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Home My WebLink About2020 Bartnik Oath of OfficeCollins Cockrel ola. EstSS 1978 A. Clerk of the Court Eagle County District Court Eagle County Justice Center 885 Chambers Avenue Eagle, Colorado 81631 SHAREHOLDERS Paul R. Cockrel James P. Collins Robert G. Cole Timothy J. Flynn Evan D. Ela Linda M. Glesne David A Greher Kathryn G. Winn Allison C. Ulmer Matthew P. Ruhland March 10, 2020 Re: Eagle County Health Service District Case No. 82CV85 Dear Madam Clerk: ASSOCIATES Joseph W. Norris Bart W. Miller Ayshan E. Ibrahim VIA E -FILING Enclosed for filing in the above -referenced District file are the Oath of Office and Notice of Appointment for Janet Bartnik, who was appointed to fill the vacancy on the Board left by Jon Asper, until May 2020, for a term to expire in May, 2022. Finally, enclosed is the certification of coverage for the current Bond for all of the Directors and Treasurer of the District. Thank you for your assistance in this matter. Sincerely, Micki L. Mills Paralegal Enclosures cc: Division of Local Government (via eportal) Eagle County Clerk and Recorder Ms. Veronica Ross (00746373.DOCX/ ) 390 Union Blvd, Suite 400, Denver, CO 80228-1556 office 303.986.1551 1 toll free 800.354.5941 1 fax 303.986.1755 1 www.cccfirm.com DISTRICT COURT, EAGLE COUNTY, STATE OF COLORADO Court Address: Eagle County Justice Center 885 Chambers Avenue P.O. Box 597 Eagle, CO 81631 Phone Number: 970-328-6373 IN RE THE MATTER OF EAGLE COUNTY HEALTH SERVICE DISTRICT COURT USE ONLY James Collins Collins Cockrel & Cole Case No.: 82CV85 390 Union Blvd., Suite 400 Denver, Colorado 80228-1556 Telephone: (303) 986-1551 Div.: 1 Ctrm.: Facsimile: (303) 986-1755 E -Mail: rcole@cccfirm.com Attorney Reg. No.: 15943 OATH OF OFFICE I, Janet Bartnik, will faithfully support the Constitution of the United States and of the State of Colorado, and the laws made pursuant thereto, and will faithfully perform the duties of the office of Director of the Eagle County Health Service District upon which I am about to enter. Janet Bartnik STATE OF COLORADO ss. COUNTY OF EAGLE ) Subscribed and sworn to before me this 20a` day of February, by Janet Bartnik. Jeff Babb Person authorized to administer oaths (County Clerk and Recorder, Clerk of the Court, Notary Public, Chairman of the Board or any other person authorized to administer oaths) Title: Chairman of the Board My commission expires: N/A {00499027.DOCX /} NOTICE OF APPOINTMENT TO THE BOARD OF DIRECTORS OF THE EAGLE COUNTY HEALTH SERVICE DISTRICT TO: Janet Bartnik 54 Field Street, PO Box 231 Eagle, Co 81631 Pursuant to Section 32-1-905(3), C.R.S., notice is hereby given that you have been appointed to the Board of Directors of the Eagle County Health Service District to fill a vacancy on the Board until the May, 2020 regular special district election, for a term to expire at the May, 2022 regular special district election. Dated this 20`h day of February, 2020. EAGLE COUNTY HEALTH SERVICE DISTRICT (00744490.DOCX/ ) �..� GAPI r•_nrt.nq KIMTn1 ACOREY CERTIFICATE OF LIABILITY INSURANCE 11%.� DATE(MMIDDNYYY) 1 06/05/2018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(les) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s) PRODUCER k2tRcr acNNE% Ext 303 368-5757 ac No 303 368-5863 T. Charles Wilson Insurance Service 384 Inverness Parkway Suite 170 Englewood, CO 80112 kBiBa Info@wilsonins.com INSURER(Sl AFFORDING COVERAGE NAIC # INSURER RLI Insurance Company DAMAGETORENTED MED EXP one arson S INSURED INSURERS: INSURER C: Eagle County Health Service District INSURER D 1 P O BOX 990 Edwards, CO 81632 INSURER E INSURER F l.nVFRA[:RC CF:RTIRIRATR NIIMRPR- RFVISInN NLIMRER! