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HomeMy WebLinkAbout2020 Courtney Holm Oath of OfficeDISTRICT COURT OF EAGLE COUNTY, STA TE OF COLORADO Court Address: Eagle County Justice Center 885 Chambers Avenue PO Box 597 Eagle, Colorado 81631 IN RE THE MATTER OF BERRY CREEK A COURT USE ONLY A METROPOLITAN DISTRICT Attorneys for the District: Collins Cockrel & Cole, P.C. James P. Collins Case No. 79 CV 41 390 Union Boulevard, Suite 400 Denver, Colorado 80228-1556 (303) 986-] 551 Div.: Ctrm.: (303) 986-1755 -Facsimile E-mail: jcollins@.cccfirm.com Atty . Reg. #: 7958 OATH OF OFFICE I , Courtney Holm , do affirm that I will support the Constitution of the United States , the Constitution of the State of Colorado, and the laws of the State of Colorado , and will faithfull y perform the duties of the office of Director of Berry reek Metropolitan District upon which I am about to enter to the best of my ability . I I c__ Title of Pers n Administering Oath * *Pe rs ons authorized to adm inister oaths: Chairman o f the Board of Directors, Notary Public, County Clerk and Recorder or Clerk of the Court IF SWORN OR AFFIRMED BEFORE A NOTARY THE FOLLOWING MUST BE COMPLETED: ST A TE OF COLORADO ) ) ss . COUNTY OF EAGLE ) tJ/1 t-r-- Subscribed and sworn to before me this -'-~ ____ day of May, 2020 . Mycommissionex pires: :(1,_\y !'1,7,.0~(!lf:-'i ~ CHERI L CURTIS Notary Public State of Colorado Notary ID# 20074027333 My Commission Expires 07-17-2023 Comprehensive Crime Certificate Holder Declaration Master Coverage Document Number: CR 00 26 11 15 Insurer: Fidelity and Deposit Company of Maryland Certificate Number: POL-0002394 Coverage Period: 1/1/2020 to EOD 12/31/2020 Named Member:Broker of Record: Berry Creek Metropolitan District T. Charles Wilson Insurance Service PO Box 1058 384 Inverness Parkway Edwards, CO 81632-1058 Suite 170 Englewood, CO 80112 Covered ERISA Plan: Covered Designated Agent(s): Coverage Limits: Public Employee Dishonesty Coverage:$15,000 Limit is Per Loss Faithful Performance of Duty Officers, Directors, and Trustees Welfare and Pension Plan ERISA Compliance if Covered Plan is shown Volunteer Workers as Employees Forgery or Alteration Coverage:$15,000 Theft, Disappearance, and Destruction Coverage:$15,000 Inside Premises Outside Premises Computer and Funds Transfer Fraud Coverage:$15,000 Debit, Credit or Charge Card Forgery Coverage:$15,000 Money Orders and Counterfeit Paper Currency Coverage:$15,000 Fraudulent Impersonation Coverage:$15,000 Crime Deductible:$250 Fraudulent Impersonation Deductible: 20% of Fraudulent Impersonation Limit Contribution: $211 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 CR 25020506 Include Designated Agents as Employees, when listed CR 04171115 Fraudulent Impersonation 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: Authorized Representative