Fee Calculation Worksheet

Name of School: ~ ~ //~ //~~~~

City: ~-- ~ ~C{'~(S L (( afe: ,~/~~~ UI --~-, ~l

Initial Licensure Application and Student Protection Fund Fees:Amount Owed Amount Paid

Resident School Yes No If yes, $500 fee

Student Protection Fund Contribution $500

Non-Resident School Yes No If yes, $1,250 fee

Student Protection Fund Contribution $1,250

Agent Fees:

Number of Agents: Multiply this number by $175 fee

CDlSCHOOL

Application for Resident CDL School License Fee If yes, $500 feeApplication fee KRS 165A.475(2) $200 feeContribution to Student Protection Fund $500 feeNumber of CDL Instructors: ~ Multiply this number by $220 feeNumber of Agents: Multiply this number by $175 fee

Application for Non-Resident CDL School License Fee If yes, $1,250 feeApplication fee KRS 165A.475(2) $200 feeContribution to Student Protection Fund $1,250 feeNumber of CDL Instructors: Multiply this number by $220 feeNumber of Agents: Multiply this number by $175 fee

RESIDENT AND NON-RESIDENT SCHOOL RENEWALTransfer of Ownership of School? (referto application) Yes -or- No If yes, $SOO fee

Chanze of Name of a School? Yes -or- No If yes, $150 fee

Chanze of Location of a School? Yes -or- No If yes, $500 fee

Application to Award an Associate De¢ree? Yes -or- No If yes, $750 per degree

Pro¢ram Revisions? Yes -or- No

for 25% or more of an existing

program If yes, $200 fee per program

for less than 25% If yes, $100 fee per program

Amount Owed Amount Paid

Resident School Yes -or- Na $500

Non-Resident School Yes -or- No $1,250

Gross Revenue =Total Amount of Tuition Earned -

Tuition Refunds paid to student from July 1, 2018 -

June 30, 2019 See how to calculate below:

How to Calculate Fees if Revenue is above $50,000 -refer to attached calculation sheet (additional $25 per $10,000)

New Pro¢ram(s): Amount Owed Amount PaidNumber of New Program(s): Multiply this number by $200 fee

Anent Fees: ~ r~ ~ L / /7bYY1 D1'1 ~L~~) ~~ `~\ ~ St

Number of New Agents~~/ ~ ~

Z9S Multiply this number by $175 fee ✓

Number of Agent RENEWAI$~ ~ Multiply this number by $175 fee

~7CDLSchool? Yes -or- No If Yes, $200 Annual fee

Number of CDL Instructor RENE ~WQ ~, ~ ,'"-r Multiply this number by $220 fee

QI.~, -_ /,''rte+`Number of New CDL Instructors: ~V~C~YI ~~ Multiply this number by $220 fee

ne 1 (l~t~ I 1Site VisiT: VariesLate Fee: ~~ aJ~'Jy ~''•

ACTION STEPS o otal Fees Owed: T~ ~V

Total Fees Received: ~~ /~

Caris College, LLC

001105

2780 Jefferson Centre Way, Su

ite 102

Jeffersonville, IN 47130

ss-siaaa

www.cariscollege.edu

DATE

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ORD ROF ~`~~~,~G~<L~ ~~a~P ~.~~~ c~~I~V~Y

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DOLLARS B o.,y

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.

WesBanco

1 Bank Plaza

Wheeling, WV 26003

MEMO`L-I~ ~YM~~

~~fl C~C~~~ Q(~~~~

7~

~~'00

L ~0 5~

~' ~:0 4 3 4000 3 6~

: 4 5 L 200 288 6~

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\ETARY E

C4NTINUATI~N CERTIFICATE(For Use On Surety Bonds)

St~t~Farm

STATE FARM FIRE AND CASUALTY COMPANYBLOOMINGTON, ILLINOIS

The STATE FARM FIRE AND CASUALTY COMPANY {hereinafter called the Company) hereby continues in

force its Bond Na. 97 EN 3091 0 in the sum of Dollars ($ lo, o00 . oo }, TErr mxousAlvU

DOLLARS AND NO CENTS

on behalf of CARIS COLLEGE LLC

in favor of KEN'T'UCKY COMMISSI023 ON PROPRZETA.RY EDUCATION

for the (extended} term, subject to all the covenants and conditions of said bond, beginning on

Jttty~ 3a, 2ols and ending on J~~ 30, 2020

This Continuation is executed upon the express condition that the Company's liability under said Band and this

and all continuations thereof shai! not be cumulative and shall in na event exceed the sum stated above.

IN WITNESS WHEREOF, the company has caused this instrument to be signed by its officers proper for the

purpose and its corporate seal to be hereto affixed APRzi, t2, 2oi9

~_ ~P̀E GNU Cgsvt'i~:.

e};'~ ' ~'~ ~`~ a:4r. ̀ oaron~~ ~~.o ~:

..... F . Y

~f 'n ~'. J..GN.7L.i ,'

'~' i.,,,

STATE FARM FIRE ND CASUALTY COMPANY(Surety)

By: -- (SEAL)Attorney-in-Fact

FB-9045.3 1045870 127433 3 04Q4-2Q19

CONTINUATION CERTIFICATE(For Use On Surety Bonds)

StateFarm

STATE FARM FIRE AND CASUALTY COMPANYBLOOMINGTON, ILLINOIS

The STATE FARM FIRE AND CASUALTY COMPANY {hereinafter called the Company) hereby continues in

force its Bond No. 9~ EN 3Q91 0 in the sum of Dollars ($ la, o00 . oo ), T~r~ mxous~rU

DOLLARS AND NO CENTS

on behalf of CARIS COLLEGE LLC

in favor of KENTUCKY COMMISSIOi3 ON PROPRIETARY EDUCATIQN

for the {extended} term, subject to alI the covenants and conditions of said bond, beginning on

Jtm1E 30 , 2olg and ending on JUNE 30, zo2o

This Continuation is executed upon the express condition that the Company's liability under said Bond and this

and all continuations thereof shall not be cumulative and shall in no event exceed the sum stated above.

