agenda item palm beach county board of ...2016/11/22 · that we hal robert valeche of palm beach...
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Agenda Item #:
PALM BEACH COUNTY BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: November 22, 2016
Department
[X] Consent [ ] Regular
Submitted By: County Attorney
Submitted For: County Attorney
[ ] Public Hearing
I. EXECUTIVE BRIEF
Motion and Title: Staff recommends motion to approve and file with the Clerk of the Circuit Court the official bonds on the newly elected or re-elected Commissioners of Palm Beach County.
Summary: Immediately following the election newly elected or re-elected Commissioners must secure bonding for presentation to the Board of County Commissioners for approval pursuant to Section 137.01, Florida Statutes. Section 137 .01 requires that such official bonds must be approved by the Board and then filed with the Clerk of the Circuit Court. Countywide (PFK)
Background and Justification: The following individuals were elected or re-elected to serve as County Commissioners for their respective districts:
Hal Valeche Dave Kerner Mary Lou Berger Mack Bernard
District 1 District 3 District 5 District 7
Attachments: Official Bonds on newly elec d and/or re-elected Commissioners.
Recommended by: Date
Approved by: __________ N_/A ____________ _ .Date
-J
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IL FISCAL IMPACT ANALYSIS
Five Year Summary of Fiscal Impact:
Fiscal Years 2017
Capital Expenditures ·~Operating Costs $1-,...3..6 o External Revenues Program Income (Co.) In-Kind Match (County)
NET FISCAL IMPACT$1..!l_60
# ADDITIONAL FTE POSITIONS (Cumulative)_
Is Item Included in Current Budget?
2018 2019
Yes~No
2020
Budget Account No.: Fund 0001 Department 760 Unit 7601 Object 4501 Reporting Category __
B. Recommended Sources of Funds/Summary of Fiscal Impact:
C. Departmental Fiscal Review: _________ _
Ill. REVIEW COMMENTS
A. OFMB Fiscal and/or Contract Dev. and Control Comments:
B. Legal Sufficiency:
C. Other Department Review:
Department Director
THIS SUMMARY IS NOT TO BE USED AS A BASIS FOR PAYMENT.
G:\ WPDA T A\ENG\PFK\BONDS\CommissionerBonds2016 ElectiorlAIS.Election_2016.doc
2021
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PUBLIC OFFICIAL BOND (Definite Term)
Bond No. 21BSBHO5943
KNOWALL MEN BY THESE PRESENTS,
That we Hal Robert Valeche of Palm Beach Gardens, FL 33418 as Principal, and Hartford Fire Insurance Company ' a corporation duly incorporated
under the laws of the State of Connecticut, as Surety are held and firmly bound unto Palm Beach County Board of Commissioners as Obligee in the penal sum of Two Thousand ( $2, ooo ) Dollars, lawful money of the United States of
America, for the payment of which well and truly to be made, said Principal binds himself/herself, his/her heirs, executors, administrators and assigns, and said Surety binds itself, its successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the said principal has been Elected to the office of County Commissioner for a definite term beginning November 22, 2 016 and ending November 3 o, 2 02 o and is required to furnish a bond for the faithful performance of the duties of the said office or position.
NOW, THEREFORE THE CONDITION OF THIS OBLIGATION is such that if the above bounden Principal shall (except as hereinafter provided) faithfully perform the duties of his/her said office or position during the said term, and shall pay over to the persons authorized by law to receive the same all moneys that may come into his/her hands during the said term without fraud or delay, and at the expiration of said term, or in case of his/her resignation or removal from office, shall turn over to his/her successor all records and property which have come into his/her hands, then this obligation to be null and void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that the above named Surety shall not be liable hereunder for any loss of any public fund resulting from the insolvency of any bank or banks in which said funds are deposited; and, if this provision shall be held void, this entire bond shall be void.
