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HomeMy WebLinkAboutT-5608 - Cashier Memo - 12/13/2018 CIIY°' MEMORANDUM ff-fflk�� PUBLIC WORKS DEPARTMENT LAND DIVISION 2600 FRESNO STREET FRESNO,CA 93721 DATE: December 13, 2018 TO: YOLANDA SMITH Public Works Department FROM: JONATHAN BARTEL Public Works Department SUBJECT: SUBMITTAL OF PAYMENT FOR TRACT NO. 5608 THE FOLLOWING ITEMS ARE SUBMITTED FOR PROCESSING: 1. Performance Bond in the amount of$515,000.00 2. Payment Bond in the amount of$271,000.00 3. 5% Performance Security a. Certificate of Deposit in the amount of$27,000.00 (California Bank &Trust) 4. Check in the amount of$227,564.00 (California Bank &Trust No. 1015) a. Deposit$4,478 for document preparation fees into 180503 10101 34559 b. The Balance on Exhibit B of the Subdivision Agreement 5. Copy of the Subdivision Agreement identifying itemized applicable charges. Thank you,,. Jonathan Bartel City of MEMORANDUM IIIII�IC,III►41, 1 PUBLIC WORKS DEPARTMENT LAND DIVISION 2600 FRESNO STREET FRESNO,CA 93721 DATE: November 28, 2018 RECEIVED TO: HEIDI BRIGGS NI1v� 2018 Personnel Services Department CITY OF FRESNO Personnel Services Department OFFICIAL USE ONLY FROM: JONATHAN BARTEL Public Works Department SUBJECT: REQUEST FOR BOND APPROVAL FOR THE FINAL MAP OF TRACT NO. 5608 Attached are original bonds required for the subdivision agreement for the Final Map. Please review the following bonds for conformity to City acceptance policies: 1. Performance Bond in the amount of: $515,000.00 2. Payment Bond in the amount of: $271,000.00 If you have any questions, please contact me at 621-8684. Thank you Jonathan Bartel RISK�ANAAKMRNT DIV RION Approved 4 Appiroved wl haegeS Lj Date Bond No.: PB11511003243 Premium:$12,875.00 SUBDIVISION IMPROVEMENT PERFORMANCE BOND Whereas, the City Council of the City of Fresno, State of California, and Mazen Alhindi and Anjanette Alhindi, Husband and Wife as Joint Tenants ("principal") will be entering into an agreement whereby principal agrees to install and complete certain designated public improvements, which said agreement, identified as Subdivision Agreement for the Final Map of Tract No. 5508 is hereby referred to and made a part hereof; and Whereas, principal is required under the terms of said agreement to furnish a bond for the faithful performance of said agreement. Now, therefore, we, the principal and Philadelphia Indemnity Insurance Company , as surety, are held and firmly bound unto the City of Fresno ("C�y"},*lnkthe penal sum of two million Five hundred fifteen thousand and Ivo o dollars ($ 515,000.00*** ) lawful money of the United States,for the payment of which sum well and truly to be made, we bind ourselves, our heirs, successors, executors and administrators,jointly and severally, firmly by these presents. 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 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 therefor, 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 thereunder or the specifications accompanying the same shall in anywise 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 ` November 20 , 2018 Principal: Mazen Alhindi and Anjanette Alhindi, Husband and Wife as Joint Tenants By: r- (Principal Surety: Philad hia l;,d_ernnity Insurance Company By: (Surety) rney-In-Fact:,lustir,A Smit 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 Fresno ) On [1 1?,V 1 �o Obefore me, Roberta Voss, Notary Public Date Here Insert Name and Title of the Officer personally appeared Justin A. Smit Name(s) of Signer(s) who proved to me on the basis of satisfactory evidence to be the person() whose name(30 is/Exx subscribed to the within instrument and acknowledged to me that hemexecuted the same in hisftoog authorized capacity(ies),and that by his/MN)MMsignatureN