IN WITNESS WHEREOF, the company has caused th+s instrument to be signed by its officers proper for the

purpose and its corporate seal #o be hereto affixed APRIL t2 , 2oi9

T r~P̀E A%tl CqS~~~~~:.

t ~,

..... ~ ;i ~ ~+ j~̀ ;,STATE FARM FIRE Np CASUALTY COMPANY

{Surety)By: (SEAL}

Attorney-in-Poet

FB-9045.3 105870 127433 3 04-Q9-2019

Power ~f '+ttorney

STATE FARM FIRE AND CASUALTY COMPANY

KNOW ALL PERSONS BY TNESE PRESENTS: That STATE FAf2M FIRE AND CASl1ALTY COMPANY, an Illinois corporation, with its principal once inBloomington, Illinois, does hereby constitute and appoint: Eugina Brant, Amanda J. CEifton, Pamela Chancellor, Julie Fehrman, Kim Filter, Mark Fink, Julie

Freed, Matthew J. Gibbons, Jay W. Hendren, John R. Horton, Jeanette Hughes, Jerry Jacek, Julia Kiinzing, Connie S. Knox, Leann Lemmef, Lori McDowell,

Thomas P. Miller, Melissa L. Morris, Carey J Rice, Suzanne M. Robertson, Alice Schuler, Neidi Simmons, Heidi Stevens, Steven M. Straub, Perry Tracy.Kathy J. Walker, Karen Weber, Karli Yoder of Bloomington, Illinois its true and lawful Attorneys)-in-Fact, to make, execute, seal and deliver for, and on its

behalf as surety, any and a!I bonds, undertakings or other writings obligatory in the nature of a bond as follows:

Any such obligation in any amount

1

This appointment is made under and by the authority of a resolution which was passed by the Executive Committee of the Board ofDirectors of State Farm Fire and Casualty Company on the 14'" day of March, 2018, as is duly authorized by the Board of Directors in ArticleII, Section 6 of the By-Laws of the Company, which resolution is:

Resolved, that the Officer of the Company who works regularly with surety bonds is hereby authorized to appoint and empower anyrepresentative of the Company or other person or persons as Attorney-in-Fact to execute on behalf of the Company any bonds,undertakings, policies, contracts of indemnity or other writings obligatory in the nature of a bond, which the Company might execute throughits officers, and affix the seal of the Company thereto. Any said execution of such documents by an Attorney-in-Facf shall be as bindingupon the Company as if they had been duly executed and acknowledged by the regularly elected or appointed o~cers of the Company. AnyAttorney-in-Fact, so appointed, may be removed for good cause and the authority so granted may be revoked as specified in the Power ofAttorney. '

Resolved, that the signature of any O~cer of the Company noted above and the seal of the Company may be axed by facsimile onany power of attorney granted, and the signature Qf the any Officer of the Company noted above, and the seal of the Company may beaffixed by facsimile to any certificate of any such power and any such power or certificate bearing such facsimile signature and seal shall bevalid and binding on the Company. Any such power so executed and sealed and certificate so executed and seated shall, with respect toany band or undertaking to which it is attached, continue to be valid and binding on the Company.

IN WITNESS THEREOF, STATE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its AssistantSecretary Treasurer, and its Corporate Seal to be axed this 14"' day of March, 2018.

This APPOINTMENT SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31, 2421, UNLESS SOONERREVO}CED AS FROVtDED.

'_P~t~eEi,~oc~su~~r~,~.' STATE FARM FIRE AND CASUALTY COMPANY

E J

~ i ~+ ~ p ~/,4 ~

',,,s,''•. ... .. ..•',~_= John R: Horton -Assistant Secretary Treasurer % `'~„ °~~ ~«`• ~ - ISTATE OF ILLINOIS ~,,,, ~*~~.

COUNTY OF McLEAN

On this 1Ath day of March, 2018, before me personally came John R. Horton to me known, who being duly sworn, did depose and say that he.is

Assistant Secretary Treasurer of STATE FARM FfRE AND CASUALTY COMPANY, the corporation described in and which executed the above instrument;

that he knows the seal of said corporation; that the seal affixed to said instrument is such Corporate Seal; and that he executed said instrument on behalf of

the corporation by authority of his office under the By-Laws of said corporation.. ~;.

}~ x J t

"QT+'~`°~ -~f'`-~~ Notary Public''~C~'"""'"~`"~:̀~'~`~`~~~` Nly commission expires August 3fl, 2021

CERTIFICATE

I, the undersigned Assistant Secretary Treasurer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of

Attorney of which the foregoing is a krue and correct copy, is in full force and effect and has not been revoked and the resafutions as set forth are now in

force.

Signed and sealed at Bloomington, Illinois. Dated this ~`'~'~~ day of

~=k̀PE ►.NO C.~s`~~ iii

~p*Ort~r `-.ni W ~ ~ E : ; i

If you have a question concerning the validity of this Power of Attorney, call (309) 766-2090.FB6-9045. R(06-19-2018)

~. ,

ulia Klinzing —Assistant easur

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