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HomeMy WebLinkAbout02-10-11i =. i I f (f i .......... OBLIGEE .COPY ~~ ~- ~ - -~_~; 940 2/02 ~~~- --' ERIE I NSUIRANCE COMPANY Erie SURETY T ~~~ Insurance AMENDED DECLARATIONS 00 * * EFFECT i VE 01/15/11 Group ATTACH THIS TO YOUR POLICY. 100 Erie Ins. PI. Erie, PA 16530 REASON FOR AMENDMENT - AMENDED ADDRESS OF PRINCIPAL 1k~~~IT'S N~~f~3~~ L~tVD k11~kM~ BQI~+p T~RI~I BOf~IO <N[Jf~B~R AA7027 FETROW INS ASSOC LLC 01/15/11 TO 01/15/12 Q85 6570243 H >~Nl~111~f4 ANO AQQR~~~ ; Qf~ PRf1~IfC1~'AL" »1Vlk#VfE A~f© ADDRESS OF C,1BL~~EE JOHN M VAN SCYOC III CUMBERLAND COUNTY 5475 WISTERIA WAY CIRCUIT COURT LIVERMORE CA 94551-6914 1 SOUTH COURT HOUSE AV;E CARLISLE PA 17013 CLASS CODE - 203 TYPE OF BOND - PERSONAL REPRESENTATIVE AMOUNT OF BOND - $ 39,000. TYPE OF ATTACHMENT - CONTINUOUS RATE - $ 9.00 - 2M; $ 5.00 - 37M MINIMUM PREMIUM - $ 100. --- DAYS CANCELLATION NOTICE - POLICY CANNOT BE CANCELLED PREMIUM - - - - - - - $ 203. LLJ/U NO DIFFERENCE IN PREMIUM DUE TO THIS CHANGE - - - $ 0. ADDITIONAL INFORMATION ESTATE OF: JOHN M VAN SCYOC JR ~, C7 ~-=; -> ~ '„ -t-, --r ~ ~r ~ _ ._3 ~ -1 f_~ _' _ p ; fi tY 1"~ } '.»~ ~. 'J ~ -- L ~ ~ -. _ .' - f t~1 .~~ ~! ~ ~ t ~~ i„ OBLIGEE ~v =© `.a =-= ~ i CUMBERLAND COUNTY .r> ~, cn Q --~-~ CIRCUIT COURT ~" 1 SOUTH COURT HOUSE AVE CARLISLE PA 17013 /~ ' ~..~ -- Q/LG _.` Marc Cipriani, CIC 000025 ATTORNEY-IN-FACT 01/25/11 Erie POWER OF ATTORNEY ~\ Insurances KNOW ALL MEN BY THESE PRESENTS: That ERIE INSURANCE COMPANY, a corporation of the Commonwealth of Pennsylvania, having its principal office in the City of Erie, Pennsylvania, does hereby make, constitute and appoint John F. Kearns, Senior Vice President; Marc Cipriani, Vice President; .Edward A. Mazzeo; Katherine D. Pawlak; and Darlene Musica, its true and lawful Attorney(s)-in-Fact, in their separate capacity if~ more than one is named above, to make, execute, seal and deliver for and on its behalf as surety, any and all bonds which are or may be allowed, required or permitted by law, statute, rule regulation, contract or otherwise, provided., however, that the penal sum of any one such instrument executed hereunder shall not exceed FIVE MILLION DOLLARS ($5,000,000) and that the execution of such instrument shall be binding upon ERIE INSURANCE COMPANY. This Power ofAttorney is signed and sealed by facsimiles under and by the authority of the following Resolution adapted. by the Board of Directors of ERIE INSURANCE COMPANY at a meeting duly called and held on thy: 18th day of September, 2008, and said resolution has not been amended or repealed: RESOLVED, that the signature of Terrence W. Cavanaugh, as President and Chief Executive Officer of the Company, and the Seal of the Company may be affixed by the following facsimiles on any Limited Power of Attorney for the execution. of bonds, undertakings, recognizances, contracts and other writings in the nature thereof, and the signature of James J. Tanous, as Secretary of the Company, the Seal of the Company, the signature of Sheila M. Hirsch, as Notary Public, and her Notarial Seal, may also be affixed by tl~~e following facsimiles to any certificate or acknowledgment of any such Limited Power of Attorney, and only under such circumstances shall said facsimiles be valid and binding on the Company. IN WITNESS WHEREOF, ERIE INSURANCE COMPANY has caused these presents to be signed by its Presi- dent and Chief Executive Officer, and its corporate seal to be hereto affixed this 18th day of September, 2008. ``,,,iiirrrrrrrrr ,,~~ JaA N c F'~'-, =w~. 1972 `"°- b ~ _ _ A' y d'; r Z ; Ten-ence W. Cavanaugh = ~~'~ ~ ~; President and Chief T/xecutive Officer FACE, PP .,, ,.• `` ;~ -• '. * ~~. rrrrrrrnnr„~i~~ STATE OF PENNSYLVANIA COUNTY OF ERIE ss. On this 18th day of September, 2008, before me personally came Terrence W. Cavanaugh, President and Chief Executive Officer, to me known, who being by me duly swonl, did depose and say: that he is President and Chief Executive Officer of ERIE INSURANCE COMPANY, the corporation described in anal which executed the above instrument; that he knows the Seal of said corporation; that the Seal affixed to the said instrument is such corporate Seal; that it was so affixed by order of the Board of Directors of said corporation and that he signed his name thereto by like order. ~,,,~„~rr,r,rrr.r% ~\ ~ONW~y~9: . ~? OF _ . "~ •'• ~SYL~P.-" ~V:~ My commission expires June 27, 2012 Notary Public "=~TgRY •~~g~o 'rrr,rrr~~~~r~~` CERTIFICATE 1, James J. Tanous, Secretary of ERIE INSURANCE COMPANY, do hereby certify that the original POWER OF ATTORNEY, of which the foregoing is a full, true and correct copy and is in full force anal effect. h1 witness whereof, I have hereunto subscribed my name and affixed the corporate Seal of the Company by facsimiles pursuant to the action of the Board of Directors of the Company, this 15th day of January 2011 ,,~i~rr,rr;,,, .~`~J P, A N C F ~~'' ~•'~~ •FO•, ~: -~i' 1972 ~_ ~'. ~~Z; U~' FREE, ?P 'C. .._.. ,:. ~ ~~ ' ,~~~rirrrrrririri~~~, James J. Tanous, Secretary U F831 9/08