Bond Exec ution Report %(5 030118 &XVWRPHU &RS\ Producer Principal Obligee Bond Number Bond Amount Contract Amount Effective Date Expiration Date Issuing Company Type of Bond AutoͲUW Bond Type Transaction Type Transaction Effective Date Prepared Date Bill Type Accounting Date Processed by Comments: 3UHPLXP 6WDWH 6XUFKDUJH 7D[ )HHV $PRXQW 'XH Branch Territory P.O. Box 5900 Madison, WI 53705-0900 866-509-7322 678-528-6638 17946 Southwest Surety Bonds Jose Martin Flores dba 6044 Gateway Blvd. East 18 Ste 304 42 El Paso, TX 79905 Luis Carlos Solis Chavez 240 Desert Pass St. El Paso, TX 79912 555 State of Texas Department of Transport Motor Vehicle Division Titles and Registration 4000 Jackson Avenue Austin, TX 78731 A190071286 $26,850.00 10/18/2021 10/18/2024 Capitol Indemnity Corporation CERTIFICATE OF TITLE/UP TO $30,000 Certificate of Title Surety Bond - up to $50,000 CIC-TX-3468-50-10-S New Business 10/18/2021 10/18/2021 Agency Bill 202110 JMFlores 403.00 .00 403.00
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Bond Exec ution Report
03 01 18
Producer
Principal
Obligee
Bond NumberBond Amount Contract AmountEffective Date Expiration Date Issuing Company Type of BondAuto UW Bond Type
Transaction TypeTransaction Effective Date Prepared Date Bill Type Accounting Date Processed by
Comments:
Branch
Territory
P.O. Box 5900Madison, WI 53705-0900
866-509-7322678-528-6638
17946
Southwest Surety BondsJose Martin Flores dba6044 Gateway Blvd. East
18 Ste 304
42 El Paso, TX 79905
Luis Carlos Solis Chavez
240 Desert Pass St.
El Paso, TX 79912
555
State of TexasDepartment of Transport Motor Vehicle DivisionTitles and Registration4000 Jackson AvenueAustin, TX 78731
A190071286$26,850.00
10/18/202110/18/2024Capitol Indemnity CorporationCERTIFICATE OF TITLE/UP TO $30,000Certificate of Title Surety Bond - up to $50,000CIC-TX-3468-50-10-S
New Business10/18/202110/18/2021Agency Bill202110JMFlores
PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent or the company first. If the dispute is not resolved, you may contact the Texas Department of Insurance.
ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document.
Surety Bond Information Bond Number Bond Effective Date Bond Amount
Vehicle Information Vehicle Identification Number Year Make Body Style Model
Owner Information (Principal) First Name (or Entity Name) Middle Name Last Name Suffix (if any)
Additional Applicant First Name (if applicable) Middle Name Last Name Suffix (if any)
Address City State Zip
Surety Bond Company Information (Surety) Surety Bond Company Name
Address City State Zip
Certification – State law makes falsifying information a third degree felony KNOW ALL BY THESE PRESENTS, THAT the above named Principal and above named Surety, duly authorized and qualified to do business as a surety company in this state, are held and firmly bound to prior or subsequent owners, purchasers, lienholders, or their agents who hold or acquire an interest in the above described motor vehicle in the sum as listed above for the payment of which we bind ourselves, our heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents. WHEREAS, the above named Principal is applying for a Texas Certificate of Title by means of the bonded title procedure on the above described motor vehicle. AND WHEREAS, said Principal is in possession of the vehicle. AND WHEREAS, said Principal is required by law, Transportation Code, §501.053, to submit a properly executed surety bond, conditioned as set forth below, with said application for Texas title. Said bond shall run and be in full force and effect for a period of three (3) years from and after the effective date as shown above. Payment of any judgment by the Surety shall be immediately reported to the Texas Department of Motor Vehicles, Vehicle Titles and Registration Division, 4000 Jackson Ave, Austin, TX 78779-0001. IT IS FURTHER UNDERSTOOD AND AGREED that this bond shall be open to successive claims up to the face value of the bond. The Surety shall not be liable for successive claims in excess of the bond amount regardless of the number of claims made against the bond for three (3) years from its effective date. THE CONDITIONS OF THIS OBLIGATION ARE SUCH that if the Principal shall indemnify any prior owner and lienholder or their agents and any subsequent purchaser of said vehicle or person acquiring any security interest in it and their respective successors in interest against any expense, loss, or damage, including reasonable attorney's fees, by reason of the issuance of the certificate of title for said vehicle or on account of any defect in or undisclosed security interest upon the right, title, and interest of the applicant in and to said vehicle, then this obligation shall be void. Otherwise, it shall remain in full force and effect. IN WITNESS WHEREOF said Principal and Surety have executed this bond to be effective on the above listed bond effective date and to expire three (3) years from the effective date of said bond.
