SUPREME COURT OF THE STATE OF NEW YORK COUNTY OF RICHMOND -------------------------------------------------------------------X POLINA DORTS f/k/a POLINA KLIMENYUK and X ALL POINTS MEDICAL SUPPLY, INC., Plaintiffs, RECEIVER'S OATH -against- Index No.:151183/2015 MICHAEL BEREZOVSKY, ELENA RYNSKY (as a stakeholder and necessary party) and FAZIO, RYNSKY & ASSOCIATES, L.L.P. (as stakeholder and necessary party), Defendants. --------------------------------------------------------------X I, Allyn J. Crawford, Esq., having been appointed receiver in the above-entitled action by an Order of the Hon. Kim Dollard dated January 29, 2018, execute this oath pursuant to the provisions of CPLR 6402, and do solemnly swear that I will faithfully, honestly, and impartially discharge the trust committed to me as such receiver. th. CitÖ/FORD Sworn to before me this day of March, 2018 Nt Joy Speights Notr.ry, State of New York No. 0iSP6153113 Ouclified in Richmond County (.'mninissioii Expires September 25, 201~ 1 of 6
R RLI Insurance Company ECEWRS BOND P.O. Box 3967 Peoria IL 61612-3967 Phone: (309)692-1000 Fax: (309)683-1610 Bond No. LSM1099980 Supreme Court of the State of New STATE OF New York IN THE York County of Richmond ss County of Richmond } NO. 151183/2015 Plaintiff(s): POLINA DORTS F/K/A POLINA KLIMENYUK AND ALL POINTS MEDICAL SUPPLY, INC. Vs. Defendant(s): MICHAEL BEREZOVSKY, ELENA RYNSKY(AS A STAKEHOLDER AND NECESSARY PARTY) AND FAZIO, RYNSKY 8 ASSOCIATES, L.L.P. (AS STAKEHOLDER AND NECESSARY PARTY) KNOW ALL MEN BY THESE PRESENTS: That we, Al I YN J CRAWFORD as Principal, and the RLI Insurance Company, a corporation duly licensed to do business in the State of New York as Surety, are held and firmly bound unto rem Court of the State of New or County of Richmond in the sum of Two Hundred Fifty Thousand and 00/100 DOLLARS ( $ 250,000.00 ), for the payment of which well and truly to be made, we bind ourselves and our legal representatives, jointly and severally by these presents. THE CONDITION OF THE ABOVE OBLIGATION IS SUCH,. That whereas on the 29th day of January, 2010, the above named Principal was appointed Receiver in the above entitled matter. NOW THEREFORE, if the said Principal shall faithfully discharge the duties of Receiver in said action, and shall obey the orders of the Court therein, then this obligation to be null and void, othewise to remain in full force and effect. Dated this 27th day of February, 2018. ALLYN J. CRAWFORD Principal A YN J. C R ATTORNEY RLI Insurance Company By Herbert R. Applebaum Attorney In Fact Page 1 J000521040,0 2 of 6
Individual Acknowledgment State of W Îeda/L County of +t c.b vaawl On the day of wta--, O ( b.,before me personally appeared 4r~> to me known and known to me to be the person described in and who executed the foregoing instrument and he/she thereupon acknowledged to me that he/she executed the same. Partnership Acknowledgment Joy Sociphts Naiary Pilblic, State of New York State of ¾.,i 01GP6153113 Onahqed M Richinond County County of GoiaÏnsoa Expires Septernber 25, 201 E On the day of,, before me personally appeared to me known and known to me to be one of the firm of described in and who executed the foregoing instrument and he/she thereupon acknowledged to me that he/she executed the same as and for the act and deed of said firm. Corporate Acknowledgment State of County of On the day of,, before me personally appeared to me known, who being by me duly sworn, did depose and say that he/she is the of the, the corporation described in and which executed the foregoing instrument; that he/she knows the seal of said corporation; that the seal affix 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/she signed his/her name thereto by like order. A3103N04 DT 3 of 6
RLI Insurance Company P.O. Box 3967 Acknowledgment of Peoria IL 61612-3967 Surety Phone: (309)692-1000 Fax: (309)683-1610 STATE OF New York COUNTY OF Richmçnd } ss. On this 27th day of February, 2018. before me, a in and for said County, personally appeared Herbert R. Applebaum. personally known to me, who being by me duly sworn did say that he/she is the aforesaid Attorney In Fact of the RLI Insurance Company of Peoria Illinois, a corporation duly organized and existing under the laws of the State of Illinois, that the seal affixed to the foregoing instrument is the corporate seal of said corporation, that the said instrument was signed, sealed and executed in behalf of said corporation by authority of its Board of Directors, and further acknowledge that the said instrument and the execution thereof to be a voluntary act and deed of said corporation. IN WITNESS WHEREOF, I have hereunto subscribed my name and affixed by official seal the day and year last above written. I My Commission Expires: GARY APPLEBAUM, State of New York No. 01AP4752798 Qualified in Richmond County Jommission Expires January 31, 2022.;:ommlsslon A0007204 4 of 6