AND PROVIDED FURTHER, that the Surety may cancel bond at any time during the said term by giving to the obligee a written notice of its desire so to cancel and at the expiration of thirty (30) clays from the receipt of such notice by the obligee the surety shall be completely released as to all liability thereafter accruing. If this provision shall be held void, this entire bond shall be void.
SEALED and dated this November 1s, 2016
Hal Robert Valeche
Witness (Principal)
Hartford Fire Insurance Company
By: ________________ _ Melissa Haskins, Attorney-in-Fact
S-2232 (08-99)
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Direct Inquiries/Claims to: THE HARTFORD
POWER OF ATTORNEY BOND, T-12 One Hartford Plaza
Hartford, Connecticut 06155 [email protected]
call: 888-266-3488 or fax: 860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: A J GALLAGHER RISK MNGMT SVCS INC Agency Code: 21-224940
[D Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut [=:J Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana D Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut D Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut [=:J Twin City Fire Insurance Company, a corporation duly organized under the laws of the State oflndiana D Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois CJ Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana D 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 Melissa Haskins of Lake Mary, Florida, its true and lawful Attorney-in-Fact, to sign its name as surety(ies) only as delineated above by , and to execute, seal and acknowledge the following bond, undertaking, contract or written instrument: Bond No. 21BSBHO5943
Naming Hal Robert Valeche as Principal, and Palm Beach County Board of Commissioners as Obligee, in the amount of See Bond Form(s) on behalf of Company in its 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 May 6, 2015 the Companies have caused these presents to be signed by its Senior 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.
·t~~~ a~t .,,._ ,~-..... ~"'~ I;l~~ ;f rt#u;~,~\H ,{ ~ V;.\ t~7li'I ;ff 1.i\tlil7'.tJ' _.r1.l ·1 :wr, ~ ~••l•· ~·/~~:/" x~~'-",." •••~ ~9 /2-1 >,.,,,,,~ ~·~· '-.;:;:;:.~/
John Gray, Assistant ~ecretary M. Ross Fisher, Senior Vice President
STATE OF CONNECTICUT } ss. Hartford
COUNTY OF HARTFORD
On this 11th day of January, 2016, 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 Senior 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.
CERTIFICATE
ePOA 2016
Nora M. Stranko Notary Public
My Commission Expires March 31, 2018
?"~. ~ LJ~ .. -~· /,/R'fi,A-A---. 7 ,
Kevin Heckman, Assistant Vice President
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OATH OF OFFICE (Art. II.§ 5(b), Fla. Const.)
STATE OF FLORIDA
County of PALM BEACH
I do solemnly swear ( or affirm) that I will support, protect, and defend the Constitution and Government of the United States and of the State of Florida; that I am duly qualified to hold office under the Constitution of the State, and that I will well and faithfully perform the duties of
PALM BEACH COUNTY COMMISSIONER, DISTRICT 1 (Title of Office)
on which I am now about to enter, so help me Go.d.
[NOTE: If you affirm, you ~Y ~~it the wor, "so ~elp me Go!'.' See§ 92.52, Fla. Stat.]
s!Ci-Q t -~l~ s;gnature v
Sworn to and subscribed before me this l'lr'~ay of /JdVtJIVi'A , Lb/(. ____ Wr:: Signature of Officer A
Print, Type, or Stamp Commiss_,,,__,_..,_~-~~~===...
Personally Known ~R Produced ldent{fication D
Type of Idenrffication Produced ______________ _
~------ ·-------------------~-~-~-~~~~-~--~--~~~-~, ACCEPTANCE
I accept the office listed in the above Oath of Office.
