HomeMy WebLinkAbout05-07-13 . �
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` BOND �� 98 BC Z398 9 • � w � �
. BEFORE THE REGISTER OF ��,5 OF� �, �
: CUMBERLAND COUNTY, PE�Y�VF�IA ci� �
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ESTATE OF ROBERT B KOEHLER � : � � � � " `�
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DECEASED : � c� ca '� ''"`
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BOND AND SURETY FOR PERSONAL REPRESENTATIVE
KNOW ALL BY THERE PRESENTS, that FREDERICK P KOEHLER As prinCipal(s)
and STATE FARM FIRE AND CASUALTY C�� �sureties) are held and firmly bound unto the
Commonwealth of Pennsylvania in the sum of TWO MILLION AND NO/100 dollars
2,000,0oC.CC
($ ) to be paid to the Commonwealth, for which payment we do bind ourselves,jointly and
severally, our heirs, executors, administrators and successors, the condition of this obligation being that if
FREDERICK P KOEHLER as (state
fiduciary capacity) PERSONAL REPRESENTATIVE of the estate of
ROBERT B KOEHLER
, deceased, or any of them, shall well and truly administer the estate
according to law, then this obligation shall be void as to the personal representative or representatives who shall
so administer the estate and his or their surety or sureties; but otherwise it shall remain in full force.
STH APRIL 2013
Signed and sealed this_day of , ,each intending to be legally bound hereby.
�T . V • Personal Representative Signature(seal)
Personal Representative Signature(seal)
� Personal Representative Signature(seal j
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� �� 98 BC Z398 9
— Bondsman/Agency Bond f�umber
(Attach POA/Authority to transact in PA)
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' � Power of Attorney
' STATE FARM FIRE AND CASUALTY COMPANY
KNOW ALL PERSONS BY THESE PRESENTS:That STATE FARM FIRE AND CASUALTY COMPANY,an Illinois corporation,with its principal o�ce in
Bioomington,Illinois,does hereby constitute and appoint:Jennifer Bless,Eugina Brant,Amanda J.Clifton,Ceola Campbell,Pamela Chancellor,Julie
Fehrman,Mark Fink,Julie Freed,Matthew J.Gibbons,John R. Horton,Cynthia Johnson,Susan K.Johnson,Connie S. Knox,Christine Macdonnell, Lori
McDowell,Melissa L.Morris,Mary Ann Nix,Vicki Redman,Leann Rees,Suzanne M. Robertson,Alice Schuler,Karen Sparks,Mary A.Spotts,Steven M.
Straub,Heidi Stevens,Perry Tracy,Karen Weber,Jennifer Wyant,Karli Yoder of Bloomington,Illinois its true and lawful Attorney(s)-in-Fact,to make,
execute,seal and deliver for,and on its behalf as surety,any and all bonds,undertakings or other writings obligatory in the nature of a bond as follows:
Any such obligation in any amount
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This appointment is made under and by the authority of a resolution which was passed�a�,th�fr�z�cutive Committee of the Board of
Directors of State Farm Fire and Casualty Company on the 8 th day of June,2009,as is duly autMor,ized by the Board of Directors in Article
II, 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 herel3jr�iui�orized to appoint and empower any
representative of the Company or other person or persons as Attorney-in-Fact:to execlut�on`behalf of the Company any bonds,
undertakings, policies,contracts of indemnity or other writings obligatgry�i�the nature`"of a.�ond,which the Company might execute through
its officers, and affix the seal of the Company thereto.Any said execution��"�,uch documents by an Attorney-in-Fact shall be as binding
upon the Company as if they had been duly executed and acknowledged by�e regularly elected or appointed officers of the Company.Any
Attorney-in-Fact,so appointed, may be removed for good c�aus�and the au��ority so granted may be revoked as specified in the Power of
Attorney.
Resolved,that the signature of any Officer of t�,��c�mpany r�otetl above and the seal of the Company may be affixed by facsimile on
any power of attorney granted,and the signatut'e of the;ar�y t�cer of the Company noted above,and the seal of the Company may be
affixed by facsimile to any certificate of arty such po�er�and any such power or certificate bearing such facsimile signature and seal shall be
valid and binding on the Company �ny.'si:tch power so,ex�cuted and sealed and certificate so executed and sealed shall,with respect to
any bond or undertaking to which i�fi�a#t�ched,contiriue to be valid and binding on the Company.
