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HomeMy WebLinkAbout1980-1989STOCK COMPANIES ROYAL INDEMNITY COMPANY A NEW YORK CORPORATION ROYAL GLOBE INSURANCE COMPANY AN ILLINOIS CORPORATION GLOBE INDEMNITY COMPANY A NEW YORK CORPORATION NEWARK INSURANCE COMPANY A NEW JERSEY CORPORATION East Orange, New Jersey AMERICAN AND FOREIGN INSURANCE COMPANY A NEW YORK CORPORATION SAFEGUARD INSURANCE COMPANY A CONNECTICUT CORPORATION Hartford, Connecticut Executive Office: 150 William Street, New York, New York 10038 BOND NO. 635906 PUBLIC OFFICIAL BOND C.ow Ali By i hese resen s. that ARTHUR FANNING as Principal (hereinafter called "Principal") and the ROYAL GLOBE INSURANCE COMPANY ,, a corporatioa having an office in the City of NEW YORK~ 150 WILLIAM STREET as Surety (hereinafter called "Surety") are held and firmly bound unto ....................... MATTITUCK FIRE DISTRICTs MATTITUCKs NEW YORK in the penalty of TWENTY-FIVE THOUSAND AND 00/I00 .... Dollars ($25,000.00 ) to the payment whereof, well and truly to be made and done, the said principal binds himself, his heirm, executors and administrators, and the sa~d Surety binds itself, its successors and assigns, jointly and severally, firmly by these presents. ~tgtt£~l, sealed and dated this . 12TH day of SEPTEMBERs 1980 A.D., Ninetee~ hundred and E I GliTY · he (~onbttton of the eforegotng C~bltgetton ts such. that ~hereas. the said prin- cipal was elected or appointed SECRETARY-TREASURER for the term-heginning dANUARY I, .1~181 and ending DECEMBER 21 s 198 I or until his successor is elected or appointed and qualifies. ~Tolla, ~l~ergfore, if the said Principal shall well and faithfully perform all and singular the duties incumbent upon him by reason of his election or apl~_intment as saia SECRETARY-TREASURER FOR THE YEAR COMMENCING JANUARY Is 1981 AND ENDING DECEMBER 31, 1981 except as hereinafter limited, and honestly account for all moneys coming into his hands as said ........ SECRETARY-'TREASURER FOR THE SAID YEAR ABOVE according to law, then this obligation shall be null and void; it is otherwise to be and remain in full force and virtue. ~h~lt ~illll~l is executed by the Surety subject to the following conditions: FIRST--That t~v~A.~iyT~ h~l,vfl~e ~h~ ~ tel~?_.natl~lJ[Wio~16~[ _g. iv~t~i%~) days notice in writing to the said the said surety remaining liable for all or any act or acts covered by this bond which may have been committed by the principal up to the date of such termination, and the surety shall, as soon as practicable after demand therefor, refund the premium paid, less a pro rata part thereof, for the time that this bond shall have been in force. SECOND--That the Surety shall not be liable to the said ......................... MATTITUCK FIRE 01STRICTs MATIITUCKs NE~ YORK by reason of the refusal, inability or failure of any bank, depository or depositories to pay upon demand any public moneys which now are or may hereafter be placed on general or special deposit by or on behalf of said Principal, or by reason of the allowance to or acceptance by said Principal of any interest thereon, any Law, Ordinance or Statute of the State of NElt/ YORK or any O,'dinance of the said MATTITUCK FIRE DISTRICT~ MATTITUCK ~ NEW YORK to the contrary notwithstanding. 31n i~esttmon§ 1~lhereof. Surety has caused this instrument of NEW YORK~ NEW YORK and year first above written. the said Principal has hereunto set his hand and seal, and the said writing to be signed by its duly authorized representative at , and its corporate seal to be hereunto affixed, the day Principal Witness: ROYAL GLOBE INSURANCE COMPANY CF22042B 12TH SEPTEHBER 80 19~, before ~re personally On this da) ol , MILDRED W. OEIIL who, I,eing by me d.ly ~worn, said: that he resides~ Brooklyn,S,Y, ; tlmt he is Attorney-in-Fact of the Ihe coq,ornlion descril~d in ..d which exec.ted tim foregoing instru~nt; that he knows the cor- pornle ~enl of die said Comlmny; that the seal affixed to said tnstrumenl is such cor~rate seal; thai it was so affixed 5y order nnd mdhorlty of the Donrd of Direclors of said Company; and that he sig.ed his name Ihemto as Atlorney-ln-Fnct by like ~uthorily; and that ~l~e liabilities of the snld (;ompnny do ~1 exceed it~ assets, the L.w~ of 1939, constitullng Chapter 20 of die Consolid~led Laws of the State of New Y~k, and known ns the lnsnmnce [,nw, nnd that p, rsu~nt to ~c. 327 of t~ Insurance Law the S~erintendent of In~nrnnce ~ the Stnto o[ Hew York qnnli[icztion to [~come surety or guarantor on nil bonds, undertakings, recognizances, guarnntles and other obligations m?~ired ~ permitted hE, aw; and that such certificate has not been revoked. ROYAL GLOBE INSURANCE COMPANY (Incorporated 1891 ) A Stock Company, Organized Under the Laws of the State of Illinois 150 WILLIAM STREET, NEW YORK, N.Y. 10038 Financial Statement, December 31, ~979 ASSETS Cash and Bank Deposits ........................................... $ Bonds ......................................................... Preferred Stocks ................................................. Common Stocks .................................................. Real Estate ..................................................... Interest Due and Accrued .......................................... Net Agents Balances or Uncollected Premiums not more than three months due. Other Admitted Assets ............................................ TOTAL ADMITTED ASSETS ..................................... 3,859,484 471,021,917 0 124,389,617 3,522,675 9,442,783 38,521,193 19,687,032 670,444,701 LIABILITIES Reserve for Losses, Claims and Related Expenses ....................... $371,840,227 Reserve for Unearned Premiums .................................... Reserve for Contingent COmmissions and other similar charges ............. Reserve for Taxes ................................................ Reserve for Accounts Due or Accrued ................................ Other Liabilities .................................................. CAPITAL ...................................................... SURPLUS ...................................................... SURPLUS TO POLICYHOLDERS .................................. TOTAL LIABILITIES AND SURPLUS .............................. 129,202,111 3,176,450 4,172,942 1,734,614 21,461,809 9,300,000 129,556,548 531,588,153 138,856,548 $670,444,701 Securities carried at $15,702,034 in the above statement are deposited as required by law. Bonds and Stocks are valued on the basis prescribed by the National Association of Insurance Commissioners. STATE OF NEW YORK ] SS. COUNTY OF NEW YORK ~ PAUL FILKA, Vice President and Comptroller and R.V. HILL, Assistant Comptroller of the ROYAL GLOBE INSURANCE COMPANY being duly sworn, each for himself deposes and says that they are the above described officers of the said Company and that on the 31st day of December, 1979 the Company was actually possessed of the assets set forth in the foregoing statement and that such assets were available for the payment of losses and claims and held for the protection of its policyholders and creditors, except as hereinbefore indicated, and that the foregoing statement is a correct exhibit of such assets and liabilities of the said Company on the said 31st day of December, 1979 according to the best of their information, knowledge and belief. Sworn and subscribed to before me this 17 day of April 1980 NOTARY PUBLIC, State of New York No. 31-4519480 Qualified in New York County Commission Expires March 30, 1982 P26499B-1 P~e President a~i~l'C'o~nptroiler - "' Assistant Comptroller ower of No. KNOW ALL MEN BY THESE PRESENTS: That the MO~'tt?, ~T,O~, T~_~_~ COM?_A~N~r~ , a Corporation organized and existing under and by virtue of the laws of the State of ILLINOIS , pursuant to Article V, Section 1 of the By- Laws of said Company, an extract from which is hereunto attached, does hereby nominate, constitute and appoint MTT,BI~n W'= O~__;.!'r_. of N~ng ¥01qK , in the State of 'r,r,~,r its true and lawful attorney(s)-in-fact to make, execute, attest, seal and deliver for and on its behalf, as surety, and as its act and deed, where required, any and all bonds, undertakings, recognizances and written obligations in the nature thereof, the penal sum of no one of which is in any event, to exceed UNLIMITED ..... .($ -.) Dollars. Such bonds and undertakings, when duly executed by the aforesaid Attorney(s)-in-fact shall be binding upon the said Company as fully and to the same extent as if such bonds and undertakings were signed by the President and Secretary of the Company and sealed with its corporate seal. IN ~ITNESS WHEREOF, the has caused its corporate seal to be hereunto affixed, and these presents to be signed by its duly authoriZed officers this 9 day of ]~o'n-m~ ,- ?? 19 tva: Attest: ~T.~AlffO~ ~.!;j~___TSTT__~_~.SEN By O. B'. I)~-E'~'O~3g~. Assistant Secretary Vice President STATE OF NEW YORK '~ss.: COUNTY OF NE~/YORK ELEANOR CERISTIANSEN , being duly sworn, deposes and says: That She is an Assistant Secretary of the ]:{0~'_~_T. the corporation described in and which executed the above instrument; that $he knows the corporate seal of the said corporation; that the seal affixed to the aforementioned instrument is the corporate seal of the said Company and was affixed thereto by order and authority of the Board of Directors of the said Company, that She signed h eI~ame thereto by like order and authority; that she is acquainted with . G, ,T. DYKHOUSE and knows him to be the Vice President of the said Company; that the signature subscribed to the said instrument is in the handwriting of the said Go ~'o DYKHOUOE and was subscribed thereto by order and authority of the said Board of Directors and ~he further states that the following is a true copy of an extract from the By-Laws of said Company, and that the By-Laws are now in full force and effect: 'The Presid~tat, any Vice President, or any other Officer designated by the Board of Directors, shall have power and authority to appoint Resident Vice Presidents, Resident Secretaries, Resident Assistant Secretaries, and Attorneys-in-fact, and to give such appointees full power and authority to sign and to seal with the Company's seal, where required, all policies, bonds, recognizances, stipulations and all underwriting