HomeMy WebLinkAbout02-1524 General Power Of Attorney
Sirius America Insurance Company
c/o Capital Bonding Corporation
525 Penn Street, Reading, Pennsylvania 19601
s caP NO
000898
Know All Men By These Presents, that Sirius America Insurance Company, a corporation organized under the
laws of the State of Delaware, with its principal office located in New York, New York, hereby constitutes and appoints
Jason Wolgemuth
in the City of , County of Cumberland , State of Pennsylvania ,
its true and lawful Attorney-in-Fact for it and in its name, place and stead, to execute on behalf of the said company, as Sole
Surety, subject to the limitations herein set forth Bail Bonds and Recognizances only, in a penalty not to exceed
$250,000.00 Two Hundred Fifty Thousand Dollars and No Cents for each bond or recognizance.
Each bail bond or recognizance must be accompanied by an individual, numbered Power of Attorney properly
executed.
This General Power of Attorney shall become void on 1/04/2003 unless previously revoked.
The execution of such bonds or undertakings in pursuance of these presents shall be binding upon said Company as
fully and amply, to all intents and purposes, as if they had been duly executed and acknowledged by the regularly elected
officers of the Company at its office in New York, New York, in their own proper persons.
In Witness Whereof, Sirius America Insurance Company has caused these presents to be signed by its authorized
Program Administrator, and its corporate seal to be hereunto affixed this 4th day of January 2002.
By
State Of Pennsylvania
County Of Berks
Qualifying Power Only. Not To Be Attached To Any Bond.
Valid Only If Individual Power Of Attorney Is Attached To Each Bond Executed.
Vincent J. Smith being duly sworn, deposes and says that he is the Program Administrator of the Sirius America
Insurance Company Bond Program, the corporation which is described in and which executed the foregoing instrument; that he
knows the corporate seal of said corporation; that the seal affixed to the said instrument is the corporate seal of Sidus ^merica
Insurance Company and was thereto affixed by authority of a resolution is now in full force and effect, as follows:
Be it Resolved, that any one of the following persons: President or any Vice President of Sirius America Insurance
Company or the Program Administrator of the Sirius America Insurance Company Bond Program, is hereby authorized to
execute on behalf of Sirius America Insurance Company Powers of Attorney authorizing and qualifying the Attorney-in-Fact
named therein to execute on behalf of Sirius America Insurance Company Criminal bail bonds in a principal sum not to exceed
one million ($1,000,000.00) dollars on any one bond, and further that any one of the aforesaid authorized persons is hereby
authorized to affix the corporate seal of the said Company to Powers of Attorney executed pursuant to this resolution.
Sworn to before me this
4th day of January 2002.
,~,l.~'.t~ 7~,~ Notary Public
Reading, Pennsylvania
My Commission Expires July 9, 2002
Form SAICQP
NAIC Group Code 0000
QUARTERLY STATEMENT
AS OF SEPTEMBER 30, 2001
OF THE CONDITION AND AFFAIRS OF THE
SIRIUS AMERICA INSURANCE COMPANY
0000 NAIC Company Code 35405 Employer's ID Number 13-2930697
(Pr~' P~dod)
Delaware
(Curtain PedodI
Organized under the Laws ct
Country of Domicile
, State of Domrcile or Port of Entry
United States of America
Incorporeled
Statutory Home Office
Main AdmtnlstraUve Office
11/18/1977 Commenced Business
32 Loockerman Square Suite L100
01101/~978
Dover, DE 19901
NewYork NY 10152
Mail Address 375 Park Avenue Sulle 2107
Pdmary Location of Books and Records
New York~ NY 10152
Inlernet Webalte Address
212-702-3700
New York~ NY 10152
375 Park Avenue Suite 2107
212-702-3704
(Ama Code) (Telephone Number)
Statement Contact
ich n.komobia~,alramlna.com
John Mrchael Kamobis
OFFICERS
212-702-3704
Chairmen of the Board
President and Chief
Executive Officer
, Executive Vice President,
Chief Operating Officer
· ' and Chief Financial
Officer
Senior Vice President and
Chief Underwriting Officer
Senior Vice President and
. Chief information Officer
Goran Thoratanason
Bard Erllng Bunaes
William Francis Davis
Christopher Uam Galla~lher
James Andrew Crowe
Vice President, Senior Financial
Officer and Treasurer
Vice President, General Counsel
and Corporate Secretary
Vice President and Audit
Manager
Vice President
Asslstanl Vice President
John Mlchesl Komobis
Jean Made Cho
John Sullivan
isabella Levers DeRoy
Jiten MofllaJ Kapadla
DIRECTORS
Anders Barsk
Jeffrey Alan Kurnen~z
Bard Erring Bunaes
Goren Thorslanason
Lars Ek
Sl~te of ............................. .New York ............................ '~ 8S
Counly of ............................ New York .............................. ~
The officers of this reporting entity, being duly sWOrn, each depose and say that they are the dascflbed officers of eald repodlng entlly, and thai on the
reporUng period stated above, all of the herein described assets were the edsolula property of the said reporting entity, free and clear from any liens or
claims thereon, except as herein alaled, and that this slatemen[, together with rblated exhibits, schedules and explanations Iherein contained, annexed or
referred to Is a full and true statement of all the asesle and liabilities and of the condition and affairs of fha said reporUng Chilly as of the repoding period
stated above, and of ils income and deductions therefrom for the period ended, and have been completed In accordance with the NAIC Annual Statement
Inalrucfions and Accounting Pra~fioes and Procedures Manual except to the extent that:. (1) state law may differ; or, (2) that state rules or regulations
require differences In reporting not related to accounting practices and procedures, according to the beet of their Information, knowledge and belief,
respectively.