on the instrument the person(), or the entity upon behalf of which the personk) 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. ROBERTAVOSS WITNESS my hand and official seal. t NOTARY PUBLIC-CALIFORNIA COMMISSION 0 2228217 ■ FRESNO COUNTY My Comm.Exp,January 19,2022 Signature CQ Signature of Na#ary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date: Number of Pages: Signer(s) Other Than Named Above: Capacity(ies) Claimed by Signer(s) Signer's Name, Signer's Name: ❑ Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 485 PHILADELPHIA INDEMNITY INSURANCE COMPANY One Bala Plaza,Suite 100 Bala Cynwyd,PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and existing under the laws of the Commonwealth of Pennsylvania,does hereby constitute and appoint Justin A.Smit and Roberta Voss of Dibuduo and DeFendis insurance Brokers.LLC.,its true and lawful Attorney-in-fact with full authority to execute on its behalf bonds,undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof,issued in the course of its business and to bind the Company thereby,in an amount not to exceed 55,0n0,0110.00 This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14°i of November,2016. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (l) Appoint Attomey(s) in Fact and authorize the Attorney(s) in Fact to execute on behalf of the Company bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney-in-Fact and revoke the authority given. And,be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile,and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14TH DAY OF NOVEMBER,2016. % (Seal) �m.,�,„* Robert D.O'Leary Jr.,President&CEO Philadelphia Indemnity Insurance Company On this 14'"day of November,2016,before me carne the individual who executed the preceding instrument,to me personally known,and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is the Corporate seat of said Company;that the said Corporate Seal and his signature were duly affixed. MNOr 1'N . NN ,naww s� Hwy Horord,Nohry Po011e yUry 041pignrmlo.np•.HUM 1GmMf[h`ItS� ^ NY W�11hU1 qM1 H[pins ,eu.n nn w. .�o-wrm v 0'x-J Ori Notary Public: residing at: Bala Cynwyd.PA (Notary Seal) My commission expires: January 8,2018 I,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 14"day of November,2016 are true and correct and are still in full force and effect.I do further certify that Robert D.O'Leary Jr.,who executed the Power of Attorney as President,was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof 1 have subscribed my name and oMned the facsimile seal of each Company this j ' day of ""'�"" ,20 ff,. 3a N .. ..• ,PGs 6-- 192 3 Cdward Sayago,Corporate Secretary _ r yarn,fir;'L7i PHILADELPHIA INDEMNITY INSURANCE COMPANY Bond No.: PB11511003243 SUBDIVISION IMPROVEMENT PAYMENT BOND Whereas, the City Council of the City of Fresno, State of California and Mazen Alhindi and Anjanette Alhindi, Husband and Wife as Joint Tenants ("principal") have entered or will be entering into an agreement whereby the principal agrees to install and complete certain designated public improvements, which agreement, identified as Subdivision Agreement for the Final Map of Tract No. 5608 , is hereby referred to and made a part hereof; and Whereas, under the terms of the agreement, the principal is required before entering upon the performance of the work, to file a good and sufficient payment bond with the City of Fresno ("City") to secure the claims to which reference is made in Title 15 (commencing with Section 3082) of Part 4 of Division 3 of the Civil Code of the State of California. Now, therefore,the principal and Philadelphia Indemnity Insurance Company as corporate surety, are held firmly bound unto the City and all contractors, subcontractors, laborers, material men, and other persons