IN WITNESS THEREDF,., ST}�TE FARM FIRE AND CASUALTY COMPANY has caused this instrument to be signed by its Assistant
Secretary Treasurer,antl its�Corporate Seal to be affixed this 8 th.day of June,2009.
This APPOINTIVIENT>SHALL CEASE AND TERMINATE AUTOMATICALLY AS OF DECEMBER 31,2013, UNLESS SOONER
REVOKED AS PRUVIDED.
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_;PE�NOL'qsG��Ii�I STATE FARM FIRE AND CASUALTY COMPANY
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'%��'�..S3EA�G .'�: By�
'�,,,•,o�.., .•�= ssistant Secr ary Treasurer
STATE OF ILLINOIS ��''h����*or,�����=-
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COUNTY OF McLEAN
On this 8th day of June 2009, before me personally came Bradley M. Weaver to me known, who being duly sworn, did depose and say that he is
Assistant Secretary Treasurer of STATE FARM FIRE 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.
..........,.,..�......
V��t4iV^t�v7GJ't.�
Katen wEb�r Notary Public
h�OTARY PUBt.IC-STATE t�tW t�1iS
���������2� �,�� My commission expires July 24,2014
CERTIFICATE
I, the undersigned O�cer of STATE FARM FIRE AND CASUALTY COMPANY, do hereby certify that the original Power of Attorney of which the
foregoing is a true and correct copy, is in full force and effect and has not been revoked and the resolutions as set forth are now in force.
Signed and sealed at Bloomington, Illinois. Dated this 5TH day of APRIL 2013.
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If you have a question concerning the validity of this Power of Attorney,call(309)766-2090.
FB6-9043.47A
(01-03-12) Printed in U.S.A.
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Agent Name F E�r�,am�tn.' Agent Code#& State p�t ���3
Bond/Policy# pq qg-p,C-�398 -9
The enclosed materials were: Underwritten b Jerr T ed b �� �i 4
y:_y yp y: f� Checked by:
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The Fidelity& Surety Bond department appreciates your business. Please read the checked items.
� Bond'O°°�•-�°' ° -': with power of attorney. After the customer has signed as Principal, he/she needs to send both to
the Obligee(entity requiring the bond).
• Resident Agent: if required, you will need to sign.
• Acknowledgment of Principal: if required, your insured will need to have a Notary Public
or County Clerk complete it.
Please verify this bond appears on your system. If it does not,please contact us immediately.
For renewals, a bill is being sent to the insured. If this renewal bond is not needed, please mark `cancel' and
return it to us.
❑ Indemnitv Agreement: Please have appropriate person(s) sign where indicated, and return to us within 30 days.
❑ Continuation Certificate: with power of attorney. The customer needs to send both to the Obligee(entity requiring
the bond). A bill is being sent to the customer. If the bond is no longer needed, please mark `cancel' and return
the original Continuation Certiftcate to us.
❑ Stipulation: (endorsement)with power of attorney. After the customer has signed as Principal, he/she needs to send
both to the Obligee (entity requiring the bond).
❑ When this indented box is marked, the Obligee(entity requiring the bond) must sign a copy of the
the stipulation and have it returned to us within 30 days.
❑ Bill: Attached for$ ❑ Please collect the premium before releasing the bond to the customer.
To follow for$
❑ Fidelitv Policy: This is for the customer. No countersignature is required. The extra copy of the Declaration page and
Schedule page(if schedule bond) are for your files or you can give them to the customer.
❑ Fidelity-Amended Dec. Page/Chan�e Form: This is for the customer.
❑ When this indented box is marked, the insured must accept the amendment by signing a copy and
have it returned to us within 30 days.
❑ Notarv Public Errors and Omissions Liability Insurance Policv: This is for the customer.
❑ Other:
State Farm Fire and Casualty Company
Fidelity & Surety Bond Department
One State Farm Plaza—D-1
Bloomington, Illinois 61710-0001
800-251-BOND (2663)
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