..__3Secretary
Subscribed and sworn to before me this
2fith day of Octobeq 20{31
Notary Public, S~ate ot N~w Ynrk
No. 01DE5037571
Qunlified in Richmond ~':,, ,r '
~erhi:'.'t: Fih~,d!~,Nnw.':,,,::' / .
STATEMENT AS OF SEPTEMBER 30, 2001 OF THE Sirius America Insurance Company
ASSETS
'- Current Ststement Dale 4
t 2 3
Net Admitted December 31.
Nonadmi{led Assets Prior Year Net
................................................................................................................. I ................ 87,141,146 ................................................... J?,141,146 ............... 81,110,292
STATEMENT AS OF SEPTEMBER 30, 2001 OF THE Sirius America Insurance Company
LIABILITIES, SURPLUS AND OTHER FUNDS
Currant Da~enlber 31.
1, P. olsea(~urrentaccidentyear$ .................... .1,180,776 ) ...................................................................................................... : ............. .11,$19.21XI . ................ .I0,407,609
STATEMENT AS OF SEPTEMBER 30,200t OF THE Sirius America Insurance Company
STATEMENT OF INCOME
I 2 3
Current Year Prior Year Pdor Year Ended
lo Da~e ~ Dale December 3t
UNDERWRITING INCOME
1.1 Dlrec~(wflttan$ ................ 89,093,392 ) .................................................................................................. ~6,769,658 ................... 5,875,813 ............... .10,326,191
1.2 Assurned(wflttan$ ................... 2,721,525)~ .............................................................................................. ],523,335 .................. 9,049,042 ................ J0,146,382
1,3 Ceded(wilinesS .................. 57,189,914 ) .................................................................................................. 38,793,498 ............... .11,729,892 ............. .15,924,459
1.4 Net{wr;tten$ ................ .13,625,003 ) ....................................................................................................... 9,499,455 ................. 3,195,353 ................. 4,54~,114
2. Losseslnc~rred(~Jn'enlaccide~lyear$ ................... 2,499,924 ):
2.1 Direct ........................................................................................................................................................... 89,435,847 ............... 3,846,765 ................. 6,197,095
2.2 Assumed ........................................................................................................................................................ 2,989,1g0 ........... 11,671,197................ 9,861,152
2.3 Ceded .................................................................................................................................................................... 32,882,481 ................ .10,545,251 ............... .14,317,894
2.4 Nel ..................................................................................................................................................................... 5,541,589 ................... .1,972,711 ............... .I ,740,553
4, Other undem~ritlng expanses incurred. ....................................................................................................... 3,117,634 ................ 2,797,892 ................. 3,789,268
7. Net undem~flting gain or (loss) (Line 1.4 minus Line 6) ............................................................................................ 210,7~6 ................ .(1,898,196 ................ (1,913,864
8. Net Invea~ent ir~come earned .................................................................................................................................... 2,622,845 .................. 3,73g,335 ................. .4,743,895
10. Ne~ Investment gai~ (loss) (Ll~es 8 + g) .................................................................................................................. 2,1(]6,352 ................. 6,034,511 ................... 11,178,472
11. Net gain or (k~ss) florn agents' or premium balances charged off
13, Aggregate wdta-in s for miscall aneous income ..................................................................................... (98,631) (125,293 (177~674)
14. Total ot~er income (UPas 11 through 13) ................................................................................................ (89~631 (125~293 { 177~67,~
7 + 10 + 14) .............................................................................................................................................. 2,218,517 ................... .4,011,022 ..........
17. Net Income, after dlvldends to policyholders but before federal aed foreign Income taxes (Line t 5
t9. Nel in~ome (line 17 r~nus Line 18)(lo Line 21) ........................................................................... 1,121 r725 2~20g~207 3~669~589
GAINS AND {LOSSES) IN SURPLUS
21. Net income (from Line 19) .................................................................................................................................. .1,121,725 ................. 2,209,20? ................... 3,6~9,588
22. Net unrealized r. apita gainser oases ....................................................... (1 104 712 ................ (2,897,71C .................. (3,894,5~
24. Change In net defe~ed Inc~ne ~ax ........................................................................................................... 283,314 .......................................................................