Mailing Address: D Horne [Z] Office
301 N. Olive Avenue, 12th Floor Street or Post Office Box
West Palm Beach 1 FL. 33401 City, State, Z.ip Code
DS-DE 56 (Rev. 02/10)
Signature
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PUBLIC OFFICIAL BOND (Definite Term)
Bond No. 21BSBHO5952
KNOWALL MEN BY THESE PRESENTS,
That we Dave Kerner of West Palm Beach, FL 33401 as Principal, and Hartford Fire Insurance Company , a corporation duly incorporated
under the laws of the State of Connecticut, as Surety are held and firmly bound unto Palm Beach County Board of Commissioners as Obligee in the penal sum of Two Thousand ( $2, ooo ) Dollars, lawful money of the United States of
America, for the payment of which well and truly to be made, said Principal binds himself/herself, his/her heirs, executors, administrators and assigns, and said Surety binds itself, its successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the said principal has been Elected to the office of County Commissioner, DiSt rict 3
for a definite term beginning November 22, 2 016 and ending November 3 o 1 2 02 o and is required to furnish a bond for the faithful performance of the duties of the said office or position.
NOW, THEREFORE THE CONDITION OF THIS OBLIGATION is such that if the above bounden Principal shall (except as hereinafter provided) faithfully perform the duties of his/her said office or position during the said term, and shall pay over to the persons authorized by law to receive the same all moneys that may come into his/her hands during the said term without fraud or delay, and at the expiration of said term, or in case of his/her resignation or removal from office, shall turn over to his/her successor all records and property which have come into his/her hands, then this obligation to be null and void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that the above named Surety shall not be liable hereunder for any loss of any public fund resulting from the insolvency of any bank or banks in which said funds are deposited; and, if this provision shall be held void, this entire bond shall be void.
AND PROVIDED FURTHER, that the Surety may cancel bond at any time during the said term by giving to the obligee a written notice of its desire so to cancel and at the expiration of thirty (30) days from the receipt of such notice by the obligee the surety shall be completely released as to all liability thereafter accruing. If this provision shall be held void, this entire bond shall be void.
SEALED and dated this November 1s, 2016
Dave Kerner
Witness (Principal)
Hartford Fire Insurance Company
By: ________________ _ Melissa Haskins, Attorney-in-Fact
S-2232 (08-99)
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Direct Inquiries/Claims to: THE HARTFORD
POWER OF ATTORNEY BOND, T-12 One Hartford Plaza
Hartford, Connecticut 06155 [email protected]
call: 888-266-3488 or fax: 860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: A J GALLAGHER RISK MNGMT SVCS INC Agency Code: 21-224940
[CJ Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut CJ Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana CJ Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut c=J Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut CJ Twin City Fire Insurance Company, a corporation duly organized under the laws of the State of Indiana CJ Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois CJ Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana c=J 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 Melissa Haskins of Lake Mary, Florida, its true and lawful Attorney-in-Fact, to sign its name as surety(ies) only as delineated above by , and to execute, seal and acknowledge the following bond, undertaking, contract or written instrument: Bond No. 21BSBHO5952
Naming Dave Kerner as Principal,
and Palm Beach County Board of Commissioners as Obligee, in the amount of See Bond Form(s) on behalf of Company in its 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 May 6, 2015 the Companies have caused these presents to be signed by its Senior 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.
STATE OF CONNECTICUT} ss. Hartford
COUNTY OF HARTFORD
~).~~ii} -:~ .. ~': .. ~~'4)}~~itc! * :•:.·~ • \:,:,.\197~;.fl ,;.~'f,\l.17'.?Jl_..f:f ·z, :t9'!:// '~,<,i;, ... ,.!IAI•~~' ~~"'> .... ~ ·--~
,,,1.,'tu-,r;i1~ 1.61u.•"" • ~:::..~•
M. Ross Fisher, Senior Vice President
On this 11th day of January, 2016, 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 Senior 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.
CERTIFICATE
ePOA2D16
,...., ... / }-,
/J~_jz) Nora M. Stranko
Notary Public My Commission Expires March 31, 2018
r. /#: f:_. ... ~- /fP',u~------Kevin Heckman, Assistant Vice President
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OATH OF OFFICE
STATE OF FLORIDA
County of PALM BEACH
(Art. II.§ 5(b), Fla. Const.)