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FORTHE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSR LTR TYPE OF INSURANCE AODLINSD SUSR POLICYNUM13ER POLICY EFF POLICY EXP LIMITS COMMERCIAL GENERAL LIABILITY CLAIMS -MADE F-� OCCUR EACH OCCURRENCE DAMAGETORENTED MED EXP one arson S PERSONAL& ADV INJURY S GEN'LAGGREGATE UMrrAPPLIES PER POLICY 0 jPOT F]LOC OTHER GENERAL AGGREGATE S PRODUCTS -CO /OP AGO AUTOMOBILE LIABILITY ANYAUTO �H AURTC ONLY AUpTNOOByy �o AUTOS ONLY AUTOS ONLY COMBINED SINGLE LIMIT BODILY INJURY Par erson BODILY I URY Per ecadant ar ecER "t AMAOE a UMBRELLA UAB EXCESS LIAB HOCCUR CLAIM"ADE EACH OCCURRENCE S AGGREGATE DED RETENTION; WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY �CROe(rI�ERRIEXCCiLUUDDED? IVE � Ifym, desodbetNulFHnlder 'MM O O OPERATIONS below NIA I PER OTH- EL EACH IDENT $ CCEAE EL DISEASE LO E L DISEASE - POLICY LIMIT A 3 Year Bond LSM0582394 05106/2017 0510612020 Bond Amount 10,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space In required) PUBLIC OFFICIAL POSITION SCHEDULE BOND: 1 Treasurer 0$5,000 5 Board Members @$1,000 each !`FRTIrIrATF 14ril 1711=15 (ANr Fl I ATtnN ACORD 25 (2016103) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Colorado Department of Local Affairs Division of Local Government THE Y PROVIS PROVISIONS. WILL BE DELIVERED IN ACCORDANCE WITH THE OLITION DATE THEREOF, - Special Districts 1313 Sherman St, Rm 521 AUTHORIZED REPRESENTATIVE Denver, CO 80203 ACORD 25 (2016103) ®1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD RLIRLI Insuranc e Company PUBLIC OFFICIAL POSITION P O Box 3967 Peoria IL 61612-3967 Phone (309)692-1000 Fax. (309)683-1610 SCHEDULE BOND Bond No LSM0582394 Item 1. Name of Insured: Eagle County Health Service District (the "insured") Principal Address. 1055 Edwards Village Blvd. Edwards, CO 81632 Item 2. Bond Period May 6. 2014 to Continuous Until Cancelled-. Item 3. Limit of liability does not exceed the sum specified in the Schedule of named Positions or written acceptances by the Company as to each Position there listed. I. INSURING AGREEMENT The RLi insurance Company, an Illinois corporation (the "Company"), in consideration of an agreed premium is held and firmly bound unto Eagle County Health Service District of Edwards CO, Obligee, for the faithful discharge of the duties of any Public Official or Employee while occupying any position named in the schedule attached, or added thereto by written acceptance of the Company as to said position after the 6th day of May 1 2014 II. CONDITIONS A. Coverage. Automatic coverage is granted for the first thirty days service of any Public Official or Employee: (1) Occupying a newly created position identical with one listed in the schedule of positions, in an equal amount. Provided, however, that the automatic coverage herein granted shall be void and of no effect from the beginning, unless during the said thirty day period the Obligee has requested in writing that the position be added to the schedule, and the Company by written acceptance has consented thereto. Coverage on any position may be increased or decreased upon written request of the Obligee, if agreed to in writing by the Company. B. Cancellation. Cancellation hereunder is effective, and all liability under this bond shall cease as to future acts or omissions as to any Public Official or Employee on the date specified in written notice given by the Obligee to the Company as to any or all positions or Public Officials or Employees, or after thirty days' written notice given by the Company to the Obligee of its intent to cancel this bond in its entirety, or as to any Public Official or Employee or position. C. Liability. The Company's liability under this bond shall not be cumulative, and in no event shall the Company be called upon to pay as a loss hereunder in an amount greater than the largest single amount for which the position occupied by any Public Official or Employee causing such loss is or has been covered in the schedule, whether said