SURETY COMPANY SEAL
(Required)
Signature of Principal Printed Name (Same as Signature) Date
Signature of Surety Company’s Agent Printed Name (Same as Signature) Date
Note: Surety bond must be executed by a surety company authorized to do business in Texas. When executed by an attorney-in-fact, the power of attorney (original or certified copy) must be attached. Any alteration of this document necessitates the issuance of a new bond or an attached amendment from the Surety Company. A surety bond not filed with the county tax assessor-collector within 30 days of the issuance date will not be accepted. Applicant's name, address, and vehicle description must match the department's refusal/rejection letter and Bonded Title Application or Tax Collector Hearing Statement of Fact (Form VTR-130-SOF).
VTR-130-SB Rev 11/16 Page 1 of 1
A190071286 10/18/2021 $26,850.00
3C7WRSAT9DG556901 2013 RAM PK
Luis Carlos Solis Chavez
240 Desert Pass St. El Paso TX 79912
Capitol Indemnity Corporation
1600 Aspen Commons, Suite 300 Middleton WI 53562
Luis Carlos Solis Chavez
Luis Carlos Solis Chavez
Capitol Indemnity Corporation
Daniel McGinnis, President of Surety 10/18/2021
POWER OF ATTORNEY Bond Number
KNOW ALL MEN BY THESE PRESENTS, That the CAPITOL INDEMNITY CORPORATION, a corporation of the State of Wisconsin, having its principal offices in the City of Middleton, Wisconsin, does make, constitute and appoint
Name of Individualits true and lawful Attorney(s)-in-fact, to make, execute, seal and deliver for and on its behalf, as surety, and as its act and deed, any and all bonds, undertakings and contracts of suretyship, provided that no bond or undertaking or contract of suretyship executed under this authority shall exceed in amount the sum of
$ for on behalf of Bond Amount Bond Number Principal
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of CAPITOL INDEMNITY CORPORATION at a meeting duly called and held on the 15th day of May, 2002.
“RESOLVED, that the President, Executive Vice President, Vice President, Secretary or Treasurer, acting individually or otherwise, be and they hereby are granted the power and authorization to appoint by a Power of Attorney for the purposes only of executing and attesting bonds and undertakings, and other writings obligatory in the nature thereof, one or more resident vice-presidents, assistant secretaries and attorney(s)-in-fact, each appointee to have the powers and duties usual to such offices to the business of this company; the signature of such officers and seal of the Company may be affixed to any such power of attorney or to any certificate relating thereto by facsimile, and any such power of attorney or certificate bearing such facsimile signatures or facsimile seal shall be valid and binding upon the Company, and any such power so executed and certified by facsimile signatures and facsimile seal shall be valid and binding upon the Company in the future with respect to any bond or undertaking or other writing obligatory in the nature thereof to which it is attached. Any such appointment may be revoked, for cause, or without cause, by any of said officers, at any time.”
In connection with obligations in favor of the Florida Department of Transportation only, it is agreed that the power and authority hereby given to the Attorney-in-Fact includes any and all consents for the release of retained percentages and/or final estimates on engineering and construction contracts required by the State of Florida Department of Transportation. It is fully understood that consenting to the State of Florida Department of Transportation making payment of the final estimate to the Contractor and/or its assignee, shall not relieve this surety company of any of its obligations under its bond.
In connection with obligations in favor of the Kentucky Department of Highways only, it is agreed that the power and authority hereby given to the Attorney-in-Fact cannot be modified or revoked unless prior written personal notice of such intent has been given to the Commissioner – Department of Highways of the Commonwealth of Kentucky at least thirty (30) days prior to the modification or revocation.
IN WITNESS WHEREOF, the CAPITOL INDEMNITY CORPORATION has caused these presents to be signed by its officer undersigned and its corporate seal to be hereto affixed duly attested, this 1st day of January, 2020.
Attest: CAPITOL INDEMNITY CORPORATION
John L. Sennott, Jr. Chief Executive Officer and President
STATE OF WISCONSIN COUNTY OF DANE S.S.:
On the 1st day of January, 2020 before me personally came John L. Sennott, Jr., to me known, who being by me duly sworn, did depose and say: that he resides in the County of Hartford, State of Connecticut; that he is Chief Executive Officer and President of CAPITOL INDEMNITY CORPORATION, the corporation described in and which executed the above instrument; that he knows the seal of the said corporation; that the seal affixed to 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.
STATE OF WISCONSIN COUNTY OF DANE S.S.:
David J. Regele Notary Public, Dane Co., WI
My Commission Is Permanent
I, the undersigned, duly elected to the office stated below, now the incumbent in CAPITOL INDEMNITY CORPORATION, a Wisconsin Corporation, authorized to make this certificate, DO HEREBY CERTIFY that the foregoing attached Power of Attorney remains in full force and has not been revoked; and furthermore, that the Resolution of the Board of Directors, set forth in the Power of Attorney is now in force.
Signed and sealed at the City of Middleton, State of Wisconsin this day of , 20 .
THIS DOCUMENT HAS BEEN GENERATED FOR A SPECIFIC BOND. IF YOU HAVE ANY QUESTIONS CONCERNING THE AUTHENTICITY OF THIS DOCUMENT CALL 800-475-4450. CIC-ePOA (Rev. 01-2020)
Andrew B. Diaz-Matos Senior Vice President, General Counsel and Secretary