Minyards Freeport Xing-CS090420
THE.CITY.OF
corrELL
April 20, 2009
Shawn Rockenbaugh, P.E.
Jones & Carter, Inc.
3030 LB.I Freeway, Suite 910
Dallas, TX 75234
RE: Minyards Addition (Freeport Crossing)
Final Acceptance
Dear Mr. Rockenbaugh:
Representatives of the City of Coppell have confilmed a final inspection of paving and utilities for
the referenced project. The two-year maintenance bonds and record drawings have been received.
Maturity on the bonds will be two years from the date of this letter.
You may notify the MS4 (City of Coppell) at any time during the two-year maintenance period if
stabilization of the site per the SWPPP permit can be demonstrated. If so, complete and submit a
Notice of Tem1ination (NOT) to discontinue coverage under the SWPPP permit.
A follow-up inspection of the facilities will be conducted prior to the lapse of the two-year bond
period. If any punchlist items are noted at that time, you will be contacted to make repairs. Thanks
for your cooperation.
Sincerely,
/?A';l~0(i ill
Rick O'Dell
Construction Inspector
Office Phone: (972) 304-7090
Fax: (972) 304-3570
~
Michael Garza, E.I.T.
Engineer In Training
Office Phone: (972) 304-7090
Fax: (972)304-3570
cc: Ken Griffin, P.E.. Director of Engineering & Public Works
Glenn I-Iollowdl, r.E., Asst. Director of Public Works
Tim Oates, Deputy Chief/Prevention
255 PAHKWAY * P.O.BOX 9478 * COPPELL TX 75019 * TEL 972/462 0022 * FAX 972/304 3673
MAINTENANCE BOND
Bond No. 46BCSFG3892
KNOW ALL MEN BY THESE PRESENTS, That we, Potter Concrete, Ltd.
(hereinafter called the "Principal") as Principal, and the
Hartford Fire Insurance Company , a corporation duly
organized under the laws of the State of Connecticut and duly licensed to transact business in the
State of Texas (hereinafter called the "Surety "), as Surety are held and firmly bound unto
City of Coppell (hereinafter called the "Obligee "), in the
sum of Four Thousand Five Hundred And No /100ths Dollars
0;4,500.00 ) for the payment of which are well and truly to be made, we, the said Principal and the
said Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and
severally, firmly by these presents.
Signed and sealed this 90 day of March , 2009
THE CONDITION OF THIS OBLIGATION is such, that WHEREAS, the said Principal has heretofore
entered into a contract with C. F. Jordan dated
4/14/2008 , for 3 approaches for Freeport Crossing, 921 West Bethel Rd., Coppell, TX,75019
WHEREAS, the obligee has requested that said work be guaranteed against failure because of defective
workmanship or material, performed or fumished by said principal for a period of Two (2) years from date of
completion and acceptance, normal wear and tear excepted.
NOW THEREFORE, if the said Principal shall indemnify and save harmless the obligee against loss or
damage occasioned directly by the failure of said materials or workmanship, then this obligation to be void,
otherwise to remain in full force and effect. It is understood, however, that this bond shall not include loss or
damage by failure of workmanship or materials due to hurricane, cyclone, tomado, earthquake, volcanic
eruption or any similar disturbance of nature, nor military, naval or usurped power, insurrection, not or civil
commotion, nor any act of God.
It is further understood and agreed that the total liability of the surety under this bond shall in no event
exceed the sum of Four Thousand Five Hundred And No /100ths (S4.500.00) Dollars.
No right of action shall accrue upon or by reason of this obligation, to or for the use or benefit of any person,
firm or corporation, other than the obligee herein named.
POTTER CONCRETE. I,TD. HARTFORD RE, INSIJRAN COMPANY
Jignaturc luc : principal FI Surety
POTTER CO CRETE, LTD.