R m g RLI InsuranceCompany P.O. Box 3967 Peoria IL 61612-3967 Phone: (309)692-1000 Fax: (309)683-1610 POWER OF ATTORNEY RLi i rance Compan Bond No. LSM1099980 Know All Men by These Presents: That the RLI Insurance Company. a corporation organized and existing under the laws of the State of Illinois, and authorized and licensed to do business in all states and the District of Columbia does hereby make, constitute and appoint: Herbert R. Applebaum in the City of Staten Island. State of New York. as Attornev In Fact. with full power and authority hereby conferred upon him/her to sign, execute, acknowledge and deliver for and on its behalf as Surety, in general, any and all bonds, undertakings, and recognizances in an amount not to exceed Five Million and 00/100 Dollars ( $ 5,000,000,00 ) for any single obligation, and specifically for the following described bond. Principal: ALLYN J. CRAWFORD Obligee: _ Supreme Court of the, ia of New York County of Richmond Type Bond: Receiver Bond Bond Amount: $ 250.000.00 Fffective Date: February 8, 2018 The RLI Insurance Company further certifies that the following is a true and exact copy of a Resolution adopted by the Board of Directors of RLI Insurance Company. and now in force to-wit: "All bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation shall be executed in the corporate name of the Company by the President, Secretary, any Assistant Secretary, Treasurer, or any Vice President, or by such other officers as the Board of Directors may authorize. The President, any Vice President, Secretary, any Assistant Secretary, or the Treasurer may appoint Attorneys in Fact or Agents who shall have authority to issue bonds, policies or undertakings in the name of the Company. The corporate seal is not necessary for the validity of any bonds, policies, undertakings, Powers of Attorney or other obligations of the corporation. The signature of any such officer and the corporate seal may be printed by facsimile." IN WITNESS WHEREOF, the RLI Insurance Company has caused these presents to be executed by its Vice President with its corporate seal loot 1W% 7th day of February. 2018. ~ aew ~ g ~ ~ R ~ ~ ~ ~ itiiilaile ~ ffj ~ ATTEST: ip+~t: " o + "".+~ *,...Insurance Company Cherie L. Montgomery sistant Secreta, <"".."" ~+ B ton W. Davis Vice President ~,, C"f"gff 0'- On this 27th day of February, 2018 before me btoo a P blic, personally appeared Barton W. Davis and Cherie L. Montgomerv. who being by me duly sworn, acknowledged that they As' Attorney as Vicç President and Assistant Socretary, respectively, of the said RLI Insurance Company. and acknowledged said instrument to be the voluntary act and deed of said corporation. GRETCHENL JOHNIGK L c "official SEAL" Gretchen L. Johnigk t'tt't'ted@ MyCo In n plros MRV2e,2020 A0006104 5 of 6
R RLl lnsurance Company RLI Insurance P.O. Box 3967 Peoria ll 61612-3967 Company Phone: (309)692-1000 Fax: (309)683-1610 December 31, 2016 Admitted Assets Liabilities and Surplus Investments: Liabilities: Fixed maturities..,.....,...................... $ 691,592,014 Reservefor unpaid losses and loss Equity securities.,...,..,,.,.................. 890,779,919 adjustmentexpenses........................ $ 489,669,057 Short-terminvestments.....,,...,.............. 3,606,726 Unearned premiums,.......,...,.............. 238,082,518 Real estate..................,.................. 30,057,188 Accrued expenses............................ 54,157,871 Propertiesheld to produceincome...,...,...... 0 Funds held................................ 559,190 Cash on hand and on deposit.,,.,,................. 14,824,739 Advance premiums............................ 5,514,072 Other invested assets........,,.................. 23,767,004 Amounts withheld............................. 75,489,279 Receivablesfor securities.,,,..,................... 65,707 Dividendsdeclared and unpaid.................. 29,298 Agents' balances............,,............... 72,408,650 Ceded reinsurancepremiumpayable............, 5,073,678 Investmentincome due and accrued.................. 6,410,724 Payablefor securities,..........,,............ 1,182,782 Funds held............................... 4,000 Statutory penalties...........,,............... 470,200 Reinsurancerecoverableon paid losses.............. 9,891,389 Currentfederal & foreign incometaxes............ 0 Federal income taxes receivable,......,............. 1,880,750 Federal incometax payable............... 11,018,129 Net deferredtax asset.......,,,,.................. 0 Borrowed moneyand accrued interest............ 0 Guaranteefunds receivableoron deposit............. 46,136 Drafts outstanding.......,,,..................... 0 Electronicdata processingequipment, Payableto affiliate.....,,,.,,................ 3,615,055 net of depreciation..........,............. 3,036,720 Other liabilities................................. 8,514,592 Receivablefrom affiliate.......................... 824,582 Other admittedassets,...,...,,................... 4,154,773 Total Llabilities............................. $ 893,375,721 Total AdmittedAssets $ 1,753,351,921 Surplus: Common stock............................... $ 10,000,375 Additional paid-in capital....................... 242,451,084 Unassignedsurplus........................... 607,524,741 State of lilinois Total Surplus $ 859,976,200 County of Peoria Total Liabilitiesand Surplus $ 1,753,351,921 The undersigned, being duly sworn, says: That he is the President of RLI Insurance Company; that said Company is a corporation duly organized, in the State of Illinois, and licensed and engaged in business in the State of New York and has duly complied with all the requirements of the laws of said State applicable of said Company and is duly qualified to act as Surety under such laws; that said Company has also complied with and is duly qualified to act as Surety under the Act of Congress approved July 1947, 6U.S.C sec. 6-13; and that to the best of his knowledge and belief the above statement is a full, true, and correct statement of the financial condition of the said Company on the 31st day of December 2016. Attest: ivy ttitillll iiii Iu lo ~ ~ e>iunuuui ~ I s Barton W. Davis Vice President,... Co orate ~ ~ eal =: IJV% Affixed I n I I I I Iu i Cherie L. Montgomery istant Secretary Sworn to before me this 13th day of March, 2017. GRETCHENL JOHNIGK "OFFICIAL SEAL" MyCommission Explrea Notarial usy2s.2020 Seal. '"""""'""""'"""""' Affixed Gretchen L. Johnigk No, State of Illinois M0058317 6 of 6