1991-178ORDINANCE NO 91:1a
AN ORDINANCE ACCEPTING A COMPETITIVE SEALED BID AND AWARDING A
CONTRACT FOR SECTION 125 FLEXIBLE BENEFIT PLAN ADMINISTRATION
SERVICES TO ANTHEM LIFE INSURANCE COMPANY, PROVIDING FOR THE EX-
PENDITURE OF FUNDS THEREFOR, AND PROVIDING FOR AN EFFECTIVE DATE
WHEREAS, the City has solicited, received and tabulated com-
petitive sealed bids for services in accordance with the procedures
of State law and City ordinances, and
WHEREAS, the City Manager, or a designated employee, has re-
viewed and recommended that the herein described bid is the lowest
responsible bid for the service as shown in the bids submitted
therefor, and
WHEREAS, the City Council has provided in the City Budget for
the appropriation of funds to be used for the purchase of the ser-
vices approved and accepted herein, NOW, THEREFORE,
THE COUNCIL OF THE CITY OF DENTON HEREBY ORDAINS
SECTION I That bid number 1291, providing for Section 125
Flexble Benefit Plan Administration is hereby awarded to Anthem
Life Insurance Company, and this bid is hereby accepted and ap-
proved as the lowest responsible bid, based upon a projection of
lowest net cost, assuming current employee participation levels
SECTION II That by the acceptance and approval of this bid,
the City accepts the offer of Anthem Life Insurance Company for
such services and agrees to purchase the services in accordance
with the terms, specifications, standards, quantities and for the
specified sums contained in the bid submittal form
SECTION III That the City Manager or his designated represen-
tative is hereby authorized to execute the written contract at-
tached hereto
SECTION IV That by the acceptance and approval of the above
bid, the City Council hereby authorizes the expenditure of funds
therefor in the amount and in accordance with the approved proposal
or pursuant to a written contract made pursuant thereto as autho-
rized herein
SECTION V That this ordinance shall become effective imme-
diately upon its passage and approv 1
PASSED AND APPROVED this h day of ~X 1991
BOB CASTLEBERRY, MAY
ATTEST
JENNIFER WALTERS, CITY
BY
APPROVED A TO LEGAL FORM
DEBRA A DRAYOVITCH, CITY ATTORNEY
W:ALL0008E
THE STATE OF TEXAS $ AGREEMENT BETWEEN THE CITY OF DENTON
AND
COUNTY OF DENTON $ ANTHEM LIFE INSURANCE COMPANY, INC
This agreement, executed the 1st day of January, 1992, is between
the City of Denton ("Denton") and Anthem Life Insurance Company,
Inc , a Texas Corporation (the "Claims Administrator")
WW. TNESSETH
SECTION I
The Plan
1 1 Denton will adopt a cafeteria plan of benefits under Section
125 of the tax code (the "Plan") providing means by which
eligible employees of the City of Denton can secure the bene-
fits set forth in the plan
1 2 The administrator of the Plan (as defined by the Employee
Retirement Income Security Act of 1974) is the City of Denton
("Plan Administrator")
1 3 The name of the Plan is the Delta Plan
1 4 The effective date of the Plan is January 1, 1992
1 5 The Plan Administrator hereby appoints Claims Administrator,
an independent third party administrator, to perform certain
functions for the operation of the plan
SECTION II
The Claims Administrat
2 1 The Claims Administrator, within the scope of its profession-
al ability and its employment under this agreement, shall
provide certain services for and shall assist Denton in the
administration of the Plan as it may be requested and
authorized from time to time Such services shall include,
but not necessarily be limited to the following
a Completion of reports and payment of claims from the Plan
to the participants
b Provide periodic reports on a monthly basis, summarizing
Plan expenditures
c Provide necessary data required for regulatory disclosure
information compliance
d Provide claim review, examination, and benefit payments,
in accordance with the Plan Document
e Maintain the Plan checking account, and all the necessary
records for the Plan (if required)
f Communicate the Plan to Denton's employees in accordance
with the Claims Administrator proposal submitted on
November, 1991
g Provide information for form 5500 preparation
h Prepare anti-discrimination report as required by law
2 2 The Claims Administrator is authorized as an agent of the
Plan Administrator to do all things the Plan Administrator
deems necessary to carry out the terms and purposes of this
Agreement, including execution of documents in the name of
the Plan
2 3 The Claims Administrator shall design and provide all
necessary forms for the implementation, administration, and
operation of the Plan
2 4 The Claims Administrator shall maintain a toll-free (800)
business phone number for use by Denton or shall maintain a
business telephone within the Dallas/Fort Worth metro dialing
area, so that Denton may contact Claims Administrator as