By: Potter o e a ent, LLC, General Partner •
Michele Degnon Atto 'ey -in -Fa
Direct Inquiries/Claims to:
POWER OF ATTORNEY THE HARTFORD
BOND, T-4
P.O. BOX 2103, 690 ASYLUM AVENUE
HARTFORD, CONNECTICUT 06115
call: 888 - 266 -3488 or fax: 860 - 757 -5835)
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Code: 4 4614 96
1 X I Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut
Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana
Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut
1 I Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut
Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana
Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State of Indiana
Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida
having their home office in Hartford, Connecticut (hereinafter collectively referred to as the "Companies ") do hereby make, constitute and appoint,
up to the amount of UNL I M I TED
DENNIS DOWD, JOHN D. FULKERSON, KAE PERDUE, TOM P. ELLIS, III, DONNIE D. DOAN,
MICHELE DEGNON, DEBBIE SMITH OF DALLAS, TEXAS
their true and lawful Attorney(s) -in -Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies) only as
delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written instruments in the
nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the performance of contracts and
executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings allowed by law.
In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on January 22, 2004, the Companies
have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly attested by its Assistant
Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby unambiguously affirm that they are
and will be bound by any mechanically applied signatures applied to this Power of Attorney.
y �y15 4441. .& a '`.. 111 "' yF ^ills b ♦ A. C S ' e♦ " „ 'F Myp ,+_s - i +ar. r
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Paul A. Bergenholtz, Assistant Secretary M. Ross Fisher, Assistant Vice President
STATE OF CONNECTICUT
SS. Hartford
COUNTY OF HARTFORD
On this 1st day of February, 2004, before me personally came M. Ross Fisher, to me known, who being by me duly sworn, did depose and say:
that he resides in the County of Hartford, State of Connecticut; that he is the Assistant Vice President of the Companies, the corporations described in and
which executed the above instrument; that he knows the seals of the said corporations; that the seals affixed to the said instrument are such corporate seals;
that they were so affixed by authority of the Boards of Directors of said corporations and that he signed his name thereto by like authority.
s e.a� „}
Scott E. Paseka
Notary Public
CERTIFICATE My Commission Expires October 31, 2012
I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and correct copy of
the Power of Attorney executed by said Companies, which is still in full force effective as of March 9, 2009
Signed and sealed at the City of Hartford.
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Yp.'rF • � •. %t hWi��i. Y °�+ Aixy� �=•
Gary W. Stumper, Assistant Vice President
POA 2007
IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener informacion o para someter una
queja.
You may contact your agent.
You may call Hartford Insurance Group at the Puede comunicarse con su agente.
toll free telephone number for information or to Usted puede Ilamar al numero de telefono
make a complaint at: gratis de The Hartford Insurance Group para
indormacion o para someter una queja al
1 -800- 392 -7805
1 -800- 392 -7805
You may also write to The Hartford:
Usted tambien puede escribir a The Hartford.
The Hartford
Hartford Financial Products The Hartford
2 Park Avenue, 5 Floor Hartford Financial Products
New York, New York 10016 2 Park Avenue, 5 Floor
1 -212- 277 -0400 New York, New York 10016
1- 212 -277 -0400
You may contact the Texas Department of
Insurance to obtain information on companies, Puede comunicarse con el Departamento de
coverages, rights or complaints at: Seguros de Texas para obtener informacion
acerca de companias, coberturas, derechos o
quejas al:
1 -800- 252 -3439 1 -800- 252 -3439
You may write the Texas Department of Puede escribir al Departamento de Seguros de
Insurance Texas
P.O. Box 149104 P.O. Box 149104
Austin, TX 78714 -9104 Austin, TX 78714 -9104
Fax Number (512) 475 -1771 Fax Number (512) 475 -1771
Web: http: / /www.tdi.state.tx.us Web: http: / /www.tdi.state.tx.us
E -mail: ConsumerProtection @tdi.state.tx.us E -mail: ConsumerProtection @tdi.state.tx.us
PREMIUM OR CLAIMS DISPUTES: Should DISPUTAS SOBRE PRIMAS 0 RECLAMOS:
you have a dispute concerning your Si tiene una disputa concerniente a su
premium or about a claim you should prima o a un reclamo, debe comunicarse
contact the agent first. If the dispute is not con su agente primero. Si no se resuelve la
resolved, you may contact the Texas disputa, puede entonces comunicarse con
Department of Insurance. el departamento (TDI).
ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA: Este aviso
This notice is for your information only and es solo para proposito de informacion y no
does not become a part or condition of the se convierte en parte o condicion del
attached document. documento adjunto.
F- 4275 -1, ./TX4275 -1
HR 42 H006 00 0807
Mar -10 -2009 02:01 PM Potte — :oncrete 214 - 631 -4306 1/1
TTER
ONCRETE, LTD.
Concrete Contractors
Tuesday, March 10, 2009
City of Coppell
Engineering Department
255 Parkway Blvd.
Coppell, Texas 75019
RE: Freeport Crossing
08 -05 -153
SUBJECT: Detailed Report
Dear Carol,
The Detailed report for the $9,000 Maintenance Bond is: Material - $5,850
Labor - $3,150
Total - $9,000
Sincerely,
POTTER CONCRETE, LTD
Melonie Lowrie
Project Administrator
ea - 2005
26
O F
C .K Collo
PnlicY (hI1CYC1�
4820 Gretna • Dallas, Texas 75207 • Office 214- 630 -2191 • Fax 214 -689 -1066 C , E
/<
iJ
: z �� e
Merchants Bonding Company
2100 FLEUR DRIVE • DES MOINES, IOWA 50321 -1158
(515) 243 -8171 • (515) 243 -3854 FAX
MAINTENANCE BOND
KNOW ALL PERSONS BY THESE PRESENTS: Bond No. TXC 78933
That Wright Construction Co., Inc. 601 W. Wall Street, Grapevine, TX 76051
of Texas
as Principal, and the MERCHANTS BONDING COMPANY (MUTUAL) of Des Moines Iowa as Surety are
held and firmly bound unto the City of Coppell 255 Parkway Blvd., Coppell, TX 75019 -9478
in the penal sum of
Thirty Two Thousand Two Hundred and 00/100
*********** * * * * * * * * * * * * * * * * * * * * * * * * * * * * * **
($ 32,200.00 * * * * * *)
DOLLARS, lawful money of the United States of America, for the payment of which, well and truly to be
made, the Principal and Surety bind themselves, their and each of their heirs, executors, administrators,
successors and assigns, jointly and severally, firmly by these presents.
Signed and delivered this 10th day of March 2009
WHEREAS, the Principal entered into a certain contract, dated the 26th day of March
2008 with the C.F. Jordan, LP
to furnish all the material and labor necessary for the construction of
water, sanitary sewer, and storm drainage to serve Freeport Crossing Buildings A -D
in the City of Coppell , in conformity with certain specifications; and
WHEREAS, a further condition of said contract is that the Principal should furnish a bond of indemnity,
guaranteeing to remedy any defects in workmanship or materials that may develop in said work within a
period of two years from the date of acceptance of the work under said contract; and
WHEREAS, the above work has been completed and accepted and if not accepted will be automatically
accepted upon the filing of this maintenance bond; and
WHEREAS, the MERCHANTS BONDING COMPANY (MUTUAL) of Des Moines, Iowa for valuable
consideration, has agreed to join with said Principal in such bond or guarantee, indemnifying said
City of Coppell
as aforesaid;
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said Principal does
and shall, at the Principal's own cost and expense, remedy any and all defects that may develop in said
work, within the period of two years from the date of acceptance of the work under said contract, by
reason of bad workmanship or poor material used in the construction of said work, and shall keep all
work in continuous good repair during said period, and shall in all other respects, comply with all the
terms and conditions of said contract with respect to maintenance and repair of said work, then this
obligation to be null and void; otherwise to be and remain in full force and virtue in law.
