HomeMy WebLinkAbout2020 Scott Schlosser Oath of Office No. 5RLI'
Bond No. LSM0680083
Item 1. Name of Insured: Haymeadow Metropolitan District No.5
(the "Insured")
Principal Address: do Collins Cockrel & Cole 390 Union Boulevard, Suite 400
Lakewood, CO 80228
Item 2. Bond Period November 24.2014 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.
1. INSURING AGREEMENT
The RLI Insurance Company, an Illinois corporation (the "Company"), in consideration of an agreed premium is
held and firmly bound unto Haymeadow Metropolitan District No.5
of Lakewood , 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 24th day of November 2014 .
IL 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
RLI Insurance Company
P.O. Box 3967 Peoria IL 61612-3967
Phone: (309)692-1000 Fax: (309)683-1610
PUBLIC OFFICIAL POSITION
SCHEDULE BOND
OFF 0102 (2/93) Page 1 of 3 Pages
00002304-30,30
By
Roy C. Die
t ,
C
• oPPORA
Ei
▪
41C :
SEAL
...... N 0 .
....
Vice President
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 25th day of November , 2014 .
RLI Insurance Company
OFF 0102 (2/93) Page 2 of 3 Pages
00002304-30,30
Bond No. LSM0680083
SCHEDULE OF POSITIONS - EFFECTIVE THE 24th DAY OF November , 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 $ 5,000.00
2 Board Member 1 1 $ 1,000.00
3 Board Member 2 1 $ 1,000.00
4 Board Member 3 1 $ 1,000.00
5 Board Member 4 1 $ 1,000.00
6 Board Member 5 1 $ 1,000.00
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Page 3 of 3 Pages
00002304-30,30
OFF 0102 (2/93)
RLI'
RLI Insurance Company
P.O. Box 3967 Peoria IL 61612-3967
Phone: (309)692-1000 Fax: (309)683-1610
POWER OF ATTORNEY
RLI Insurance Company
Bond No. LSM0680083
Know All Men by These Presents:
That the
Illinois
constitute and appoint:
Illinois
RLI Insurance Company , a corporation organized and existing under the laws of the State of
, and authorized and licensed to do business in all states and the District of Columbia does hereby make,
Roy C. Die
in the City of Peoria , State of
Vice President , with full power and authority hereby conferred upon him/her to sign, , as
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 ( $ 500,000.00 ) for any single
obligation, and specifically for the following described bond.
Principal:
Obligee:
Type Bond:
Bond Amount:
Effective Date-
14 • 1 sl .1 I
Same as Principal
Public Official Position Schedule Bond
$ 10,000.00
November 24, 2014
The RLI Insurance Company
further certifies that the following is a true and exact copy of a
RLI Insurance Company , and now in force to-wit:
Resolution adopted by the Board of Directors of
"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 may be printed by facsimile."
IN WITNESS WHEREOF, the
its Vice President
RLI Insurance Company has caused these presents to be executed by
with its corporate seal affixed this 25th day of November , 2014 .
ATTEST:
ifl iJ
Cynthia S. ha
On this 25th day of November
and Cynthia S. Dohm
Vice President as
..s`ssN) 500 RLI Insnrance Company
oFtPORArt
:=.4r -•-
?' SEAL :
, .... _ Roy C. D.
"4,I,N 9r,
, 2014 before me, a Notary Public, persona y a peared Roy C. Die
, who being by me duly sworn, acknowledged that they signed the above Power of Attorney
and Assistant Secretary , respectively, of the said
, and acknowledged said instrument to be the voluntary act and deed of
Assistant Secre Vice President
RLI Insurance Company
said corporation.
Jac cline M. Boc r Notary Public
"OFFICIAL SEAL"
s7A1.31E'gF ' JACQUELINE M. BOCKLER
u-,,4,1p COMMISSION EXPIRES 01/14/18
A0006104