I do solemnly swear ( or affirm) that I will support~ protect> and defend the ~onstitu.tion and Government of the -United States and of the State of Florida; that I am .duly qualified to hold office under.the Constitution of the State, and.that I will well and f~ithfully'p~rform the·duties of
PALM BEACH COUNTY COMMISSIONER 1 DISTRICT 3 (Title of Office)
on which I am now about to enter, so help me God.
[NOTE: If you affirm, you may omit the words ~~so help me God." See§ 92.52, Fla. Stat.]
--, .. ~ ~. ~-----Signature
Sworn to and subscribed before me thtslt!_ day 0J/U11Ve>A ~6( , ~dlC. u .r::. --~J;,.
Print, Type, or Stamp Commissioned Nan ·
Personally Known D OR Produced Identification ~
Type of Identification Produced FL, /1. JF:4 01.. 4i'v QA. f: /,J=ct,,J f 1/C,
ACCEPTANCE I accept the office listed in the above Oath of Office.
Mailing Address: D Home [Z] Office
301 N. Olive Avenue 1 12th Floor Street or Post Office Box
West Palm Beach, FL. 33401
City, State, Zip Code
DS~DE 56 (Rev. 02/10)
Dave Kerner Print name as you desire commission issued
cL.--~ .~--:a.----Signature
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PUBLIC OFFICIAL BOND (Oefinit~ Term)
Bond No. 21BSBH05994
KNOWALL MEN BY THESE PRESENTS,
That we Mary Lou Berger of Delray Beach, FL 33446 as Principal, and Hartford Fire Insurance Company , a corporation duly incorporated
under the laws of the State of Connecticut, as Surety are held and firmly bound unto Palm Beach County Board of Commissioners as Obligee in the penal sum of Two Thousand ( $2, ooo ) Dollars, lawful money of the United States of
America, for the payment of which well and truly to be made, said Principal binds himself/herself, his/her heirs, executors, administrators and assigns, and said Surety binds itsel( its successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the said principal has been Elected to the office of County Commissioner for a definite term beginning November 22, 2016 and ending November 30, 2020
and is required to furnish a bond for the faithful performance of the duties of the said office or position.
NOW, THEREFORE THE CONDITION OF THIS OBLIGATION is such that if the above bounden Principal shall (except as hereinafter provided) faithfully perform the duties of his/her said office or position during the said term, and shall pay over to the persons authorized by law to receive the same all moneys that may come into his/her hands during the said term without fraud or delay, and at the expiration of said term, or in case of his/her resignation or removal from office, shall turn over to his/her successor all records and property which have come into his/her hands, then this obligation to be null and void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that the above named Surety shall not be liable hereunder for any loss of any public fund resulting from the insolvency of any bank or banks in which said funds are deposited; and, if this provision shall be held void, this entire bond shall be void.
AND PROVIDED FURTHER, that the Surety may cancel bond at any time during the said term by giving to the obligee a written notice of its desire so to cancel and at the expiration of thirty (30) days· from the receipt of such notice by the obligee the surety shall be completely released as to all liability thereafter accruing. If this provision shall be held void, this entire bond shall be void.
SEALED and dated this November 1s, 2016
Mary Lou Berger
Witness (Principal)
Hartford Fire Insurance Company
By: ________________ _ Melissa Haskins, Attorney-in-Fact
S-2232 (08-99)
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Direct Inquiries/Claims to: THE HARTFORD
POWER OF ATTORNEY BOND, T-12 One Hartford Plaza
Hartford, Connecticut 06155 [email protected]
call: 888-266-3488 or fax: 860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: A J GALLAGHER RISK MNGMT SVCS INC Agency Code: 21-224940
[D Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut
c=J Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana
D Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut
D Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut
D Twin City Fire Insurance Company, a corporation duly organized under the laws of the State oflndiana
D Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois
c=J Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana
c=J 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 Melissa Haskins of Lake Mary, Florida, its true and lawful Attorney-in-Fact, to sign its name as surety(ies) only as delineated above by , and to execute, seal and acknowledge the following bond, undertaking, contract or written instrument: Bond No. 21BSBHO5994
Naming Mary Lou Berger as Principal,
and Palm Beach County Board of Commissioners as Obligee,
in the amount of See Bond Form(s) on behalf of Company in its 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 May 6, 2015 the Companies have caused these presents to be signed by its Senior 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.