It is agreed that while the Principal shall be and remain liable for failure to adhere to the specifications
which form the basis for the work, the Surety, inasmuch as the original work was not bonded, shall be
obligated only to assure the maintenance of the work in the condition in which it existed at the time the
work was accepted. Any obligation beyond this shall be that of only the Principal.
Wright Co Co., Inc.
Principal / --
By / /
Approved
By MERCHA T ONDING COMPANY (MUTUAL)
By
CON 0304 (1/03) Kath Sells, Attorne -In -Fact
Y
POWER OF ATTORNEY
Merchants Bonding Company (Mutual)
Nations Bonding Company
Bond No. TXC 78933
KNOW ALL PERSONS BY THESE PRESENTS: That MERCHANTS BONDING COMPANY (MUTUAL) is a corporation duly organized under the
laws of the State of Iowa, and that NATIONS BONDING COMPANY is a corporation duly organized under the laws of the State of Texas
(herein collectively called the "Companies'), and that the Companies do hereby make, constitute and appoint
Clydene Johnson, Dustin Parker, Kathy Sells and/or Carolyn J. Scott
of Grapevine and State of Texas their true and lawful Attorney -in -Fact, with full power
and authority hereby conferred in their name, place and stead, to sign, execute, acknowledge and deliver in their behalf as surety
any and all bonds, undertakings, recognizances or other written obligations in the nature thereof, subject to the limitation that any
such instrument shall not exceed the amount of:
FIVE MILLION ($5,000,000.00) DOLLARS
and to bind the Companies thereby as fully and to the same extent as if such bond or undertaking was signed by the duly authorized officers
of the Companies, and all the acts of said Attorney -in -Fact, pursuant to the authority herein given, are hereby ratified and confirmed.
This Power -of- Attorney is made and executed pursuant to and by authority of the following bylaws adopted by the Board of Directors
of Merchants Bonding Company (Mutual) on November 16, 2002 and adopted by the Board of Directors of Nations Bonding
Company on April 19, 2003.
The Chairman of the Board or President or any Vice President or Secretary shall have power and authority to appoint
Attorneys -in -Fact, and to authorize them to execute on behalf of the Company, and attach the Seal of the Company thereto,
bonds and undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof.
The signature of any authorized officer and the Seal of the Company may be affixed by facsimile to any Power of Attorney or
Certification thereof authorizing the execution and delivery of any bond, undertaking, recognizance, or other suretyship
obligations of the Company, and such signature and seal when so used shall have the same force and effect as though
manually fixed."
In Witness Whereof, the Companies have caused this instrument to be signed and sealed this 16th day of January, 2006.
• 0 • P0,9 f NG % � •',.1,�N P * � . , • MERCHANTS BONDING COMPANY (MUTUAL)
•Uj:'�OR � � • ;:O• : n • ; �O R 9 9 A92 .1 • NATIONS BONDING COMPANY
:Z:= o- '^ 0
v • z: : 0: •
•
• 1933 3 •
1. �'. 2003 a • ; : c: By ,Z„ , -, 7 , ,i, __,
STATE OF IOWA • •t
•��•••� President
COUNTY OF POLK ss.
On this 16th day of January, 2006, before me appeared Larry Taylor, to me personally known, who being by me duly sworn did say that
he is President of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY; and that the seals
affixed to the foregoing instrument are the corporate seals of the Companies; and that the said instrument was signed and sealed in
behalf of the Companies by authority of their respective Boards of Directors.
In Testimony Whereof, I have hereunto set my hand and affixed my Official Seal at the City of Des Moines, Iowa, the day and year first
above written.
t /
CINDY SMYTH C.v { yJ '+
; y C ommission Number 173604 ""%f
owe My Commission Expires (((///
STATE OF IOWA March 16, 2005
Notary Public, Polk County, Iowa
COUNTY OF POLK ss.