undertakings, and he may at any time in his judgment remove any such appointees and revoke any authority given to them.' ELEANOR CHRISTIANSEN Assistant Secretary Sworn to before me this 9 day of February , 1976-.. Thomas Buckley~ Notary Public~ State of New York No. $1-~505615, Qualified in Queens County Cert. filed in New York County Commission Expires March ~0, 1977 STATE OF NE~ YORK ~ss.: COUNTY OF NEW YORK I, ELEANOR CHRIST~NSEN , Assistant Secretary of the ROYAL GLOBE YNSUMANCE COMPANY a corporation of the State of ILLINOIS . , do hereby certify daat the above and foregoing is a full, true and correct copy of Power of Attorney issued by said'Company, and that I have compared same with the original and that it is a correct transcript therefrom and of the whole of the original and that. the said Power of Attorney is still in full force and effect and has not been revoked. IN WITNESS II[HEREOF. I have her_eu_n_to.~_e~__my handand affixed the.~seal of said Company, at the City of New York, this ,2TH dayof S~PD'MB~'R ~~~ Assistant Secretary CF66683- JAN ~ 0 ~1 The within Bond is hereby approved as to Form and sufficiency of the Surety this day 19 CF22169A- CHANGE OF NAME NOTIFI,CATION RO~I In~urance~ ~ THIS NOTIFICATION FORMS A PART OF THE POLICY TO WHICH IT IS ATTACHED. The name of Royal Globe Insurance Company has been changed to Royal Insurance Company of America. This is a change of name only and does not affect the liability and obligations of the Company under the terms and conditions of its policies. If the name Royal Globe Insurance Company appears, the name Royal Insurance Company of America is substituted in its stead, 83903 & 66279EI STOCK COMPANIES · ROYAL INDEMNITY COMPANY A NEW YORK CORPORATION ROYAL GLOBE INSURANCE COMPANY AN ILLINOIS CORPORATION GLOBE INDEMNITY COMPANY A NEW YORK CORPORATION NEWARK INSURANCE COMPANY A NEW JERSEY CORPORATION East Orange, New Jersey AMERICAN AND FOREIGN INSURANCE COMPANY A NEW YORK CORPORATION SAFEGUARD INSURANCE COMPANY A CONNECT I CUT CORPORAT I ON Hartford, Connecticut Executive Office: 150 William Street, New York, New York 10038 PUBLIC OFFICIAL BOND Know All filch By hese lresents. fha, ArLhur as Princi~ (hereinafter ~lled "Princi~") a co~orati~ having an office ~ the Ci~ of ~ YOT~, ~ ~n ~i as Surety (hereinafter c~lcd "Surety") are held ~d fir~y bound ~to Mattituck Fire District, Mattituck, New York ~, ~h~ p~uahy o~ ~enty fiv~ thousand ~nd 00/100 D0~s ($ 25.000.00 ) to the payment whereof, well and tr~y to be made ~d done, the said princip~ binds himself, his heirs, executors and administrators, and the ~id Surety binds itsdf, its successors and ~si~s, jointly and severally, firmly by these presents. ~tBtle~, sealed and dated thi~day of M~mh~ ~. D., Ninete~ hundred and elqh~y one o tttou of the aloregotng bl aiton ts s h, that ~tr~, the said prin- cipal was elected or appointed Secretar~-~re~s~rer for the term beginning ,T~,, .... ~ a oR9 and ending De~ember or until his successor is elected or appointed and quahfies. ~a~, ~Prr{~r~, if the said Princi~ s~ll well and faithfully perform all and sin~lar the dufie~ in~mbent upon him by reason of his election or ap~in~ent as ~i3 Seevo~ar~-~rnauuver ~he year co~enctn9 g~uary ~: ~982 ~d end~n~ Dec,bet 3~_~982 except as hereinafter limited, and honestly account for all moneys coming into his hinds as hid SecreLary-Treasurer ~or Lhe sa&d year above according to law, then this obligation shall be nu~ and void; it is othe~ise to be and remain in full force and virtue. ~[fi ~a~h is executed by the Sure~ subj<t to the following conditions: FIRST--That th% Su[qt~ ~hall. haLe the right t9 ter~nate.this ~onO bygivinA thirty. (3Q) days notice in writing to the said na=<~<uc< ~'&re ~&s<r~c=~ naL=~<uc<: ~ew Zor< the said surety remaining liable for all or any act or acts covered by this ~nd which may have been committ~ by the principal up to the date of such termination, and the snrety shall, as soon as practi~ble after demand therefor, refund the premium paid, less a oro rata part thereof, for the time that this bond shall have been force. SECOND--That the Surety shall not be liable to the said MaL~Lue~ by reason of the refusal, inability or failure of any bank, depository or depositories to pay upon dmand any public moneys which now are or may hereafter be placed on general or special deposit by or behalf of said Principal, or by reason of the allowance to or acceptance by said Principal of any interest thereon, any ~w, Ordinance or Statute of the State of N~w York orany Ordinance o[the said Ma~J~ua~ P~ D~~ M~q~o~, ~ YOrk to the contrary notwithstanding. la ~esltmon~ Whereof, t~e said Principal has here~to set his hand and seal, and the said Surety bas ~used this instrument of writing to be si~ed by its duly anthorized representative Hew Yor~: Hew York , and its corporate seal to be hereunto affixed, the day and year first above written. Witness: Executed in Duplicate CF22042B By Principal Royal Insurnnce Com~nv oF Amm~ima Virgi~a Solinske ,Atty-in-Fact STAT~ OF New York CouN~ oF Onondaga On this_~ur.~_.