employed in the performance of the agreement and referred to in Title 15 (commencing with Section 3082) of Part 4 of Division 3 of the Civil Code in the sum of two hundred seventy one thousand and No/100*** dollars ($ 271000.00*** , for materials furnished or labor thereon of any kind, or for amounts due under the Unemployment Insurance Act with respect to this work or labor, that the surety will pay the same In an amount not exceeding the amount hereinabove set forth, and also in case suit is brought upon this bond, will pay, in addition to the face amount thereof, costs and reasonable expenses and fees, including reasonable attorney's fees, incurred by City in successfully enforcing this obligation, to be awarded and fixed by the court, and to be taxed as costs and to be included in the judgment therein rendered. It is hereby expressly stipulated and agreed that this bond shall inure to the benefit of any and all persons, companies, and corporations entitled to file claims under Title 15 (commencing with Section 3082) of Part 4 of Division 3 of the Civil Code, so as to give a right of action to them or their assigns in any suit brought upon this bond, Should the condition of this bond be fully performed, then this obligation shall become null and void, otherwise it shall be and remain in full force and effect. The surety hereby stipulates and agrees that no change, extension of time, alteration, or addition to the terms of the agreement 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, alteration, or addition. In witness whereof, this instrument has been duly executed by the principal and surety above named, on November 20 F 20 18 . Principal: Mazen Alhindi and Anjanette Alhindi, Husband and Wife as Joint Tenants By: _ (Pflncipal) Surety: Philadelphia Indernnity Insuras.ce Company By' - ( ureiy)Attcr^oy-In-Fact;Justin A Smit 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 Fresno ) On ti0117before me, Roberta Voss Notary Public Date Here Insert Name and Title of the Officer personally appeared Justin A. Smit Name(s)of Signer(s) who proved to me on the basis of satisfactory evidence to be the personm whose namem ishxx subscribed to the within instrument and acknowledged to me that heexecuted the same in his$booM authorized capacity(ies), and that by his/WTOWsignatureN on the instrument the person(), or the entity upon behalf of which the personk) 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. ROBERTA VOSS WITNESS my hand and official seal. NOTARY PUBLIC.CALIFORNIA w m COMMISSION N 2228217 E FRESNO COUNTY Signature-_ 1 -�51,_ My Comm,Exp.January 19,20222 Signature of Notary Public Place Notary Seal Above OPTIONAL Though this section is optional, completing this information can deter alteration of the document or fraudulent reattachment of this form to an unintended document. Description of Attached Document Title or Type of Document: Document Date; Number of Pages: Signer(s) Other Than Named Above: Capacity(les) Claimed by Signer(s) Signer's Name., Signer's Name: ❑Corporate Officer — Title(s): ❑Corporate Officer — Title(s): ❑ Partner — ❑ Limited ❑General ❑ Partner — ❑ Limited ❑General ❑ Individual ❑Attorney in Fact ❑ Individual ❑Attorney in Fact ❑Trustee ❑ Guardian or Conservator ❑Trustee ❑Guardian or Conservator ❑Other: ❑ Other: Signer Is Representing: Signer Is Representing: 486 PHILADELPHIA INDEMNITY INSURANCE COMPANY One Bala Plaza,Suite 100 Bala Cynwyd,PA 19004-0950 Power of Attorney KNOW ALL PERSONS BY THESE PRESENTS:That PHILADELPHIA INDEMNITY INSURANCE COMPANY(the Company),a corporation organized and existing under the laws of the Commonwealth of Pennsylvania,does hereby constitute and appoint Justin A.Smit And Roberta Voss of Dibuduo and D_eFendis Insurance Brokers,LLC.,its true and lawful