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BOARD OF DIRECTOR
OATH OF OFFICE
STATE OF COLORADO
BOULDER, LARIMER, AND WELD COUNTIES
LITTLE THOMPSON WATER DISTRICT
§32-1-901, C.R.S., and
Colorado Constitution Article 12, §9
I, William Prewitt, will faithfully support the Constitution of the United States and of the S_tate of Colorado, and
the laws made pursuant thereto, and will faithfully perform the duties of the office of Director/Of Little hompson Water
District, upon which I am about to enter.
Signature of Oath Taker
Subscribed and sworn to before me this 1 .1-11 day of A , 20 17.
BY:
Signature/Tjt e Oath Administrator
IF SWORN OR AFFIRMED BEFORE A NOTARY THE FOLLOWING SHOULD BE COMPLETED.
STATE OF COLORADO
j ss.
COUNTY OF Lr ! v►l
Subscribed and sworn to before me this 3— day of
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(Notary Signature)
2017-1089
5000-15
TOKIO MARINE
HCC
Tuesday, November 15, 2016
American Contractors Indemnity Company
601 S. Figueroa St., Suite 1600 Los Angeles, CA 90017
main (310) 649 0990 facsimile (310) 645 9274
CONTINUATION CERTIFICATE
BOND NUMBER BOND DESCRIPTION
BOND AMOUNT I EFFECTIVE DATE EXPIRATION DATE
P71132
CO / POSITION SCHEDULE
$36,000.00
5/31/2016
5/31/2017
Principal:
LITTLE THOMPSON WATER DISTRICT
835 E. HWY 56
BERTHOUD, CO 80513
Obligee:
-SAME AS PRINCIPAL -
CO
THIS BOND CONTINUES IN FORCE TO THE ABOVE EXPIRATION DATE CONDITIONED AND PROVIDED
THAT THE LOSSES OR RECOVERIES IN IT AND ALL ENDORSEMENTS SHALL NEVER EXCEED THE
PENALTY SET FORTH IN THE BOND AND WHETHER THE LOSSES OR RECOVERIES ARE WITHIN THE
FIRST AND/OR SUBSEQUENT OR WITHIN ANY EXTENSION OR RENEWAL PERIOD, PRESENT, PAST OR
FUTURE. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED.
Signed and dated this 15th day of November , 2016 .
E wconronalEo
s Wt. SEPT. 25.1900 :-f
American Contractors Indemnity Company
NANCY -JO TULLEY , Attorney in Fact
Agent:
Insurance Associates, Division of Arthur J. Gallagher Risk Mgmt Svcs - Boulder
PO BOX 4190
ESTES PARK, CO 80517
HCCSOZZM CONT INUATION0612016
TOKIO MARINE
HCC
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS:
That American Contractors Indemnity Company of the State of California, a California corporation, does hereby appoint,
NANCY -JO TULLEY
its true and lawful Attorney -in -Fact, with full authority to execute on its behalf bond number P71132 , issued
in the course of its business and to bind the Company thereby, in an amount not to exceed
Thirty-six thousand and 00/100 ( $36,000.00 ).
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following resolutions adopted by
the Board of Directors of AMERICAN CONTRACTORS INDEMNITY COMPANY at a meeting duly called and held on the 1s1 day of
September, 2011.
"Be it Resolved, that the President, any Vice -President, any Assistant Vice -President, any Secretary or any Assistant Secretary shall be and
is hereby vested with full power and authority to appoint any one or more suitable persons as Attorney(s)-in-Fact to represent and act for and
on behalf of the Company subject to the following provisions:
Attorney -in -Fact may be given full power and authority for and in the name of and on behalf of the Company, to execute, acknowledge and
deliver, any and all bonds, recognizances, contracts, agreements or indemnity and other conditional or obligatory undertakings, including any
and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts, and any and all
notices and documents canceling or terminating the Company's liability thereunder, and any such instruments so executed by any such
Attorney -in -Fact shall be binding upon the Company as if signed by the President and sealed and effected by the Corporate Secretary.
Be it Resolved, that the signature of any authorized officer and seal of the Company heretofore or hereafter affixed to any power of attorney
or any certificate relating thereto by facsimile, and any power of attorney or certificate bearing facsimile signature or facsimile seal shall be
valid and binding upon the Company with respect to any bond or undertaking to which it is attached."
The Attorney -in -Fact named above may be an agent or a broker of the Company. The granting of this Power of Attorney is specific to this
bond and does not indicate whether the Attorney -in -Fact is or is not an appointed agent of the Company.
IN WITNESS WHEREOF, American Contractors Indemnity Company has caused its seal to be affixed hereto and executed by its President
on this 1st day of December 2014.
=U
INCORPORATED i=I
IV, i, SEPT. 25. 1990 : ^:
;'.o
State of California
County of Los Angeles SS:
AMERICAN CONTR TORS INDEMNITY COMPANY
.
By: l•`tA
Adam Pessin, President
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.
On this 1st day of December 2014, before me, Maria G. Rodriguez -Wong , a notary public, personally appeared Adam S. Pessin, President of
American Contractors Indemnity Company, who proved to me on the basis of satisfactory evidence to be the person whose name is
subscribed to the within instrument and acknowledged to me that he executed the same in his authorized capacity, and that by his signature
on the instrument the person, 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.
Signature
MARIA G. ROORIGUEZ•WONG
Commission # 2042771
Notary Pubic • California
(seal) \`' t% Los Angelis County -
Comm. EI Irss as 20 2017
I, Kio Lo, Assistant Secretary of American Contractors Indemnity Company, do hereby certify that the Power of Attorney and the resolution
adopted by the Board of Directors of said Company as set forth above, are true and correct transcripts thereof and that neither the said
Power of Attorney nor the resolution have been revoked and they are now in full force and effect.
IN WITNESS WHEREOF, I have hereunto set my hand this 15th day of November , 2016 .
Bond No.
P71132
Agency No. 15474
`\ oa\`RACiOR61/4o'%
U i HC0RP0RATE0 j y
Fitt SEPT.25, 1990 : -(
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Kio Lo, A ant Secretary
HCCSZZ POAACIC 04/2016
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