__day al November , 1981 , before we personally appeared Virqinia Solinske , with whOm I am personally acquainted, who, being by me duly sworn, said: that tie resides in the City of Syracuse that he is Attorney-in-Fact of the Royal Insurance Company of America (Nm~ of Compl.7) the corporation described in and which executed the foregoing instrument; that he knows the cor- porate seal of the said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order and authority of the Board of Directors of said Company; and that he signed his name thereto as Attorney-in-Fact by like authority; and that the liabilities of the said Company do not exceed its assets, as ascertained in the manner provided in Chapter 882 of the Laws of 1939, constituting Chapter 28 of the Consolidated Laws of the State of New York, and known as the Insurance Law, and that pursuant to Sec. 327 of the Insurance Law the Superintendent of Insurance of the State of New York has issued to said Company a certificate of solvency and of qualification to become surety or guarantor on all bonds, undertakings, recognizances, guaranties and other obligations required or permitted by law; and that such certificate has not been revoked. JEANETTE M. WHITNEY NOTARY PUBLIC, ..~at* of 'qew York ,No. 4.555424 Qualified in Or~onr'.o~'~ C~unty CF22087C- Term Expires March 30, 19~_~ ROYAL INSURANCE COMPANY OF AMERICA (Incorporated 1891 ) A Stock Company, Organized-Under the Laws of the State of Illinois 150 WILLIAM STREET, NEW YORK, N.Y. 10038 Financial Statement, December 31, 1980 ASSETS Cash and Bank Deposits .......................................... Bonds ........................................................ Preferred Stocks ................................................ Common Stocks ................................................ Real Estate .................................................... Interest Due and Accrued ......................................... Net Agents Balances or Uncollected Premiums not more than three months due. Other Admitted Assets ............................................ TOTAL ADMITTED ASSETS .................................... $ 3,554,121 476,763,336 658,600 176,104,839 3,398,314 10,657,835 51,84t,171 18,307,541 $741,285,757 LIABILITIES Reserve for Losses, Claims and Related Expenses ...................... Reser~;e for Unearned Premiums .................................... Reserve for Contingent Commissions and other similar charges ............ Reserve for Taxes ............................................... Reserve for Accounts Due or Accrued ............................... Other Liabilities ................................................ CAPITAL ..................................................... SU~RPLUS ............. ~ ....................................... SU'RPLUS TO POLICYHOLDERS ................................ TOTAL LIABILITIES AND SURPLUS ............................ $386,546,491 137,794,5¢3 3,734,410 4,348,676 888,132 27,359,664 9,300,000 171,313,841 560,671,916 180,613,841 $741,285,757 Securities carried at $16,324,680 in the above statement are deposited as required by law. Bonds and Stocks are valued on the basis prescribed by the National Association of Insurance Commissioners.' STATE OF NEW YORK ~ ss. COUN~"Y OF NEW YORK PAUL FILKA, Vice President and Comptroller and J.F. DONOHUE, Assistant Comptroller of the ROYAL INSURANCE CO.MP.~NT OF AMERICA being duly sworn, each for himself deposes and says that they are the above described officers of the said Company and that on the 31st day of December, 1980 the Company was actually possessed of the assets set forth in the foregoing statement and that such assets were available for the payment of losses and claims and held for the protection of its policyholders and creditors, except as hereinbefore indicated, and that the foregoing statement is a correct exhibit.°f..such assets and liabilities of the said Company on the said 31 st day of December, 1980 according to the best of their information, knowledge and belief. Sworn and subscribed to before me this 7th da~ of April, 1981 PATRICIA HARyEY NOTARY PUBLIC, Stale~f New York No. 01HA67~700 Oua!ified i~ Soffolk County Cert. Filed in New York County Commission Expires March 30, 1982 P2649~D-1 ssistant Comptroller ower of No. 6 KNO~ ALL MEN BY THESE PRESENTS: That the , ROY~L INSUPd~t~ COHPAI~ ~? _~_M~_ _T~ , a Corporation organized and existing under and by virtue of the laws of the State of _TT.T_._TN0_Ts , pursunnt to Article V, .Section I of the By- Laws of said Company, an extract from which is hereunto attached, does hereby nominate, constitute and appoint of BYRICU,~E , in the State of ~ FflR its ~e ~d law~l atmrn~(s)-in-fact m ma~e, excite, artes~ seal ~d deliver for ~d on its beh~f, ~re~, ~d ~ frs act and ~eed, where required, any ~d ~I ~nds, undert~ings, re~iz~ces wH~m obHga~ons [n ~e nature ~er~f, ~e pmal sum o~ no ~e of whi~ [s in any ev~ ~ ezce~ ~ITED ~ch ~nds ~d unde~in~ wh~ duly exe~t~ ~y ~e aforesaid Attorney(s)-in-fac~ sh~ be ~g upon ~e s~ ~mp~y as ~lly ~d to ~e s~e extmt as if such ~n~s ~ under~ings were s[~ed by ~e Presidmt ~ ~creta~ of ~e Comply ~d se~e~ wi~ its co~o~te se~. ~ ~ESS ~HEREOF, ~e ROYAL INS~NCE ~O~A~ fl~ hns c useO its be hereunto a[fized, presents its duly · .