Orange County NC Website
DocuSign Envelope ID:29F350EB-C553-4EEB-BD97-898B3775EE03 <br /> ACKNOWLEDGEMENT OF PRINCIPAL—IF A CORPORATION <br /> STATE OF .. . . �-)' <br /> S <br /> COUNTY OF. . . . ........... <br /> On th' . .-/ .�.:. ........... day of..-�..:��....... before me personally appeared <br /> to be known,who, being by me duly sw,orb,di epo$e and say; that he/she <br /> r des t , that he/she is the ��/ ....... , ,... of <br /> corporation described in 'c <br /> � rp and which executed the within insurance <br /> instrument; that he/she knows the seal of said corporation; that the seal affixed to said inst qq s such <br /> corporate seal; that is was so affixed by the Board of Directors of said corporation; and,h1d <br /> his/her name thereto by like order. <br /> ACKNOWLEDGEMENT FOR PRINCIPAL,IF LIMITED LIABILITY COMPAT�X�j�yyAKF yCp�a�`� <br /> STATE OF .........................) SS <br /> COUNTY OF .......................} <br /> Onthis ............................. day of ..................... , .......,........ before me personally <br /> appeared .......................................................................... to me known and known to me to be the <br /> I...... ..... ...................... .....................of ..............................................................., a <br /> Limited Liability Company, described in and who executed the foregoing insurance instrument and acknowledged to me <br /> that he/she executed the foregoing insurance instrument and acknowledged to me that he/she executed the same as and for <br /> the act and deed of said Limited Liability Company, <br /> ACKNOWLEDGMENT OF SURETY COMPANY <br /> STATE OF ,.NEW YORK SS <br /> COUNTY OF ..NASSAU,.......} <br /> MARCH 12, 2015 SUSAN LUPSKI <br /> Onthis ..,......I.................... .. before me personally came.......................,................,.,....... <br /> to me known, who, being by me duly sworn, did depose and say; that he/she resides in <br /> .RgA,�U.COUNTY. ........... State of......New.York.............................at he/she is the Attorney-In-Fact <br /> of the ,ARCH INSURANCE COMPANY.. ......................... .....the corporation described in which executed the <br /> above instrument; that he/she knows the seal of said corporation; that the seal affixed to said instrument is such <br /> corporate seal; that is was so affixed by order of the Board of Directors of said corporation; and that he/she <br /> signed his/her name thereto by like order; and the affiant did further depose and say that the Superintendent of <br /> Insurance of the State of New York, has, pursuant to Section I I I I of the Insurance Law of the State of New <br /> York, issued to .,ARCH(NSURANCE Ct ...... , (Surety) his/her certificate of <br /> qualification evidencing the qualification of said Company and its sufficiency under any law of the State of <br /> New York as surety and guarantor, and the propriety of acceptin a ing it as such; and that such <br /> certificate has nol;been revoked. <br /> GRACE ACKER50N <br /> Notary Pudic,State of New York ...... .......•..I.........•.• <br /> Nassau County Notary Pu 7C <br /> Uc.#01AC6111590 <br /> 'term Expires June 14,2016 <br /> NY acknowledgment <br />