25. Change In r~onadmittad assets ....................................................................................................................................... (4,953 .................... (148,196 ................... (136,14~
31. Net mmJttances fl'om or (to) Home Office ...............................................................................................................................................................................................
35. Cbengein aurplusas rega~l$ poJicyholders(Lines 21 Ihn=ugh 34) ................................................ 623,264 905~116 1r478~237
31). Surplus as re~ards poliwholdersr as of statement dele (Unes 20 plus 35) 72,201~189 71~004~720 71,577,841
1301. ~ncollectible reinsurance. .............................................................................................................................................................................................................. (12,1~
t3o2. Other Interest inc0ee (expense) ............................................................................................................................... (126,797) ................... (125,293 .................. (165,44;
1399. Totals (Llne~ 1301 thru 1303 p~us 1398) (Line 13 above) (g8~631) (125~293} (177r67,1)
STATEMENT AS OF SEPTEMBER 30, 2001 OF THE Sirius America insurance Company
CASH FLOW
Year to Ende~
................................................................................ 2,072,430 ...................
7. Other ir~orne (expetmea]:
7,4 Aggregatewrite-lns for miscellaneous ems (1271304) (177~674}
~decl (~et) ............................................................................. . .................................................................................
I';.1 Boncls ........................................................................................ 54,337,414 ................ E~,953,58g
...................................................................................................... .18,712,g1~z ................. 17,297,448
11.7 Miscellaneous pmceedl ................................................................................... (23~1964)
12.1 Bonds ......................................................................................................................................................................................................... 5g ,4g0,g52 ................. .41,188,616
................................................................................................................................................. 2,417,34§
07.401 t~ncolieciible reinsurance. ............... _ ................................................................................................................. (12,182)~
07.4O2 0thor inieresl exper~e ................................................................................................................................. (126,797) ..................... (165,442)
07,403 Fires & Penal I les ......................................................................................................................................................................................................................... (50)!
o7.4gg Totals (Lines 07.401 th~u 07.403 plus 07.498) (Line 7.4 above) (IL~, 304) (1771674)
COMIVIONWEALTH OF PENNSYLVANIA
INSURANCE DEPARTMENT
CERTIFICATE OF AUTHORITY
Effective Date: April 1, 2001
SIRIUS AMERICAN INSURANCE COMPANY
NAIC NO 35408
HAS COM~LrgD WITH THE REQUIREMENTS OF THE LAWS OF THE COMMONWEALTH OF
PENNSYLVANIA RELATING TO ADMISSION IN SAiD COMMONWEALTH FOR THE PURPOSE OF
TRANSA~G INSURANCE BUSINESS IN PENNSYLVANIA AND THAT THE ABOVE NAMED
COMPANY IS HEREBY AUTHORIZED TO TRANSACT THE BUSINESS OF:
40-54 o2 (c) (2)
40-5-102 (c)
40-54o2 (c) (7)
40-5-102 (c) (t)
40-5-102 Co) (2)
4o-54o2 (¢) (4)
4o-54o2 Co) (0
40-5-I02 (¢) (14)
· Accident and Heallh
· Boiler and Machinery
Credit
Fidelity and Surety
Inland Mar/ne and Physical Damage
Other Liability
Property and Allied Lines
Worker's Compensation
40-5-102 (c) (11) Auto L/ability "
40-5-102 (¢) (6) . Burglary and Theft
40-5-102 (c) (9) Elevator
40-5-102 (c) (3) Glass
40-5-102 Co) (3) Ocean Marine
40-5-102 (c) (13) Personal Property Fldam'
40-5-102 (c) (8) Water Damag~
FOR THE YEAR ENDING MARCH 31, 2002, IN ACCORDANCE WITH ITS CHARTER AND
IN CONFORMITY WITH ~ LAWS OF.SAID COMMONWEALTH OF PENNSYLVANIA.
IN WITNESS WHEREOF, I HAVE HEREUNTO SET MY HAND AND
AFFIXED MY OFFICIAL SEAL, THE DATE AND YEAR FIRST ABOVE
WRI I I ~-N.
M. DIANE KOKEN
INSURANCE COMMISSIONEK
JASON MICi
Licen~
is licensed to engage in the business of
capacity stated below, subject to applicat
LICENSE TYPE
Resident Agent
QUALIFICATIONS
Casualty and Allied Lines, Property and
Allied Lines
WOLGEMUTH, JASON MICHAEL
24 .VINEMONT ROAD
REINHOLDS, PA 17569-0000
EMUTH
Ith of Pennsylvania in the ~
EXPIRATION DATE
12-02-2002 ~' r.:i.i,_..~ · I!
CE REQUIREMENTS
Total 48 Ii