~o~z.d o[fic~m ~is__ tiny of Auks , 19~. Attes~ E~NOR ~ISTI~R~ By ~: ~: Assistant $~e~ Vice President ~OFNEWYO~~ , 5eing dul~ sworn, deposes ~d says: ~ts~e is ~ Assistan~ Se~re~ o~ ~e R0~A~ ~~C~ C0~ O~ ~CA , ~e co.option desk, bed in and wMc~ executed ~he ~ve ins~ment; ~SSe knows ~e s~ of ~e s~d ~oradon; ~t the seal ~ffixed ~o ese a~oremendoned instmm~ is ~e ~o~or~te se~I of ~e s~ ~omp~ ~n~ ~s ~fixed there~ 5y order and ~u~od~ of ~e ~oard of D~re~mrs of ~e said Comply, ~atS ~e s~ed he~ame ~erem 5~ Hk~ order an~ aurora; ~a~ ~e ~s ~quain~ed ~..T. ~~ and knows him to be the Vice Presider of ~e s~d Comply; ~at ~e si~amre subscribed to the said instmm~t is in the handwriting of the said ~..T. ~OU~ and was subscribed ~ereto by order ~d authofi~ of · e said Board of Directors and she ~rther states that the following is a tree copy of an extract from · e By-Laws of s~d Company, ~d that ~e By-Laws are now in hll force md effect: '~ Presiding may Vie~ P~sldeut, or zuy other Officer desigu~ted by th~ Bo=d of Directors, shall have powe~ ~fi~ m ~p~iat Resider Vice Presidents, Resident Secretaries, Resideut Assistant Seceet,eies, ~d Atromeys-~-f~ct, ~d m giv~ such a~inte~ f~l ~wee and ~u~oeity to si~n aad to se~l wi~ the Comp~uy's seal, where requ~ed, all ~licies, ~d~, e~cog~zauces, stipulations aud ~11 uud~eidu8 ~de~akiugs, ~d h~ rosy at auy dine i~ his jud~eut rmove ~y Sworn to before me this 26 day of Doris illiams, No. 03-b636521, Certificate filed with N. Y. Commission Expires March 30, ELEANOR CHRISTIANSEN Assistant Secretary Notary Public, State of New York Qualified in Bronx County Co. Clerk 1982 STATE OF NEW YOEK '~ss.: COUNTY OF NEW YORK I, ELEANOR CHRISTIANSEN , Assist t Secretary of the ROYAL INSURANCE COMPANY Oil' AM*RRTP.~ a corporation of the State of ILLINOIS , , do hereby certify that the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and that I'have compared same with the original and that it is a correct transcript therefrom and of the whole of the original and that the said Power of Attorney is still in full force and effect and has not been revoked. IN WITNESS WHEREOF, I have hereunto set my hand and affixed the seal of said Company, at the Assistant Secretary CF66683- RECEIVED '¥ow~ Cleft( Southoid Royal Insurance [/il'. The ~t~n Bond. ~s.Aere~y approved as to Form ~d ~fficiency of t~e Surety this day 19 22169A ROYAL INDEMNITY COMPANY A DELAWARE CORPORATION ROYAL INSURANCE COMPANY OF AMERICA AN ILLINOIS CORPORATION GLOBE INDEMNITY COMPANY A DELAWARE CORPORATION Royal Insurance NEWARK INSURANCE COMPANY A NEW JERSEY CORPORATION AMERICAN AND FOREIGN INSURANCE COMPANY A DELAWARE CORPORATION SAFEGUARD INSURANCE COMPANY A CONNECTICUT CORPORATION Executive Office: 150 William Street, New York, New York 10038 PUBLIC OFFICIAL BOND now Aft llien By lhese reseuts, fha, Arthur Fanning as Principal (hereinafter called "Principal") 8nS me Royal Insurance Company of America , a corporatios having an office in the City of New York, 150 William St. as Surety (hereinafter ca.lled "Surety") are held and firmlybound unto Mattituck Fire DistricT, Mattituck, NY in the penalty of Twen..ty-five Thousand and 00/100 Dollars ($ 25,000. O0 ) tO the payment whereof, well and truly to be made and done, the said principal binds himself, his heirs, executors and administrators, and the said Surety binds itself, its successors and assigns, jointly and severally, firmly by these presents. ~tgttr~, sealed and dated this 1 st. day of. December A.D., Nineteen hundred and Eighty-two · he (IIoni ttton the aforegotng ( bllgatton ts su ll, that Whereas. the said prin- cipal was elected or appointed for the term beginning January 1 , 198~ and ending December 31, 1983 or until his successor is elected or appointed and qualifies. ~am. i~tterrt~nre, if the said Principal shall well and faithfully perform ali and singular the duties incumbent upon him by reason of his election or appointment as said Secretary-Treasurer for the year commencing January 1, 1983 and ending December 31, 1983 except as hereinafter limited, and honestly account for all moneys coming into his hands as said ._q~e~.n~y-T~_a.~ur~r for the said year above according to law, then this obligation shall be null and void; it is otherwise to be and remain in full force and virtue. ~l~{g ~OIl~l is executed by the Surety subject to the following conditions: FIRST--That the Surety shall ~ave the_right, to.tergmna, t.e t,hi$ J~gnd ~y gbL~g thirty (30) days notic~ in writing to the said Mattj, tuck ,,'ire g~.s'l;ra.c'g~ Mal;~;a.