loss occurred during any one or more years. The liability of the Company for any Public Official or Employee occupying more than one position at one time, or at different times, shall not exceed the largest amount of coverage specified for any single position occupied by said Public Official or Employee. The liability of the Company shall never exceed the amount in effect for the position when the act OFF 0102 (2/93) Page 1 of 3 Pages 00002304-30,30 of the Public Official or Employee causing the loss shall have occurred. In the event there are more Public Officials or Employees occupying the position covered In the schedule than are listed therein, the Company shall be liable for such proportion of the amount of coverage as the number of Public Officials or Employees listed bears to the number of Public Officials or Employees actually occupying the position when the loss occurred. The Liability of the Company hereunder Is subject to the terms and conditions of the following Riders, attached thereto, None of the specifications of this Bond shall be altered or waived, except in writing by the Company executed by its President, Vice President, Secretary, Assistant Secretary or Treasurer. Dated this 6th day of May 2014 RLI Insurance Company By I Roy C Dle0 -A-0.WUUAW%- Vice President *" ft r# BEA.L OFF 0102 (2/93) Page 2 of 3 Pages 00002304-30,30 Bond No. _ LSM0582394 SCHEDULE OF POSITIONS - EFFECTIVE THE 6th DAY OF May 2014 (if there Is more than one position of like classification, list by number, thus: Cashier No. 1, Cashier No. 2) Schedule Number Position Name No. Position Location Bond Amount 1 Treasurer 1 $ 5,00000 2 . Board Member 1 $ 1,00000 3 Board Member 1 $ 11000.00 4 Board Member 1 $ 1,00000 5 Board Memeber 1 $ 11000.00 6 Board Member 1 $ 1,000.00 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 OFF 0102 (2193) Page 3 of 3 Pages 00002304-30,30 RURU Ina" °�°mPOWER OF ATTORNEY P O Box 3967 PeonnsaIL 61612-3967 Phone (309)692-1000 Fax, (309)683-1610 RLI Insurance Company Bond No. LSM0582394 Snow All Men by These Presents.- That resents: That the RLI Insurance Company , a corporation organized and existing under the laws of the State of Illinois and authorized and licensed to do business in all states and the District of Columbia does hereby make, constitute and appoint- Roy C Die in the City of Peona , State of Illinois , as Vice President , with full power and authonty hereby conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds, undertakings, and recognizances in an amount not to exceed Five Hundred Thousand and 00/100 Dollars ( S 500.000.00 ) for any single obligation, and specifically for the following descubed bond Principal: Ragle County Health Service District Obligee: Same as Principal Type Bond: Public Official Position Schedule Bond Bond Amount: S 10,000.00 Effective Date: May C 2014 The RLI Insurance Company further certifies that the following is a true and exact copy of a Resolution adopted by the Board of Dnectors of RLI Insurance Company , and now in force to - wit - "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 maybe printed by facsimile." IN WITNESS WHEREOF, the RLL Insurance Company has caused these presents to be executed by its Vice President with its corporate seal affixed this 6th— day of May 2014 M,a ATTEST: "or% RLI Insurance Company 811 L • r � Cynthia S Inn Assistant SecretaryV Roy C Die"' Vice President On this 6th day of May , 2014 before me, a Notary Pubhc, perso eared Roy C. Die and Cynthia S Dohm , who being by me duly sworn, aclniowledged that they signed the above Power of Attorney as Vice President and Assistant Secretary , respectively, of the said RLI Insurance Com rRa33y , and aclmowledged said instrument to be the voluntary act and deed of said corporation. &J:AC(QUEUN:EM FFIEAL' OCKLERlac elute M. Bo r NotazyPublic6SIONSe1nu18 A0006104