HomeMy WebLinkAbout20141995.tiff DISTRICT COURT, COUNTY OF WELD, STATE OF
COLORADO
901 9,h A`nue RECEIVED
Greeley. Colorado 806,1 e
970-351-7300
JUN 2 6 2C,4
PETITIONER: IN RE sTtPjAND , WELD COUNTY
F$(j yy
SANITATION METROPOLITAN DISTRICT COMMISSIONER
Mar>Ann M. Nietieadv Number:
USE ON`Y6A
nn
McGeady Seros. P.C.
Case450 L. 17th Ace., Suite 4011
Denver, Colorado 8020;-1214
Phone: (303) 59'-4380 Div.: 1 Co n.:
Env 13031592-4385
E-mail: mmcgeady4rncgeadysisneros.eom
k bow ers,a:mcgeadysi snero s.eo m
Atty. Reg. 12417
OATH OF DIRECTOR
The undersigned solemnly swears (or affirms) that she will Iaithnilly perform the duties
of this office as required he law and will support the Constitution of the Irnited States, the
Constitution of the State of Colorado. and the laws i - pursuant thereto.
lean Go
Addres : 7882 Sweet Water Road
Lone free. CO 80124
S'.A}E. O1- COLORADO
1 ss.
CO( NTY OF O tVv (
Subscribed and sworn to before me this 3 °day of �� 1(' . 2014.
WITNESS my hand and official seal. C
TONI SERRA -- -C `
NOTARY PUBLIC No "1, Public
STATE OF COLORADO
NOTARY ID 20094001459
MV C041MISS�ON EXPiRE6 JANUARY A,2017 C - / _ �L I I
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Colorado Special Districts Property and Liability Pool
Comprehensive Crime Certificate Holder Declaration
Master Coverage Policy Number: CCP0037259
Certificate Number: 27C60721-1146 Coverage Period: 1/1/2014 Until Cancelled
Named Member: Billing Period: 1/1/2014 to 1/1/2015
Resource Colorado Water 8 Sanitation Metropolitan District Broker of Record:
c/o Special District Management Services, Inc.
141 Union Blvd., Suite 150
Lakewood, CO 80228
Covered ERISA Plan:
Coverage, Limits of Insurance and Deductibles Limits:
Public Employee Dishonesty Coverage: $5,000
-Limit is Per Loss
-Faithful Performance of Duty
-Officers, Directors, and Trustees
-Welfare and Pension Plan ERISA Compliance
if Covered Plan is shown on application
-Volunteer Workers as Employees
Forgery or Alteration Coverage: $5,000
Theft, Disappearance, and Destruction Coverage:
Inside Premises $5,000
Outside Premises $5,000
Computer and Funds Transfer Fraud Coverage:
Limits are equal to Employee Dishonesty Coverage or$25,000 whichever is less
Debit, Credit or Charge Card Forgery Coverage:
Limits are equal to Employee Dishonesty Coverage or$25.000 whichever is less
Money Orders and Counterfeit Paper Currency Coverage: $5.000
Crime Deductible: $100
Contribution: $133.31
Policy Forms: CR 00260506 Government Crime Policy
CR 25070300 Include Specified Directors or Trustees on Committee as Employees
CR 25080300 Include Specified Non-Compensated Officers as Employees
CR 25090300 Include Volunteer Workers as Employees
CR 25190506 Add Faithful Performance of Duty
CR 25120300 Include Treasurers or Tax Collectors as Employees
CR 02151104 Colorado Changes
CR 25200300 Debit,Credit or Charge Card Forgery
This Certificate Holder Declaration is made and is mutually accepted by the CSD Pool and the Named Member
subject to all terms which are made a part of the Master Comprehensive Crime Policy. This Certificate
represents only a brief summary of coverages. Please refer to the Master Policy Document for actual coverage,
terms, conditions, and exclusions.
11uusions./
Countersigned by: "14. '" `"Q`�- Thursday. December 05. 2013
Authorized Representative
Entity ID#: 60721
DISTRICT COURT,COUNTY OF WELD, STATE OF
COLORADO
901 9th Avenue
Greeley. Colorado 80631
970-351-7300
PETITIONER: IN RE RESOURCE WATER AND
SANITATION METROPOLITAN DISTRICT
MaryAnn M. McGeady A COURT USE ONLY
McGeady Sisneros, P.C. Case Number: 2004 CV 1567
450 E. 17`h Ave., Suite 400
Denver, Colorado 80203-1214
Phone: (303) 592-4380 Div.: 1 Ctrm.:
Fax: (303) 592-4385
E-mail: mmcgeady(2mcgeadysisneros.com
Atty. Reg. #: 12417
OATH OF DIRECTOR
The undersigned solemnly swears (or affirms) that she will faithfully perform the duties
of this office as required by law and will support the Constitution of the United States, the
Constitution of the State of Colorado, and the laws made pursuant thereto.
Ton(':( , . --,
L. Serra
Address: 8897 Cloverleaf Circle
Parker. CO 80134
STATE OF COLORADO )
ss.
COUNTY OF Y/ )
Subscribed andlyvo 1 to before me this /(o day of i i , 2014.
WITNESS my hand and official seal. )
INbtary4ub
T STEELE
My commi sion e -,f1QTARY PI BSIC
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NOTARY ID 20004029771
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Colorado Special Districts Property and Liability Pool
Comprehensive Crime Certificate Holder Declaration
Master Coverage Policy Number: CCP0037259
Certificate Number: 27C60721-1146 Coverage Period: 1/1/2014 Until Cancelled
Named Member: Billing Period: 1/1/2014 to 1/1/2015
Resource Colorado Water& Sanitation Metropolitan District Broker of Record:
do Special District Management Services, Inc.