~;ucK, NX- the said surety remaining liable for all or any act or acts covered by this bond which may have been eommitte41 by the principal up to the date of such termination, and the surety shall, as soon as practicable after demand therefor, refund the premium paid, less a pro rata part thereof, for the time that this bond shall have been in force. SECOND--That the Surety shall not be liable to the said Mattituck Fire District, Mattituck, Ny by reason of the refusal inability or failure of any bank, depository or depositories to pay upon demand any public moneys which now are or may hereafter be placed on general or special deposit by or on behalf of said Principal, or by reason of the allowance to or acceptance by said Principal of any interest thereon, any Law, Ordinance or Statute of the State of New York .. or any O:dinance of the said Mattituc$ Fire District, Mattituck, NY Lo the contrary notwithstanding. ~Jtt ~ei~limo~t§ lll~er.,'i3f., Surety has caused this instrument of N~_w Ynr'k; NY and year first above written. the said Principal has hereunto set his hand and seal, and the said writing to be signed by its duly authorized representative at , and its corporate seal to be hereunto affixed, the day Witness: Principal Bond # 635906 By C~22042C Bo_val Insurance Compap~y of AmeriGa Surety V~rg~n~a So~s~e~ A~y-~n-Eac~ CHANGE OF NAME NOTIFICATION Ro~l Immrance ~ THIS NOTIFICATION FORMS A PART OF THE POLICY TO WHICH IT IS ATTACHED. The name of Royal Globe Insurance Company has been changed to Royal Insurance Company of America. This is a change of name only and does not affect the liability and obligations of the Company under the terms and conditions of its policies. If the name Royal Globe Insurance Company appears, the name Royal Insurance Company of America is substituted in its stead. 83903 66279D STOCK COMPANIES ROYAL INDEMNITY COMPANY A DELAWARE CORPORATION ROYAL INSURANCE COMPANY OF AMERICA AN ILLINOIS CORPORATION GLOBE INDEMNITY COMPANY A DELAWARE CORPORATION Royal Insurance NEWARK INSURANCE COMPANY A NEW JERSEY CORPORATION AMERICAN AND FOREIGN INSURANCE COMPANY A DELAWARE CORPORATION SAFEGUARD INSURANCE COMPANY A CONNECTICUT CORPORATION Executive Office: 150 William Street, New York, New York 10038 PUBLIC OFFICIAL BOND By hese as Principal (hereinafter called "Principal") and the, Royal Ins~ce Company of America a corporation having an office in the City of NeW York, 150 William St. as S~re~y. ~hfrein~ft~led~urfty'~) ye heLeJd ~ ~rnd r~bo~ Nl~to to the payment whereof, well and truly to be made ~d done, the smd pr[nc[p~ b{nds h[mseff, his heirs, executors ~nd ~dmhfistrators, and the ~[d Surety binds hs~, hs successors a~d ~s[~s, jo{ntly and firmly by these presents. ~tgtte~, sealed and dated this,,1at' day of. ~c~mb~r A.D., Ninete~ hundred and o Mtto. the aforegotng bl atton ts s h. that Whereas. the said prin- cipal was elected or appointed ~¢y~&~--~_~%lT~ for the term beginning J~~ 1~ 1~ and ending ~cem~= ~ $ 198~ or until his successor is elected or appointed and qualifies. ~am. ~errfnre. if the said Princi~ shall well and faithfully perform all and sin~lar the dufie~ in~mbent upon him by reason of his election or a~in~ent as ~id ~C~~-~S~r ~Or ~e year cc~nenc~ J~~- 1, ~3 ~d end~ ~cember 31, 1983 except as hereinafter limited, and honestly account for all moneys coming into his hands as said Secretary-Treasurer for the said year above according to law, then this obligation shall be null and void; it is otherwise to be and remain in full force and virtue. ~llts t!tanh is executed by the Surety subject to the following conditions: FIRST--That t~il~l[~;~u~h~1~l"eve thej~{~%l,,],c.~r~' h to te 'n~l[~¢]~!'s b nd gi'~g thirty (.30) days notice in writing to the said the said surety remaining liable for all or any act or acts covered by this bond which may have been committed by the prir. cipal up to the date of such termination, and the surety shall, as soon as practicable after demand there£or, refund the premium paid, less a pro rata part thereof, for the time that this bond shall have been in force. SECOND--That the Surety shall not be liable to the said l~ttttuck ~ NY by reason of the refusal, inability or failure of any bank, depository or depositories to pay upon demand any public moneys which now are or may hereafter be placed on general or special deposit by or on behalf of said Principal, or b~ reason of the allowance to or acceptance by said Principal o{ an)' interest thereon, any Law, Ordinance or S~tute of the State of },I~W ~'ork or any Oldinance of the said hatt:Ltucll: Fire Dlst;ri¢t;, MattttUck, NY to the contrary notwithstanding. 3hi ~,~Itmml§ ttt[ler,of, the said Principal has hereunto set his hand and seal, and the said Surety has caused this instrument of writing to be signed by its duly authorized representative at New York, NY , and its corporate seal to be hereunto affixed, the day and year first above written. Bond ~ 6 0 ' Vlrgin~a $ol~e, Atty-~-Fact ~T E'~V 1' ~ ~ ........... ST^~ oF New York cou~ oF Onondaga On this appeared 1 St. da} ot December Virginia Solinske , 1982, before me personally , with whom I am personally acquainted, who, being by me duly sworn, said: that he resides in tile c'-~+,, ~* e,~ ..... try · that he is Attorney-in-Fact of the RO.Sm_! 'rn=,,,.~,,,o r,,.,,,,,.,o,.,,, ,,.e ^,,,.,.,.,.