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Western Surety Company
CONTINUATION CERTIFICATE
Western Surety Company hereby continues in force Bond No. 694808 briefly
described as CLERK/RECORDER COUNTY OF WELD
for STEVE MORENO
, as Principal,
in the sum of $ FIVE THOUSAND AND NO/ 100 Dollars, for the term beginning
January 01 , 2009 , and ending _ January 01 , 2010 , subject to all
the covenants and conditions of the original bond referred to above.
This continuation is issued upon the express condition that the liability of Western Surety Company
under said Bond and this and all continuations thereof shall not be cumulative and shall in no event exceed
the total sum above written.
Dated this 03 day of December , 2008
WESTERN URETY COMPANY
By
Paul T. Bruflat, S for Vice President
THIS "Continuation Certificate" MUST BE FILED WITH THE ABOVE BOND.
Form 90-A-4.2002
.-6trtunc& K
2OO9-OO33
Western Surety Company
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That WESTERN SURETY COMPANY, a corporation organized and existing under the laws of the State of South Dakota,
and authorized and licensed to do business in the States of Alabama, Alaska, Arizona, Arkansas, California, Colorado,
Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky,
Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New
Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania,
Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Vermont, Virginia, Washington, West Virginia,
Wisconsin, Wyoming, and the United States of America, does hereby make, constitute and appoint
Paul T. Bruflat
of
Sioux Falls
State of South Dakota , its regularly elected Senior Vice President
as Attorney -in -Fact, with full power and authority hereby conferred upon him to sign, execute, acknowledge and deliver for
and on its behalf as Surety and as its act and deed, the following bond:
One CLERK/RECORDER COUNTY OF WELD
bond with bond number 69451808
for STEVE MORENO
as Principal in the penalty amount not to exceed: $5,000.00
Western Surety Company further certifies that the following is a true and exact copy of Section 7 of the by-laws of Western Surety
Company duly adopted and now in force, to -wit:
Section T All bonds, policies, undertakings, Powers of Attorney, or other obligations of the corporation shall be executed in the corporate
name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the
Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint
Attorneys -in -Fact or agents who shall have authority to issue bonds, policies, or undertakings in the name of the Company. The corporate
seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The
signature of any such officer and the corporate seal may be printed by facsimile.
In Witness Whereof, the said WESTERN SURETY COMPANY has caused these presents to be executed by its
2008
Senior Vice President with the corporate seal affixed this 03 day of December
ATTEST
L. Nelson, Assistant Secretary
STATE OF SOUTH DAKOTA
SS
COUNTY OF MINNEHAHA
By
On this 03 day of December 2008
Paul T. Bruflat and
WE F,R'N SUREX9 COMPANY
Paul T. Brunt, Senior Vice President
, before me, a Notary Public, personally appeared
L. Nelson
who, being by me duly sworn, acknowledged that they signed the above
and Assistant Secretary, respectively, of the said WESTERN SURETY
be the voluntary act and deed of said Corporation.
455y5s5y555s555555s5555sy +
D. KRELL
r SEAL NOTARY PUBLIC SEAL r
.SOUTH DAKOTA
�f
45�,S55555555555555hv5555♦
My Commission Expires November 30, 2012
Power of Attorney as Senior Vice President
COMPANY, and acknowledged said instrument to
Notary Public
Form F1975-9-2006
w
Western Surety Company
CHANGE NOTICE
WESTERN SURETY COMPANY is hereby requested to make the following additions to and -or deductions
from the Schedule of Employees attached to Bond No. 158425465 , issued to
Weld County _Human_Resources.
Address Greeley, CO
subject to all the terms, limitations and conditions therein set forth.
This acceptance notice is issued with the distinct understanding that the liability of WESTERN SURETY
COMPANY shall under no circumstances be cumulative, and shall not exceed the amount of bond in effect as to any
employee or employees when the dishonest act of the employees shall have been committed, and shall in no event
exceed the maximum amount at any time specified as to such employee or employees.
ADDITIONS
DATE OF
ADDITION
ITEM
NO.
NAME
POSITION
LOCATION
AMOUNT
CHARGE
12-08-08
100
Sadie Medrano
Deputy District
$ 5,000.00
$
NA
Attorney
12-08-08
101
Jennifer Schneider
Deputy District
5,000.00
NA
Attorney
DEDUCTIONS
DATE OF
DEDUCTION
ITEM
NO.
NAME
POSITION
LOCATION
AMOUNT
PREMIUM
CHARGE
$
$
Dated this
8th day of __. _ December
NOTE--; Thk fonatihust be signed by
the Era rlogeffi'Ifa'Co-partnership, by
a membeEbtrheFirm; if a corporation,
by a duly authorized officer.
Form 216-11-2002
i��lxnumve 1-5-O
2008
Weld County Human Resources
(EMPLOYER)
By
MPLOYER'S SIGNATURE)
WESTE'NSURE COMPANY
By
PAUL T. BRUFLAT. SENIOR E PRESIDENT
ODJ�
Western Surety Company
CHANGE NOTICE
WESTERN SURETY COMPANY is hereby requested to make the following additions to and -or deductions
from the Schedule of Employees attached to Bond No.
158425466 _ —, issued to
Address Greeley, CO
Weld Coi uuman_R-eGou rr eG
subject to all the terms, limitations and conditions therein set forth.
This acceptance notice is issued with the distinct understanding that the liability of WESTERN
effect SURETY
Tny_.
_COMPANY shall under no circumstances be cumulat ,.und_sb ll_nut exceed the amaunt_af
employee or employees when the dishonest act of the employees shall have been committed, and shall in no event
exceed the maximum amount at any time specified as to such employee or employees.
ADDITIONS
DATE OF
ADDITION
ITEM
NO.
11-04-08 97.
11 -04 -OS 98.
11-04-08 99.
DATE OF
DEDUCTION
11 -04 -OS
ITEM
NO.
15.
NAME
Ryan Farr
Katharine Johnson
Emela Bulijko
NAME
Robert Frick
POSITION
Deputy District
Attorney
Deputy District
Attorney
Deputy District
Attorney
DEDUCTIONS
POSITION
Deputy District
Attorney
Dated thi<� 4th _day of
November 2008
- "� ---'erm
ea Ps
= to s
'y1: i}L
N(gro This st be signed by
the t04) ,to -partnership, by
a membi4"dtMliglirm; if a corporation,
by a duly authorized officer. /
,
Form216-11-2002-C>7vit[...0/iC tc,vi
1-5 CC/
LOCATION
LOCATION
AMOUNT
$ 5,000.00
5,000.00
5,000.00
AMOUNT
5,000.00
PREMIUM
CHARGE
NAP
10.OOAP
10.00AP
PREMIUM
CHARGE
Weld Human
Resources
MPBy
WEST SURE COMPANY
By -
MPLOYER'S SIGNATURE)
PAULLA�"E PRESIDENT
NRI
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