STATE OF CONNECTICUT } ss. Hartford
COUNTY OF HARTFORD
M. Ross Fisher, Senior Vice President
On this 11th day of January, 2016, 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 Senior 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.
:(;t,•'.} .. 24 ),J.' ;;'-:· / /i .. ,,:~:ttU,,,,¥, ... 0
Nora M. Str;~o Notary Public
CERTIFICATE My Commission Expires March 31, 2018
I .,,,. ,1,Y ~-
✓.:,/f_ ... _,a,..,..,.:,_,. t?,r'~-~. 7 .( µ/(r
Kevin Heckman, Assistant Vice President
ePOA 2016
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OATH OF OFFICE (Art. II.§ S(b), Fla. Const,)
STATE OF FLORIDA
County of PALM BEACH
I do solemnly swear ( or affirm) that I will support, pl'otect, and defend the Constitution and Government of the United States and of the State of Florida; that I am duly qualified to hold office under the Constitution of the State, and that I will well and faithfully pel'form the duties of
PALM BEACH COUNTY COMMISSIONER, DISTRICT 5 (Title of Office)
on which I am now about to enter, so help me God.
[NOTE: If you affirm, yo ay omit the words "so help me God." See§ 92.52, Fla. Stat.]
s;gnature
Sworn to and subscribed before 1l1e this ~ay of ,NoVIY+",.~..f... , 2al C,,.
Type of Identification Produced ___ ~-----------
ACCEPTANCE I accept the office listed in the above Oath of Office.
Mailing Address: D Home [ZJ Office
301 N. Olive Avenue, 12th Floor Street or Post Office Box
West Palm Beach, FL. 33401 City, State, Zip Code
DS-DE 56 (Rev. 02/10)
Mary Lou Berger
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PUBLIC OFFICIAL BONO (Definite Term)
Bond No. 21BSBHO6057
KNOWALL MEN BY THESE PRESENTS,
That we Mack Bernard of West Palm Beach, FL 33401 as Principal, and Hartford Fire Insurance Company , a corporation duly incorporated under the laws of the State of Connecticut, as Surety are held and firmly bound unto
Palm Beach County Board of Commissioners as Obligee in the penal sum of Two Thousand ( $2, ooo ) Dollars, lawful money of the United States of
America, for the payment of which well and truly to be made, said Principal binds himself/herself, his/her heirs, executors, administrators and assigns, and said Surety binds itself, its successors and assigns, jointly and severally, firmly by these presents.
WHEREAS, the said principal has been Elected to the office of County Commissioner, DiSt rict l
for a definite term beginning November 22, 2 016 and ending November 3 o, 2 02 o and is required to furnish a bond for the faithful performance of the duties of the said office or position.
NOW, THEREFORE THE CONDITION OF THIS OBLIGATION is such that if the above bounden Principal shall (except as hereinafter provided) faithfully perform the duties of his/her said office or position during the said term, and shall pay over to the persons authorized by law to receive the same all moneys that may come into his/her hands during the said term without fraud or delay, and at the expiration of said term, or in case of his/her resignation or removal from office, shall turn over to his/her successor all records and property which have come into his/her hands, then this obligation to be null and void; otherwise to remain in full force and effect.
PROVIDED, HOWEVER, that the above named Surety shall not be liable hereunder for any loss of any public fund resulting from the insolvency of any bank or banks in which said funds are deposited; arid, if this provision shall be held void, this entire bond shall be void.
