HomeMy WebLinkAbout20141818.tiff RECEIVED
DISTRICT COURT,WELD COUNTY, JUN 1 0 2014
STATE OF COLORADO
WELD COUNTY
901 9th Avenue COMMISSIONERS
P.O. Box 2038
Greeley, Colorado 80631
970-351-7300
PETITIONER: IN RE BEEBE DRAW FARMS
METROPOLITAN DISTRICT NO. 2
MaryAnn M. McGeady A COURT USE ONLY
McGEADY SISNEROS, P.C.
450 E. 17th Ave., Suite 400 Case Number: 99CV683
Denver, Colorado 80203-1214
Phone: (303) 592-4380 Div.: Ctrm.:
Fax: (303) 592-4385
E-mail: mmcgeady@mcgeadysisneros.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.
Christine Hethcock
Address: 6025 South Lima Street
Englewood, CO 80111
STATE OF COLORADO )
) ss.
COUNTY OF I,l.)Q d. )
Subscribed and sworn to before me this 13 day of NM , 20 ►4-4 .
WITNESS my hand and official seal. ' \
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My coimmission expires: 6-I0I(
2014-1818
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Colorado Special Districts Property and Liability Pool
Comprehensive Crime Certificate Holder Declaration
Master Coverage Policy Number: CCP0037259
Certificate Number: 27060805-1206 Coverage Period: 1/1/2014 Until Cancelled
Named Member: Billing Period: 1/1/2014 to 1/1/2015
Beebe Draw Farms Metropolitan District No.2 Broker of Record:
c/o Special District Management Services, Inc. T. Charles Wilson Insurance Service
141 Union Blvd., Suite 150 384 Inverness Parkway
Lakewood, CO 80228-1898 Centennial, CO 80112
Covered ERISA Plan:
Coverage, Limits of Insurance and Deductibles Limits:
Public Employee Dishonesty Coverage: $25,000
- 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: $25,000
Theft, Disappearance,and Destruction Coverage:
Inside Premises $25,000
Outside Premises $25,000
Computer and Funds Transfer Fraud Coverage: $25,000
Debit, Credit or Charge Card Forgery Coverage: $25,000
Money Orders and Counterfeit Paper Currency Coverage: $25,000
Crime Deductible: $250
Contribution: $283.30
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: Friday, December 20,2013
Authorized Representative
Entity ID#: 60805
RECEIVED
JUN 10 2014
WELD COUNTY
DISTRICT COURT,WELD COUNTY, COMMISSIONERS
STATE OF COLORADO
901 9th Avenue
P.O. Box 2038
Greeley, Colorado 80631
970-351-7300
PETITIONER: IN RE BEEBE DRAW FARMS
METROPOLITAN DISTRICT NO. 2
MaryAnn M. McGeady A COURT USE ONLY •
McGEADY SISNEROS, P.C. Case Number: 99CV683
450 E. 17th Ave., Suite 400
Denver, Colorado 80203-1214
Phone: (303)592-4380 Div.: Ctrm.:
Fax: (303) 592-4385
E-mail: mmcgeady@mcgeadysisneros.com
Atty. Reg. #: 12417
OATH OF DIRECTOR
The undersigned solemnly swears(or affirms)that he 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 suanm re
Thomas A. urk
Address: 5717 Glenstone Lane
Highlands Ranch, CO 80130
STATE OF COLORADO )
) ss.
COUNTY OF 7¢F F-e,t,o of )
Subscribed and sworn to before me this 17 day of /K7 ,20 /C/.
WITNESS my hand and official seal.
ot. Public
FERDINAND A BARBERO "ii-4
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NOTARY PUBLIC y commission expires: / /W y, J/�OIJ'-
STATE OF COLORADO
Expkos:August 06,2015
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