I, Williarn Warner, Jr., Secretary of MERCHANTS BONDING COMPANY (MUTUAL) and NATIONS BONDING COMPANY, do hereby certify
that the above and foregoing is a true and correct copy of the POWER -OF- ATTORNEY executed by said Companies, which is
still in full force and effect and has not been amended or revoked.
In Witness Whereof, I have hereunto set my hand and affixed the seal of the Companies on this 10th day of March 2009.
:Q� Op,P :0 AP x ' 0 9 •
:Z; -o- o. •►—. - -o- g;;.7 •• ti u ..c/ G,'�2y S,G� ;
: �' •. 2003 ; b • • 1933 Secretary
.••• • •. *•....••`;�� •
NBC 0103 (1/06) .•
IMPORTANT NOTICE
To obtain information or make a complaint:
You may contact your insurance agent at the telephone number provided by your insurance agent.
You may call Merchants Bonding Company's toll -free telephone number for information or to make a
complaint at:
1 -800- 678 -8171
You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or
complaints at:
1 -800 -252 -3439
You may write the Texas Department of Insurance at:
P, O. Box 149104
Austin, TX 78714 -9104
Fax: (512) 475 -1771
Web: http: / /www.tdi.state.tx.us
E -mail: ConsumerProtection @tdi.state.tx.us
PREMIUM AND CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim
you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of
Insurance.
ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part
or condition of the attached document.
SUP 0032 TX (7/07)
WRIGHT CONSTRUCTION CO., INC.
601 W. WALL ST.
GRAPEVINE, TEXAS 76051
(817)481 -2594
PUBLIC QUANTITIES
TO: CF JORDAN
ATTN: MIKE KYLER
FAX: 214- 349 -7910
JOB: FREEPORT CROSSING BLDGS A -D
DATE: February 1, 2008
CITY: COPPELL
ITEM UNIT TOTAL 1
NO DESCRIPTION UNIT QTY PRICE AMOUNT � �
WATER
1 8" DETECTOR CHECK & VAULT EA 2 $12,080.00 $24,160.00
2 8" DR -18 WATER LINE LF 50 $16.50 $825.00
3 1 1/2" IRRIGATION SERVICE EA 1 $1,560.00 $1,560.00
4 4" DOMESTIC METER VAULT EA 1 $12,440.00 $12,440.00
5 4" BACKFLOW VAULT EA 1 $7,510.00 $7,510.00
6 16 "X8" TAPPING SLEEVE & VALVE EA 1 $4,420.00 $4,420.00
7 CONNECT TO EXISTING 8" LINE EA 1 $1,050.00 $1,050.00
8 REMOVE & REPLACE EX CONC. PAVEMENT SF 50 $11.00 $550.00
9 TESTING LF 9555 $0.50 $4,777.50
10 TRENCH SAFETY LF 9555 $0.50 $4,777.50
SUBTOTAL WATER $62,070.00
SANITARY SEWER
1 CONNECT TO EXISTING PIPE EA 1 $1,000.00 $1,000.00
SUBTOTAL SANITARY SEWER $1,000.00
STORM DRAINAGE
1 CONNECT TO EXISTING BOX CULVERT EA 1 $1,330.00 $1,330.00
SUBTOTAL STORM DRAINAGE $1,330.00
MAINTENANCE BOND
Bbnd. No 46BCSEW9165 Amount $43,120.00
Know All Men By These Presents
That we, San Saba Construction Services, Inc. (hereinafter called the Principal), as
Principal, and Hartford Fire Insurance Company, Hartford, CT, a corporation duly
organized under the laws of the State of Connecticut, (hereinafter called the Surety), as
Surety, are held and firmly bound unto the City of Coppell, TX (hereinafter called the
Obligee), in the sum of Forty three thousand one hundred twenty and no /100 Dollars
($43,120.00), for the payment of which we, the said Principal and the said Surety, bind
ourselves, our heirs, executors, administrators, successors and assigns, jointly and
severally, firmly by these presents.
Sealed with our seals and dated this 6th day of May, A.D. two thousand and 08.
