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Home My WebLink About2021 A. Perry - Oath of Office & Bond1615.0011; 1150219 DISTRICT COURT, EAGLE COUNTY, COLORADO Court Address: 885 Chambers Avenue Eagle, Colorado 81631 Telephone: (970) 328-6373 ▲ COURT USE ONLY ▲ Petitioner: SIENA LAKE METROPOLITAN DISTRICT Attorney for Petitioner: Name: William P. Ankele, Jr., Esq. Trisha K. Harris, Esq. Address: WHITE BEAR ANKELE TANAKA & WALDRON Attorneys at Law 2154 E. Commons Ave., Suite 2000 Centennial, CO 80122 Phone: (303) 858-1800 Fax: (303) 858-1801 Email: wpankele@wbapc.com tharris@wbapc.com Atty. Reg. #: 12142, 34820 Case Number: 2001CV464 Division: Courtroom: BOARD OF DIRECTORS OATH OF OFFICE STATE OF COLORADO ) ) ss. COUNTY OF __________ ) I, Alison Perry, do [select one of the following [__] swear, [__] affirm, or [__] swear by the everliving God], 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 faithfully perform the duties of the office of Director of the Siena Lake Metropolitan District upon which I am about to enter to the best of my ability. Signature DENVER Livenotary.com Document Id: 851-5d545b-22078 1615.0011; 1150219 STATE OF COLORADO ) ) ss. COUNTY OF ) Signed and sworn to (or affirmed) before me this __________ day of September, 2021 by ______________________ [via audio-video technology]. (S E A L) My commission expires: Notary Public ELBERT 12th 04/01/2024 Alison Perry Livenotary.com Document Id: 851-5d545b-22078 Crime Certificate Holder Declaration Master Coverage Document Number: CR 00 26 11 15 Insurer: Fidelity and Deposit Company of Maryland Certificate Number: POL-0004683 Coverage Period: 1/1/2021 to EOD 12/31/2021 Named Member:Broker of Record: Siena Lake Metropolitan District c/o Marchetti & Weaver LLC 28 Second Street, Suite 213 Edwards, CO 81632 Covered ERISA Plan: Covered Designated Agent(s): Coverage Limits: Public Employee Dishonesty Coverage:$5,000 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:$5,000 Theft, Disappearance, and Destruction Coverage:$5,000 Inside Premises Outside Premises Computer and Funds Transfer Fraud Coverage:$5,000 Debit, Credit or Charge Card Forgery Coverage:$5,000 Money Orders and Counterfeit Paper Currency Coverage:$5,000 Fraudulent Impersonation Coverage:$5,000 Crime Deductible:$100 Fraudulent Impersonation Deductible: 20% of Fraudulent Impersonation Limit Contribution: $135 Policy Forms: CR 00261115 Government Crime Policy (Discovery Form) CR 25081010 Include Specified Non-Compensated Officers as Employees CR 25091010 Include Volunteer Workers as Employees CR 25190813 Add Faithful Performance of Duty Coverage for Government Employees CR 25121010 Include Treasurers or Tax Collectors as Employees CR 02151010 Colorado Changes CR 25201010 Debit, Credit or Charge Card Forgery CR 25021010 Include Designated Agents as Employees, when scheduled 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 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