information below is not required by law, it may prove valuable to persons relying on the document
and could prevent fraudulent removal and reattachment of this form to another document.
Description ®t Attached Document
Title or Type of Document:
Document Date:
Signer(s) Other Than Named Above: _
Capacity(ies) Ciaimed by Signer(s)
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Individual
❑ Partner — ❑ Limited ❑ General r.pf thumb here
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
Number of Pages:
Signer's Name:
❑ Corporate Officer — Title(s):
❑ Individual
❑ Partner — ❑ Limited ❑ General Top of thumb here
❑ Attorney in Fact
❑ Trustee
❑ Guardian or Conservator
❑ Other:
Signer Is Representing:
_ w,'t-h71�(,•!lG"[=/.'. tJ:!�C.'YiC:-=ix�:T1.�S:`L.'C)LuC9�:f:tJ,.hL::_^L'L�Y�[�[ x -r .. • .. . - - � r .ti.._. .- _ v?Lrye. i...v v�.S.`L.}�
0 2010 National Notary Association • NatlonalNotary.org • 1-800-US NOTARY (1-800-876-6827) Item #5907
POWER OF ATTORNEY LX- 219492
Lexon Insurance Company
KNOW ALL MEN BY THESE PRESENTS, that LEXON INSURANCE COMPANY, a Texas Corporation, with its principal office
Louisville, Kentucky, does hereby constitute and appoint: James [. Moore, Bonnie Kruse, Stephen T. Kazmer, Dawn L. Morgan, Pe- Fat.
Kelly -A. -Gardner, Elaine Marcus, Jennifer J. McComb, Melissa Schmidt, Tari_e_se_M. Pisciotto its true and lawful Attorney(s)-In-Fact to ma
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 LEXON I
COMPANY on the 1st 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 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 $ 8,000,000.00, Eight Million 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 President and the seal of the Company may be affixed by facsimile on any power of attorney granted.
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
such power or certificate bearing such facsimile signature and seal shall be valid and binding on the Company. Any such power so executed
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
ing on the Company.
IN WITNESS THEREOF, LEXON INSURANCE COMPANY has caused this instrument to be signed by its President, and its Corporate]
to be affixed this 21st day of September, 2009.
Po�T
�SEAL�
ACKNOWLEDGEMENT
LEXON INSURANCE COMPANY
BY
David E. Campbell
President
On this 21st day of September, 2009, before me, personally came David E. Campbell to me known, who be duly sworn, did depose ,
say that he is the President of LEXON INSURANCE COMPANY, the corporation described in and which executed the above instrument; that
executed said instrument on behalf of the corporation by authority of his office under the By-laws of said corporation.
y[1111[If[!If �,
� TA
AMY L. TAYLOR
Notary Public- State of Tennessee
n = Davidson County
My Commission Exoires 01-09-16
CERTIFICATE
BY 3�,, A 46ft�,
Am . Taylor
Notbry Public
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 true and correct copy, is in full force and effect and has not been revoked and
resolutions as set forth are now in force.
Signed and Seal at Mount Juliet, Tennessee this 28 Day of August 20 14
SEAL BY
Andrew Smith
It GF i 4
+ Assistant Secretary
tNING: Any person who knowingly and with intent to defraud any insurance company or other person, files and application for insurance of claim
ining any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto, commits a
ulent insurance act, which is a crime and subjects such person to criminal and civil penalties."
STATE OF ILLINOIS }
COUNTY OF DU PAGE}
On August 28, 2014, before me, Dawn L. Morgan, a Notary Public in and for said County and
State, duly commissioned and sworn, personally appeared Kelly A Gardner, known to me to be
Attorney -in -Fact of Lexon Insurance Company, the corporation described in and that executed
the within and foregoing instrument, and known to me to be the person who executed the said
instrument on behalf of the said corporation, and he duly acknowledged to me that such
corporation executed the same.
IN WITNESS WHEREOF, I have hereunto set my hand and affixed my official seal, the day and
year stated in this certificate above.
My Commission Expires March 29, 2016 U'�� hz0va-1,
Dawn L. Morgan, Notary Rhblic
1MMNtntytinnf+,+�J
OFFICIAL SEAL
DAWN L MORGAN
PUBLIC - STATE OF ILLINOISMY COMMISSION EXPIRES:03/29/16[:NOTARY
,nr