HomeMy WebLinkAbout2020 Jody Lindvall Oath of OfficeDISTRICT COURT, CI
COLORADO
500 Broadway
Eagle, CO, 81631-0850
(970)328-8600
IN RE THE MATTER OF HORSE MOUNTIAN
RANCH METROPOLTTAN DISTRICT, EAGLE
COUNTY,COLORADO
COURT USE ONLY
Attorneys for the Petitioners:
White, Bear, Ankele, Tanaka and Waldron, PC
Sean Allen, Esq. Case No. 9GCV62
2154 E. Commons Ave., Suite 2000
Centennial, CO 80122 Div.: J C[rm.:
Phone:303-858-1800
Fax: 303-858-1801
Email: sallenna,wbatx.com
OATH OF OFFICE
I, Jodv Lindvall, affirm that I will support the Constitution of the United States
and of the State of Colorado, and the laws made pursuant thereto, and faithfully perform
the duties of the office of Director of Horse Mountain Ranch Metropolitan District upon
which I am about to enter. � c �
Si ed: 7�y
Subscribed and swom to before me this�b t6 day of May, 2020.
By: 4e4 ,
n Administering Oath
ubtic
•Title of Person Administering Oath
• Persons authorized to administer oaths: County Clerk and Recorder, Clerk of the Court, Notary
Public or Chairperson of the Board of Directors
IF SWORN OR AFFIItMED BEFORE A NOTARY THE FOLLOWING SHOULD BE
COMPLETED:
STATE OF COLORADO )
ss.
EAGLE COUNTY OF COLORADO )
Subscribed and swom to before me this 6'w'day of May, 2020.
My commission expires: I o — I a ' 2l
(NOTARY SEAL) �� n
NOTARY PUBLIC l'
STATE OF COLORADO Notary Public
!KtCspjQxpRES 141011021
Colorado Special Districts
Property and Liability Pool
Comprehensive Crime Certificate Holder Declaration
Master Coverage Document Number: CR 00 26 1115
Certificate Number: POL-0001604
Named Member:
Horse Mountain Ranch Metropolitan District
c/o Pinnacle Consulting Group, Inc.
550 W. Eisenhower Blvd
Loveland, CO 80537
Covered ERISA Plan:
Coverage Limits:
Public Employee Dishonesty Coverage:
Limit is Per Loss
Insurer: Fidelity and Deposit Company of Maryland
Coverage Period: 1/1/2020 to EOD 12/31/2020
Broker of Record:
Covered Designated Agent(s):
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:
Theft, Disappearance, and Destruction Coverage:
Inside Premises
Outside Premises
Computer and Funds Transfer Fraud Coverage:
Debit, Credit or Charge Card Forgery Coverage:
Money Orders and Counterfeit Paper Currency Coverage:
Fraudulent Impersonation Coverage:
Crime Deductible:
Fraudulent Impersonation Deductible:
Contribution:
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
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$5,000
$100
20% of Fraudulent Impersonation Limit
$135
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