Whereas the said Principal has heretofore entered into a contract with said Obligee dated
the 29th day of August, 2007 for Water, Sewer & Storm Drain Improvements to
Serve Pointe West VI, Coppell, Texas; and
Whereas, the said Principal is required to guarantee the work listed above installed under
said contract, against all defects in materials or workmanship, which may develop during
the period.
Now, therefore, the condition of this obligation is such, that if the principal shall
faithfully carry out and perform the said guarantee, and shall, on due notice, repair and
make good at its own expense any and all defects in materials or workmanship in the said
work which may develop during the period
Two years from date of completion and acceptance
or shall pay over, make good and reimburse to the said Obligee all loss and damage
which said Obligee may sustain by reason of failure or default of said Principal so to do,
then this obligation shall be null and void; otherwise shall remain in full force and effect.
San Saba Cons do Services_ inr_
Hartford Fire Insur ,ance Company'
13y
Tobin Tucker, Attorney -in -Fact
POWER JF ATTORNEY THE HARTFORD
HARTFORD PLAZA
HARTFORD, CONNECTICUT 06115
X Hartford Fire Insurance Company Twin City Fire Insurance Company
X Hartford Casualty Insurance Company Hartford Insurance Company of Illinois
x Hartford Accident and Indemnity Company Hartford Insurance Company of the Midwest
Hartford Underwriters Insurance Company Hartford Insurance Company of the Southeast
KNOW ALL PERSONS BY THESE PRESENTS THAT the Hartford Fire Insurance Company, Hartford Accident and Indemnity
Company and Hartford Underwriters Insurance Company, corporations duly organized under the laws of the State of Connecticut; Hartford
Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois; Hartford Casualty Insurance Company,
Twin City Fire Insurance Company and Hartford Insurance Company of the Midwest, corporations duly organized under the laws of the
State of Indiana; and Hartford Insurance Company of the Southeast, a corporation duly organized under the laws of the State of Florida;
having their home office in Hartford, Connecticut, (hereinafter collectively referred to as the "Companies ") do hereby make, constitute and
appoint, up to the amount of unlimited:
Tracy Tucker, Tobin Tucker, W. Lawrence Brown
of
Fort Worth, 7X
their true and lawful Attorney(s) -in -Fact, each in their separate capacity if more than one is named above, to sign its name as surety(ies)
only as delineated above by ®, and to execute, seal and acknowledge any and all bonds, undertakings, contracts and other written
instruments in the nature thereof, on behalf of the Companies in their business of guaranteeing the fidelity of persons, guaranteeing the
performance of contracts and executing or guaranteeing bonds and undertakings required or permitted in any actions or proceedings
allowed by law.
In Witness Whereof, and as authorized by a Resolution of the Board of Directors of the Companies on September 12th, 2000,
the Companies have caused these presents to be signed by its Assistant Vice President and its corporate seals to be hereto affixed, duly
attested by its Assistant Secretary. Further, pursuant to Resolution of the Board of Directors of the Companies, the Companies hereby
unambiguously affirm that they are and will be bound by any mechanically applied signatures applied to this Power of Attorney.
�4 g tIN *4f tlTllH Ci tue .w i� t
s " 7YIM er"4 • I u 14 ° sin 3" ttPS GAI i 1 Q '�r � ` t roRn : uv 7 °;:
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' e � - Mt. 1867 = : oe° v tr i = si° * Tr; p� de *
4,0,00 11 \ q y ti L �S �. 3, teteee,ev ,; O bauM► . 1 97 9 J. 0 °:, 1976 I w * $
� z � p � i c.�,1. p' i •• .- y + I i ,r 1" . " »s..... e�� �.,a 1919 ;• ...
sa'<ar "b� V. / • ,.��[ tiaw;rtiD } >'
Paul A. Bergenholtz, Assistant Secretary John P. Hyland, Assistant Vice President
STATE OF CONNECTICUT
ss. Hartford
COUNTY OF HARTFORD
On this 19 day of September, 2000, before me personally came John P. Hyland, to me known, who being by me duly sworn, did
depose and say: that he resides in the County of Hartford, State of Connecticut; that he is the Assistant Vice President of the Companies,
the corporations described in and which executed the above instrument; that he knows the seals of the said corporations; that the seals
affixed to the said instrument are such corporate seals; that they were so affixed by authority of the Boards of Directors of said corporations
and that he signed his name thereto by like authority.