~ the corporation described in and which executed the foregoing instrument; that he knows the cor- porate seal of the said Company; that the seal affixed to said instrument is such corporate seal; that it was so affixed by order and authority of the Board of Directors of said Company; and that he signed his name thereto as Attorney-in-Fact by like authority; and that the liabilities of the said Company do not exceed its assets, as ascertained in the manner provided in Chapter 882 of the Laws of 1939, constituting Chapter 28 of the Consolidated Laws of the State of New ~ork, and known as the Insurance Law, and that pursuant to Sec. 327 of the Insurance Law the Superintendent of Insurance of the State of New York has issued to said Company a certificate of solvency and of qualification to become surety or guarantor on all bonds, undertakings, recognizances, guaranties and other obligations required or permitted by law; and that such certificate has not been revoked. JF.~HETTE M. W~ITHEY ~K)'r~R.Y PUOLIC, Stot~ of New N~. 4655424 CF22087C- ' 10ualiCded i~ Onondaga Count~ Term Exl~ire~ March 30, 1 ~ ¢~. ROYAL INSURANCE COMPANY OF/ r ERICA (Incorporated 1891) A Stock Company, Organized Under the Laws of the State of Illinois 150 WILLIAM STREET, NEW YORK, N.Y. 10038 Financial Statement, December 981 ASSETS Cash and Bank Deposits ...................... ' .................... Bonds ........................................................ -Preferred stOCks ................................................. common Stocks ................................................ Real Estate .................................................... Interest'Due and Accrued ......................................... Net Agents Balances or Uncollected Premiums not more than three months due. Other Admitted Assets ....................... ...................... TOTAL ADMITTED ASSETS .................................... $ 3,398,013 477,371,302 17,640,097 145,682,401 4,005,099 11,563,938 73,159,243 30,331,976 $ 763,152,069 · LIABILITIES Reserve for Losses, Claims and Related Expenses ...................... Reserve for Unearned Premiums .................................... Reserve for Contingent Commissions and other similar charges ............ Reserve for Taxes . .. .............................................. Re~erve for Accounts Due Or Accrued ........... ; ................... Other Liabilities ................................................ CAPITAL ............................ ' ......................... .sURPLUS ........................ :~ ......: .................... SURPLUS TO POLICYHOLDERS ................................ TOTAL LIABILITIES AI~ SURPLUS . .. .......................... $412,101,435 164,899,221 4,403,000 4,528,023 1,344,761 22,766,613 610,043,053 9,300,000 --- 143,809,016 153,109,016 $763',152,069 Securities carried at $18,521,427 in the above statement are deposited as required by law. Bonds and Stocks are valued on the basis prescribed by the National Association of Insurance Commissioners. STATE OF NEW YORK } ss. COUNTY OF NEW YORK PAUL FILKA, Vice President and Comptroller and J.F. DONOHUE, Assistant Comptroller of the ROYAL INSURANCE CO~ANY OF AMERICA being duly sworn, each for himself deposes and says that they are the above described officers of the said Company and that on the 31st day of December, 1981 the Company was actually possessed of the assets set forth in the foregoing statement and that such assets were available for the payment of losses and claims and held for the protection of its policyholders and creditors, except as hereinbefore indicated, and that the foregoing statement is a correct exhibit of such assets and liabilities of the said Company on the said 31st day of December, 1981 according to the best of their information, knowledge and belief. Sworn and subscribed to before me this 30th day of March, 1982 NOTARY PUBLIC, State of New York No. 01HA6796700 Qualified in Suffolk County Cert. Filed in New York County., Commission Expires March 30, 198~Il Vice President and Comptroller d Assistant Comptroller ower No. 6 ·NOW ALL MEN BY THESE PRESENTS: That thb ROYAL INSI~CE COMPAIf~ ~ ~!~ , · Co.option org~ized ~d e~sdng under ~d by vi~e of ~e l~ws of ~e S~te of ~T.T~T~n~ , pumu~t co Article V, .Section I of ~e By- Laws of s~d Comps?, ~ extract from which is her~nm ~[~ched, does he.by nominate, constitute ~d appoint of S~I~_~C~JSR , in the State of ic~ ~e ~d law~ atmrn~(s)-in-fact m make, excite, accesL se~ ~d deliver for ~d on its beh~f, ~teW, ~d ~ hs act ~d de~ wh~e re~ired, any ~d ~I ~nds, undert~gs, re~iz~ces ~d ~ o~ga~ns ~ ~e nature ~er~f, ~e p~al ~ of ac ~e of whi~ is in ~n~ ev~ m exce~ ~ ~n~ ~d ~de~in~ wh~ duly exe~t~ ~y ~e aforesaid Atwrney(s)-in-fact sh~ be ~g upon &e s~d ~mp~y ~ ~lly ~d to &e s~e ext~t as if ~ch ~n~ ~d unde~ings =ere si~ed ~ ~e Pr~i~t ~d ~rem~ of &e Comply ~d se~ed =i~ its co~o~te seal. ~ ~S WHEREOF, ~e ROYA~ IN~AN~R Cfi~a~ D~ h~ c~sed its co~omte~g~ m be her~nm affixed, ~d ~ese presents m be si~ed by im duly ~~ officem ~is__ day of Au~g , 19~. A=~c E~0R ~IS~IINg~ By C-: .T_ Assismt $e~ - - Vice ~esid~t ~ATR OF N~ YO~ , berg duly sworn, de¢oses ~d says: ~ats he is ~ Assist~ Secre~ of ~e ~0~ I~~~ ~~ O~ ~OA , s~ of ~e s~d ~o~fiou; ~a~ ~e se~ affixed co ~e aforem~doned ~stmm~ of ~ s~d ~omp~y ~d ~ affixed ~e,em by order ~d au~o~ of ~e ~ard of Birecmrs of ~e said ~mp~, ~a~8 he si~ed ho~ame ~e,~m ~ like orde~ ~d au~od~; ~a~ ~e. is acquainted ~i~ ~. ~. B~~ and knows him to be the Vice Presider of ~e s~d ~mp~y; ~at ~e