141 Union Blvd., Suite 150
Lakewood, CO 80228
Covered ERISA Plan:
Coverage, Limits of Insurance and Deductibles Limits:
Public Employee Dishonesty Coverage: $5,000
- Limit is Per Loss
-Faithful Performance of Duty
-Officers, Directors, and Trustees
-Welfare and Pension Plan ERISA Compliance
if Covered Plan is shown on application
-Volunteer Workers as Employees
Forgery or Alteration Coverage: $5,000
Theft, Disappearance, and Destruction Coverage:
Inside Premises $5,000
Outside Premises $5.000
Computer and Funds Transfer Fraud Coverage:
Limits are equal to Employee Dishonesty Coverage or$25,000 whichever is less
Debit, Credit or Charge Card Forgery Coverage:
Limits are equal to Employee Dishonesty Coverage or$25,000 whichever is less
Money Orders and Counterfeit Paper Currency Coverage: $5,000
Crime Deductible: $100
Contribution: $133.31
Policy Forms: CR 00260506 Government Crime Policy
CR 25070300 Include Specified Directors or Trustees on Committee as Employees
CR 25080300 Include Specified Non-Compensated Officers as Employees
CR 25090300 Include Volunteer Workers as Employees
CR 25190506 Add Faithful Performance of Duty
CR 25120300 Include Treasurers or Tax Collectors as Employees
CR 02151104 Colorado Changes
CR 25200300 Debit,Credit or Charge Card Forgery
This Certificate Holder Declaration is made and is mutually accepted by the CSD Pool and the Named Member
subject to all terms which are made a part of the Master Comprehensive Crime Policy. This Certificate
represents only a brief summary of coverages. Please refer to the Master Policy Document for actual coverage,
terms, conditions,and exclusions.
/
Countersigned by: —7 - 4. khd ore Thursday. December 05. 2013
Authorized Representative
Entity ID#: 60721
DISTRICT COURT,COUNTY OF WELD, STATE OF
COLORADO
901 9th Avenue
Greeley. Colorado 80631
970-351-7300
PETITIONER: IN RE RESOURCE WATER AND
SANITATION METROPOLITAN DISTRICT •
MaryAnn M. McGeady — A COURT USE ONLY A
MeGeady Sisneros, P.C.
450 E. 17th Ave., Suite 400 Case Number: 2004 CV 1567
Denver. Colorado 80?03-1?14
Phone: (303) 592-4380 Di..: I ( tmt.:
Fax: (303) 592-4385
E-mail mmcgeadydi.mcgcadysisncros.com
Atty. Reg. T: 12417
OATH OF DIRECTOR _
The undersigned solemnly swears (or affirms) that he wilI faithfully perform the duties of
this office as required by law and will support the Constitution of the United States. the
Constitution of the State of Colorado. and the law made pursuant thereto.
Joel IL - rkas
Address: 1880 Arapahoe Road. 42811
Denier. CO 80202
STATE OF COLORADO
COI TYOI: ---)C 'x. CJ
Subscribed and sworn to before me this I—) dux of 1 r�� . 2014.
WITNESS m) hand and official seal.
�L ) �_ :
NOTARSPUBL�IC Notify Public
STATE OF COLORADO
NOTARY ID 20094001459
MY COMMISSION EXPIRES JANUARY T MN commission expires:201 C- f - 1 - ,l?. uI n%VIn IT rt. , I
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Colorado Special Districts Property and Liability Pool
Comprehensive Crime Certificate Holder Declaration
Master Coverage Policy Number: CCP0037259
Certificate Number: 27C60721-1146 Coverage Period: 1/1/2014 Until Cancelled
Named Member: Billing Period: 1/1/2014 to 1/112015
Resource Colorado Water&Sanitation Metropolitan District Broker of Record:
c/o Special District Management Services, Inc.
141 Union Blvd., Suite 150
Lakewood, CO 80228
Covered ERISA Plan:
Coverage, Limits of Insurance and Deductibles Limits:
Public Employee Dishonesty Coverage: 55,000
-Limit is Per Loss
- Faithful Performance of Duty
-Officers. Directors, and Trustees
-Welfare and Pension Plan ERISA Compliance
if Covered Plan is shown on application
-Volunteer Workers as Employees
Forgery or Alteration Coverage: S5,000
Theft, Disappearance, and Destruction Coverage:
Inside Premises $5.000
Outside Premises 55.000
Computer and Funds Transfer Fraud Coverage:
Limits are equal to Employee Dishonesty Coverage or $25.000 whichever is less
Debit, Credit or Charge Card Forgery Coverage:
Limits are equal to Employee Dishonesty Coverage or$25.000 whichever is less
Money Orders and Counterfeit Paper Currency Coverage: 55.000
Crime Deductible: $100
Contribution: 5133.31
Policy Forms: CR 00260506 Government Crime Policy
CR 25070300 Include Specified Directors or Trustees on Committee as Employees
CR 25080300 Include Specified Non-Compensated Officers as Employees
CR 25090300 Include Volunteer Workers as Employees
CR 25190506 Add Faithful Performance of Duty
CR 25120300 Include Treasurers or Tax Collectors as Employees
CR 02151104 Colorado Changes
CR 25200300 Debit.Credit or Charge Card Forgery
This Certificate Holder Declaration is made and is mutually accepted by the CSD Pool and the Named Member
subject to all terms which are made a part of the Master Comprehensive Crime Policy. This Certificate
represents only a brief summary of coverages. Please refer to the Master Policy Document for actual coverage,
terms, conditions, and exclusions.
Countersigned by its.) VRICts-C- Thursday Desemher 05. 20,3 •
U Authorized Representative
Entity ID#'. SC721
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