Attomey-in-fact with full authority to execute on its behalf bonds,undertakings,recognizances and other contracts of indemnity and writings obligatory in the nature thereof,issued in the course of its business and to bind the Company thereby,in an amount not to exceed 15,000,000A This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14°i of November,2016. RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the Company: (1) Appoint Attomey(s) in Fact and authorize the Attomey(s) in Fact to execute on behalf of the Company bonds and undertakings,contracts of indemnity and other writings obligatory in the nature thereof and to attach the seal of the Company thereto; and (2) to remove, at any time, any such Attorney-in-Fact and revoke the authority given. And,be it FURTHER RESOLVED: That the signatures of such officers and the seal of the Company may be affixed to any such Power of Attorney or certificate relating thereto by facsimile,and any such Power of Attorney so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking to which it is attached. IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE COMPANY HAS CAUSED THIS INSTRUMENT TO BE SIGNED AND ITS CORPORATE SEALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 14TH DAY OF NOVEMBER,2016. U41 r V S f i27�I rr (Seal) .......... D tl Robert D.O'Leary Jr.,President&CEO Philadelphia Indemnity Insurance Company On this 14"day of November,2016,before me came the individual who executed the preceding instrument,to me personally known,and being by me duly sworn said that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY;that the seal affixed to said instrument is the Corporate seal of said Company;that the said Corporate Seal and his signature were duly affixed. =K"A051d,N0tNr7 F MN V opy 1Y�ICpnSio Ml,. Mr.!/Jan./.rJl�`� Notary Public: residing at: Bala Cywyd,PA (Notary Seal) My commission expires: January 8,2018 I,Edward Sayago,Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY,do hereby certify that the foregoing resolution of the Board of Directors and this Power of Attorney issued pursuant thereto on this 14`I'day of November,2016 are true and correct and are still in full force and effect.I do further certify that Robert D.O'Leary Jr.,who executed the Power of Attorney as President,was on the date of execution of the attached Power of Attorney the duly elected President of PHILADELPHIA INDEMNITY INSURANCE COMPANY, In Testimony Whereof I have subscribed my name and af-Tkud?he t'a�aioniIt seal ofeach Company this day of Edward Sayago,Corporate Secretary PHILADELPHIA INDEMNITY INSURANCE COMPANY 11/29/2018 Philadelphia Indemnity Insurance Company-Company Profile-Best's Credit Rating Center Philadelphia Indemnity Insurance Company A.M. Best#: 003616 NAIC#: 18058 FEIN#: 231738402 Domiciliary Address pnmcW04=g*Ratmg One Bala Plaza Suite 100 aew Bala Cynwyd, PA 19004-1403 !«+ Or United States Assigned to insurance companies that have, in our Web: www.phly.com opinion, a superior ability to Phone: 610-617-7900 meet their ongoing insurance Fax: 610-617-7940 obligations. View additional news, reports and products for this company. Based on A.M. Best's analysis, 058633 -Tokio Marine Holdings, Inc. is the AMB Ultimate Parent and identifies the topmost entity of the corporate structure. View a list of operating insurance entities in this structure. Best's Credit Ratings Financial Strength Rating View Definition Rating: A++ (Superior) Affiliation Code: p (Pooled) Financial Size Category: XV ($2 Billion or greater) Outlook: Stable Action: Affirmed Effective Date: December 01, 2017 Initial Rating Date: June 30, 1981 Long-Term Issuer Credit Rating View Definition Long-Term: aa+ Outlook: Stable Action: Affirmed http://ratings.ambest.com/SearchResuIts.aspx?AltSrc=9 1/4 