.„ y f� / '
;, t
411 1 1 L---" .91/•"' .
Jean H. Wozniak
CERTIFICATE Notary Public
My Commission Expires June 30, 2004
I, the undersigned, Assistant Vice President of the Companies, DO HEREBY CERTIFY that the above and foregoing is a true and
correct copy of the Power of Attorney executed by said Companies, which is still in full force effective as of 6 th May 2008. .
Signed and sealed at the City of Hartford.
0 .iY IN, ( 4RL IN 0„„ s r Nme ct cp,.. y; it7 , eroy._
E . M► ' .�', k Y ' 1 9 3 7',; . , 1 , t Q a 7. > ��. •el £ ? .`" \, ; t .+�5 Rta1Urg0 w.
�►d t f \ ` #;:;,, <. 1`a a % °,, flitC,WI o ,„„,„. Sg 79 0 : IV i8 9 4 1 g r 9 g • Ra;;a . A „ te�a � �a ea �a
n p�
Colleen Mastroianni, Assistant Vice President
IMPORTANT NOTICE AVISO IMPORTANTE
To obtain information or make a complaint: Para obtener informacion o para someter una
queja.
You may contact your agent.
Puede comunicarse con su agente.
You may call Hartford Insurance Group at the
toll free telephone number for information or to Usted puede Ilamar al numero de telefono
make a complaint at: gratis de The Hartford Insurance Group para
indormacion o para someter una queja al
1- 800 - 392 -7805
1- 800 - 392 -7805
You may also write to The Hartford:
Usted tambien puede escribir a The Hartford.
The Hartford
Hartford Financial Products The Hartford
Hartford Financial Products
2 Park Avenue, 5 Floor
New York, New York 10016 2 Park Avenue, 5 Floor
1- 212 - 277 -0400 New York, New York 10016
1- 212- 277 -0400
You may contact the Texas Department of
Insurance to obtain information on companies, Puede comunicarse con el Departamento de
coverages, rights or complaints at: Seguros de Texas para obtener informacion
acerca de companies, coberturas, derechos o
quejas al:
1 800 - 252 - 3439 1 800 - 252 - 3439
You may write the Texas Department of Puede escribir al Departamento de Seguros de
Insurance Texas
P.O. Box 149104 P.O. Box 149104
Austin, TX 78714 -9104 Austin, TX 78714 -9104
Fax Number (512) 475 -1771 Fax Number (512) 475 -1771
Web: http: / /www.tdi.state.tx.us Web: http: / /www.tdi.state.tx.us
E -mail: ConsumerProtection @tdi.state.tx.us E -mail: ConsumerProtection @tdi.state.tx.us
PREMIUM OR CLAIMS DISPUTES: Should DISPUTAS SOBRE PRIMAS 0 RECLAMOS:
you have a dispute concerning your Si tiene una disputa concerniente a su
premium or about a claim you should prima o a un reclamo, debe comunicarse
contact the agent first. If the dispute is not con su agente primero. Si no se resuelve la
resolved, you may contact the Texas disputa, puede entonces comunicarse con
Department of Insurance. el departamento (TDI).
ATTACH THIS NOTICE TO YOUR POLICY: UNA ESTE AVISO A SU POLIZA: Este aviso
This notice is for your information only and es solo para proposito de informacion y no
does not become a part or condition of the se convierte en parte o condicion del
attached document. documento adjunto.
F- 4275 -1, ./TX4275 -1
HR 42 H006 00 0807
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