AND PROVIDED FURTHER, that the Surety may cancel bond at any time during the said term by giving to the obligee a written notice of its desire so to cancel and at the expiration of thirty (30) days from the receipt of such notice by the obHgee the surety shall be completely released as to all liability thereafter accruing. If this provision shall be held void, this entire bond shall be void.
SEALED and dated this November 1s, 2016
Mack Bernard
Witness (Principal)
Hartford Fire Insurance Company
By: ________________ _ Melissa Haskins, Atto rn ey-i n-F a ct
S-2232 (08-99)
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Direct Inquiries/Claims to: THE HARTFORD
POWER OF ATTORNEY BOND, T•12 One Hartford Plaza
Hartford, Connecticut 06155 [email protected]
call: 888-266-3488 or fax: 860-757-5835
KNOW ALL PERSONS BY THESE PRESENTS THAT: Agency Name: A J GALLAGHER RISK MNGMT SVCS INC Agency Code: 21-224940
~ Hartford Fire Insurance Company, a corporation duly organized under the laws of the State of Connecticut CJ Hartford Casualty Insurance Company, a corporation duly organized under the laws of the State of Indiana CJ Hartford Accident and Indemnity Company, a corporation duly organized under the laws of the State of Connecticut CJ Hartford Underwriters Insurance Company, a corporation duly organized under the laws of the State of Connecticut CJ Twin City Fire Insurance Company, a corporation duly organized under the laws of the State oflndiana C:J Hartford Insurance Company of Illinois, a corporation duly organized under the laws of the State of Illinois CJ Hartford Insurance Company of the Midwest, a corporation duly organized under the laws of the State oflndiana CJ 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 Melissa Haskins of Lake Mary, Florida, its true and lawful Attorney-in-Fact, to sign its name as surety(ies) only as delineated above by , and to execute, seal and acknowledge the following bond, undertaking, contract or written instrument: Bond No. 21BSBHO6057
Naming Mack Bernard as Principal, and Palm Beach County Board of Commissioners as Obligee, in the amount of See Bond Form(s) on behalf of Company in its 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 May 6, 2015 the Companies have caused these presents to be signed by its Senior 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.
STATE OF CONNECTICUT} ss. Hartford
COUNlY OF HARTFORD
~)(?1\l~ v .. \197~.-::fix~~w·i l9'!4' ~,~,~1 ~v ··~~~·-
~r2-M. Ross Fisher, Senior Vice President
On this 11th day of January, 2016, 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 Senior 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.
CERTIFICATE
oPOA2016
. / ,:;7 i;;i·: i ,,
1,:17,lL. /,i;/41,A,,.l_.''¢. Nora M. Stranko
Notary Public My Commission Expires March 31, 2018
?~~ Kevin Heckman, Assistant Vice President
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OATH OF OFFICE
STATE OF FLORIDA
County of PALM BEACH
(Art. II. § 5(b ), Fla. Const.)
I do solemnly swear ( or affirm) that I will support, protect, and defend the Constitution and Government of the United States and of the State of Florida; that I am duly qualified to hold office under the Constitution of the State, and that I will well and faithfully perform the duties of
PALM BEACH COUNTY COMMISSIONER 1 DISTRICT 7 (Title of Office)
on which I am now about to enter, so help me God.
[NOTE: If you affirm, you may omit the words "so help me God." See§ 92.52, Fla. Stat.]
Print, Type, or Stamp Commissioned ...._ ___________ __
Personally Known D OR Produced.Identification W-
Type of Identification Produced f2&4:"ll 11!1 .r L/:'t:l"-AJS<r; - Fl1;1\~)tf
ACCEPTANCE I ac<;ept the office listed in the above Oath of Office.
Mailing Address: D Home 0 Office
301 N. Olive Avenue, 12th Floor Street or 'Post Office Box
West Palm Beach, FL. 33401 City, State, Zip Code
DS-DE 56 (Rev, 02/.10)
Mack Bernard Print name as you desire commission issued
J/V!y~f/02-tA/?,~~ 6&~_/-._/~>- )j Signature