11/29/2018 Philadelphia Indemnity Insurance Company-Company Profile-Best's Credit Rating Center Effective Date: December 01, 2017 Initial Rating Date: June 03, 2005 u Denotes Under Review Best's Rating Best's Credit Rating Analyst Rating Issued by: A.M. Best Rating Services, Inc. Associate Director : Robert Raber Senior Director: Gregory T. Williams Disclosure Information Disclosure Information Form View A.M. Best's Rating Disclosure Form Press Release A.M. Best Affirms Credit Ratings of Philadelphia Insurance Companies' Members December 01, 2017 Rating History A.M. Best has provided ratings & analysis on this company since 1981. Financial Strength Rating Effective DateRating 12/1/2017 A++ 9/21/2016 A++ 6/4/2015 A++ 5/8/2014 A++ 2/28/2013 A++ Long-Term Issuer Credit Rating Effective DateRating 12/1/2017 aa+ 9/21/2016 aa+ http://ratings.ambest.com/SearchResuIts.aspx?AltSrc=9 2/4 11/29/2018 Philadelphia Indemnity Insurance Company-Company Profile-Best's Credit Rating Center 6/4/2015 aa+ 5/8/2014 aa+ 2/28/2013 aa+ Best's Credit Reports Best's Credit Report -Where applicable, includes Best's Financial Strength Rating and rationale along with comprehensive analytical commentary, detailed business overview and key financial data. Report Revision Date: 11/6/2018 (represents the latest significant change). T--- Historical Reports are available in Best's Credit Report Archive. View additional news, reports and products for this company. Press Releases Date Title Dec 01,2017 A.M.Best Affirms Credit Ratings of Philadelphia Insurance Companies' Members Sep 21,2016 A.M. Best Affirms Credit Ratings of Philadelphia Insurance Companies' Members Jun 04,2015 A.M. Best Affirms Ratings of Philadelphia Insurance Companies' Members May 08,2014 A.M.Best Affirms Ratings of Philadelphia Insurance Companies' Members Feb 28,2013 A.M. Best Affirms Ratings of Philadelphia Insurance Companies Members Sep 19,2011 A.M. Best Upgrades Ratings of Philadelphia Insurance Companies and Its Members Jul 09,2010 A.M.Best Revises Outlook to Positive for Philadelphia Insurance Companies and Its Members Jun 12,2009 A.M. Best Upgrades Issuer Credit Ratings of Philadelphia Insurance Companies and Its Members Dec 05,2008 A.M. Best Withdraws Rating of Philadelphia Consolidated Holding Corp. Following Its Acquisition by Tokio Marine Holdings May 29, 2008 A.M. Best Upgrades Rating of Philadelphia Consolidated Holding Corp.and Affirms the Ratings of Its Subsidiaries 1 2 Page size: 10 13 items in 2 pages Find a Best's Credit Rating Enter a Company Name FGo] Advanced Search How to Got a A+ Best's Crede Rating http://ratings.ambest.com/SearchResults.aspx?AltSrc=9 314 11129/2018 Philadelphia Indemnity Insurance Company-Company Profile-Best's Credit Rating Center Best's Credl RoUngs 0 Moble App European Union Disclosures A.M. Best-Europe Rating Services Limited (AMBERS), a subsidiary of A.M. Best Rating Services, Inc., is an External Credit Assessment Institution (ECAI)in the European Union (EU).Therefore, Credit Ratings issued and endorsed by AMBERS may be used for regulatory purposes in the EU as per Directive 2006/48/EC. Australian Disclosures A.M. Best Asia-Pacific Limited (AMBAP),Australian Registered Body Number(ARBN No.150375287), is a limited liability company incorporated and domiciled in Hong Kong.AMBAP is a wholesale Australian Financial Services(AFS) Licence holder(AFS No. 411055)under the Corporations Act 2001. Credit Ratings emanating from AMBAP are not intended for and must not be distributed to any person in Australia other than a wholesale client as defined in Chapter 7 of the Corporations Act. AMBAP does not authorize its Credit Ratings to be disseminated by a third-party in a manner that could reasonably be regarded as being intended to influence a retail client in making a decision in relation to a particular product or class of financial product.AMBAP Credit Ratings are intended for wholesale clients only, as defined. 