si~amre subsc~bed m the said instmm~t is ia ~e h~dwddng of the s~d ~..T_ ~0~ ~d was subscibed ~ereto by order ~d au&odw of · e s~d Board of Direcm~ and she ~er states that ~e following is a tree copy of an ex~ct from · e By-Laws of s~d ComPly, ~d &at ~e By-Laws are now in ~11 force ~d effect: ~ P~si~g ~T ~ce Ptesid~g or ~T oth~ Offic~ desigaat~ bT the Bo~d of Directors, shall ha~e ~wer and ~fiW m ap~iat Resider Vice Presid~t~, Resident Secret~es, Resident Asaist~t ~cr~ies, ~d ~d m ~v~ such a~te~ ~1 ~v~ and au~ority to sign ~d to seal vi~ the ~mpaay*s s~l, wh~e re~ed, aU ~li~es, ~ te~g~ces, afi~latioas and ~1 ~de~iting ~den~ngs, ~d he may ~ ~y ~me ia ~s jud~eat ~ove ~y such ~tees ~d t~ke ~y ~u~W ~v~ co ~.' E~0R C~STI~8~ Assistgnt Secreta~ Sworn to he, re me tis 26 day of l~et , 19~. Doris~illiams' Notary Publics State of New York No. 03-~636521, qualified in Bronx County Certificate filed with N. Y. Co. Clerk Co...ission Expires Narch 30, 1982 STATE OF NEW YORK '5 COUNTY OF NEY YORK!ss': I, ELEiNOR CHRISTIANS~ , Assistant Secretary of the ROY_iL INSIIRINCR COMPANY a corporation of the Share of ILLINOIS , do hereby certify chat the above and foregoing is a full, true and correct copy of Power of Attorney issued by said Company, and that [ have compared same with the original and that it is a correct transcript therefrom and of the whole of the original and that the said Power of Attorney is still in full force and effect and has nor been revoked. IN WITNESS ~.HEREOF, I have hereunto set my hand and affixed the seal of said Company, at the 0'7 of New York, this 3at. day of December .... 19 82...~ . Assistant Secretary CF66683- Royal Insurance The within Bond ks'hereby approved as to Form and sufficiency o~ the Surety this ~.' ~ ._.~ 19 22169A qcord, PRODUCER New York State Regional Director 84 Court Street Blnghamton, NY 13901 INSURED Mattituck Fire District Pike Street Mattituck, NY 11952 ISSUE DATE (MM/DD/YY) THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY A LETTER COMPANIES AFFORDING COVERAGE & COMPANY LETTER B Ins. Co. of North America COMPANY LETTER C COMPANY D LETTER COMPANY LETTER E THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. DESCRIPTION OF OPERATION~L~ATIONSNEHICLES/SPEClAL ITEMS Proof of Insurance for a Street Dance being held insured. ' ' '.]i']~; ~.'*d~]~ POLICY EFFECTIVE POLICY EXPIRATION LIABILITY LIMITS IN THOUSANDS TYPE OF INSURANCE POLICY NUMBER 0ATE (MM/00/Y~ 0ATE (MM/00/Y~ OCCUR.ENCE GENE~L LIABILITY BODILY X COMPREHENSIVE FORM ~PPD15381978 12/1/87 12/1/88 ,.~u.~ $ $ X PREMISE~OPE~TIONS UNDERGROUND PROPER~ DAMAGE ~PLOSION & COL~E H~RO X CONT~CTUAL B~ & PD COMBINED $ INDEPENDENT CONT~CTORS [ e 000 ,000 X BRO~ FORM PROPER~ DAMAGE X PERSONAL INJURY PERSONAL INJURY ,000 AUTOMOBILE UABILITY ~OlLY INJURY ANY AUTO , {~R PER.N) $ ALL OWNED AUT~ (PRIV. PPSS.) ~OlLY ~ ~,f~ ~L OWNED A~OS (OTHER THAN~ INJURY ~PRIV. PASS. ] (~R ~IOENT , $ HIRED AUTOS NON-OWNED AUTOS DAMAGE $ ~GE LIABILI~ COMBINED ~ I:~ r~;~ ~ EXCESSj LIABILITY ~ UMBRELLA FORM BI & PD cou~,.~o $ $ OTHER THAN UMBRELLA FORM WORKERS' COMPENSATION STATUTORY .,~ "$ (,Ac, ,cC~9~h~ ~a,LO~,S' u~e~u~ $ (O~SEAS~.POU~:U~m 0~.~. $ ~i~EAS":,~h E~,LOYE,~ 7/30/88 by the SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EX IRATIO~ DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL ~0 DAYS WRI~EN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LE~, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLI~TION OR LIABIL~ ~F ANY KIND UPON THE COMPANY, ITS A~NTS ~ REPRESENTATIVES. i AU~D REPRESENTAT,VE ~~ -- ISSUE DATE (MM/DD/YY) 7~29~88 PRODUCER V.F.I.S. New York State Regional Director 84 Court Street Binghamton, NY 13901 INSURED Mattituck Fire District Pike Street Mattituck, NY 11952 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A LETTER Ins. Co. of North America COMPANY LETTER B COMPANY LE'Iq'ER C COMPANY LE'I-rER COMPANY LETTER THIS IS TO CERTIFY THAT POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUEDTO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS, AND CONDI- TIONS OF SUCH POLICIES. I POLICY EFFECTIVE TYPE OF INSURANCE POLICY NUMBER DATE (MM/DD/YY) GENERAL LIABILITY X COMPREHENSIVE FORM GPPD15381978 12/1/87 12/1/88 X PREMISES/OPERATIONS (PROPERTY UNDERGROUND EXPLOSION & COLLAPSE HAZARD X PRODUCTS/COMPLETED OPERATIONS B, X CONTRACTUAL COMBINED INDEPENDENT CONTRACTORS X BROAD FORM PROPERTY DAMAGE X PERSONAL INJURY PERSONAL INJURY AUTOMOBILE LIABILITY I BODILY INJURY ANY AUTO ALL OWNED AUTOS (PRIV. P/~SS.) ALL OWNED AUTOS/OTHER THAN~ AUI~ ' ' 'NJuR~ ~ PR~v. PASS. / ~ ~ i <P~R A~C,DE~ $ HIRED AUTOS PROPERTY DAMAGE $ NON-OWNED AUTOS ~GE LIABILI~ ~ BI & PD ~ COMm"ED $ EXCESS LIABILITY  , BI & PD UMBRELLA FORM I OTHER THAN UMBRELLA FORM STATUTORY WORKERS' COMPENSATION $ (EACH AND EMPLO .S' L,A ,L,TY DESCRIPTIONOFOPERATIONS/L~ATIONSNEHICLES/SPECIALITEMS ~The Certificate Holder is an Additional Insured per the KK-6G11 ~endorsement with respects to a street fair being held on July 30, 1988. ~ ~ ;lll~[;:~l;: [~I,] ~; ~:~II:~ Town of Southold --~ Main Road Southold, NY 11971 LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND_UPON.THE C~MPA.~TS OR REPRESENTATIVES.