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Best Company, Inc. and/or its affiliates ALL RIGHTS RESERVED. http://ratings.ambest.com/SearchResuIts.aspx?AltSrc=9 4/4 11/29/2018 Company Profile CALIFORNIA DEPARTMENT OFINSURANJ COMPANY PROFILE Company Profile Company Search Company Information Company Information PHILADELPHIA INDEMNITY INSURANCE COMPANY Old Company ONE BALA PLAZA SUITE 100 Names BALA CYNWYD, PA 19004 Agent for Service 877-438-7459 Reference Information Old Company Names Effective Date NAIC Group List Lines of Business Agent For Service Workers' Compensation Vivian Imperial Complaint and 818 WEST SEVENTH STREET Request for SUITE 930 Action/Appeals LOS ANGELES CA 90017 Contact Information Financial Statements Reference Information PDF's Annual Statements 18058 Quarterly Statements California Company ID #: 3576-6 Company Complaint Company Date Authorized in California: 01/27/1993 Performance & Comparison Data License Status: UNLIMITED-NORMAL Company Company Type: Property&Casualty Enforcement Action Composite [State of Domicile: PENNSYLVANIA Complaints Studies Additional Info back to top Find A Company Representative In Your Area NAIC Group List View Financial Disclaimer NAIC Group #: 3098 Tokio Marine Holdings Inc GRP Lines Of Business The company is authorized to transact business within these lines of insurance. For an explanation of any of these terms, please refer to the glossary. AUTOMOBILE BOILER AND MACHINERY BURGLARY DISABILITY FIRE LIABILITY MARINE MISCELLANEOUS PLATE GLASS SPRINKLER SURETY back to top https://interactive.web.insurance.ca.gov/companyprofile/companyprofi le?event=companyProfile&doFu nction=getCompanyProfiile&eid=12973 1/2 11/29/2018 Company Profile © 2008 California Department of Insurance https://interactive.web.insurance.ca.gov/companyprofile/companyprofile?event=companyProfile&doFunction=getCompanyProfiile&eid=12973 2/2 w AUTOMATICALLY RENEWABLE ~ C T3 CALIFORNIA BANK u � {�Q�V1 TRUST j� 0 1- YISSUED AT Soy D N, Pbdrvi bg 5TH I Do OFFICE i 1& n rA DATE )I/ I� 'V (CITY OR TOWN) (STATE) w TM�� At - U 0 (CUSTOMER NAME) (CUSTOMER NUMBER) y, U DOLLARS $ Ce f' w C LX j HAS TODAY BEEN DEPOSITED WITH CALIFORNIA,-BANK & TRUST PAYABLE TO11AOf OR ORDER UPON MATURITY < (t) AS HEREINAFTER SPECIFIED AND UPON PRESENTATION A D S RRENDER OF THIS CERTIFI ATEA PERLY ENDORSED.AT THE ABOVE OFFICE. f ^ THE MATURITY OF THIS CERTIFICATE WILL BE AFTER pA .AND SUCH MATURITY WILL BE AIJTOMATICALLY EXTENDED FOR SUCCESSIVE LIKE PERIODS w 0 UNLESS (A)AT LEAST TEN DAYS PRIOR TO SIJCH ORIGIN L 00 ANY EXTENDED MATLRITY,THIS BANK HAS SENT WRITTEN NOTICE TO THE PAYEE OR OTHER HOLDER THEN DESIGNATED ON ITS RECORDS OF BANK'S ELECTION TO PAY THE DEPOSIT AT SUCH ORIGINAL OR ANY EXTENDED MATURITY,OR(B)UPON OR WITHIN TEN DAYS AFTER SUCH ORIGINAL OR ANY EXTENDED 0 MATURITY DATE,THIS CERTIFICATE ISPRESENTEDANOSURRENDEREDFQ PAYMENT. L>: SAID DEPOSIT BEARS SIMPLE INTEREST AT THE RATE OF- I U% %PER ANNUM FROM DATE HEREOF UNTIL ULTIMATE MATURITY,AS ABOVE PROVIDED,AND SUCH INTEREST WILL I BE PAID OR CREDITED AT EACH SUCCESSIVE MATURITY DATE IN ACCORDANCE WITH THE WRITTEN INSTRUCTIONS OF THE PAYEE OR OTHER HOLDER THEN DESIGNATED ON THE RECORDS OF THIS BANK-THE RATE OF INTEREST IS SUBJECT TO CHANGE BY BANK WITHOUT NOTICE,TO THE EXTENT NECESSARYTO COMPLY WITH ANY LAW OR GOVERNMENTAL REGULATION AFFECTING THE DEPOSIT. ORIZEDSIGNATURE OPS-1(05/09) r, 1015 CASA DI FORTUNA, LLC. 2727 W.LAKE VAN NESS CIR. FRESNO,CA 93711 (559)709-1190 r J 11-204/1210 DATE C PAY TO THE 0 j CJ ORDER OF OLS 8 ( B CAUFORNIA BA/K Twu n FOR .5 11"0000 LO L SII" I: L 2 100 204 21: 5 79 5 L L4