needed during the course of the contract without incurring
additional toll charges
2 5 The Claims Administrator shall maintain a claims processing
turnaround time of not more than seven (7) calendar days
2 6 Claims Administrator agrees to reimburse employees and
providers directly for child care and unreimbursed medical
expenses at no additional cost to Denton, should any partici-
pant so request
2 7 Claims Administrator shall agree to conduct group employee
open enrollment meetings on a yearly basis and shall agree to
distribute legible, meaningful and useful communication
materials and enrollment forms to all interested employees
Claims Administrator shall submit legible exemplars of
proposed communication materials and enrollment forms with
the bid
2 8 Claims Administrator must agree to reimburse Denton for up-
front medical expenditures on at least a quarterly basis
Page 2
2 9 Claims Administrator shall agree to provide Denton with a
licensed copy of any software necessary for operation of the
program at no additional cost
2 10 Claims Administrator shall agree to provide all forms and
paperwork necessary for plan administration at no additional
cost to Denton
SECTION III
The City of Denton
3 1 Denton shall assist the Claims Administrator in any reason-
able manner as to provide the services as set forth by the
Plan Such assistance shall include, but not be limited to
the following
a Denton shall provide the Claims Administrator with a
complete list of all employees who are eligible for
benefits of the Plan Thereafter, Denton shall promptly
notify the Claims Administrator of any and all changes in
employment for purpose of determining eligibility for the
Plan Changes in employment shall include termination,
lay off, change in classification, change in dependent
status, or any other change that may affect the eligibil-
ity of any employee of the City of Denton
3 2 Denton shall provide the necessary funds to pay the Plan
expenses Denton shall transfer all funds necessary to the
proper account in order that proper distribution by the
Claims Administrator may be carried out
a Denton shall collect the contributions made by the
participants of the plan, in the manner it may deem
appropriate, and shall transfer the money so collected to
the Plan on a monthly or more frequent basis
b To the extent of its liabilities, Denton hereby agrees to
make all necessary contributions to meet the obligations
incurred by the Plan for its eligible participants and
eligible dependents where applicable The Plan liabili-
ties shall include premiums, claims costs, and adminis-
tration costs as billed by the Claims Administrator
3 3 Denton shall assist in the enrollment of the employees into
the Plan, and shall maintain a supply of forms, enrollment
cards or other documents, as provided by the Claims Adminis-
trator, and shall distribute or make available such documents
to the employees Sufficient quantities of these documents
Page 3
will be provided to Denton by Claims Administrator at no
additional cost to Denton
3 4 Denton hereby agrees to cooperate with the claims Administra-
tor with regard to the proper settlement of claims and Plan
obligations, and transmit any inquiries pertaining to the
Plan to the Claims Administrator
SECTION IV
rocedure for Application and Payment of Benefits from the Plan
4 1 Any eligible participant or participant's eligible depen-
dent(s) may make application for benefits from the Plan by
completing the application form prescribed by the Claims
Administrator The applicant shall fully and truthfully
complete such application for benefits and the applicant
shall supply such pertinent information from personal or
professional sources as may be required by the Claims
Administrator
4 2 The Claims Administrator shall accept any application for
benefits made in the appropriate manner, and shall determine
eligibility of such application in accordance with the Plan
Document If the Claims Administrator determines that the
applicant is entitled to receive payment of benefits from the
Plan, the Claims Administrator shall determine the amount
payable by the Plan, and arrange for the payment of such
amount If the Claims Administrator determines that the
applicant is not eligible for benefits from the Plan or any
portion thereof is denied or reduced, the Claims Administra-
tor shall notify the applicant and Denton as to the reasons
for denial, or reduction of such claim However, the final
determination of eligibility or ineligibility rests in the
sole discretion of the Plan Administrator
The Claims Administrator may compromise or adjust any claim
or application previously denied, or reduced in whole or
part, as the Claims Administrator determines to be in the
best interests of the Plan If the Claims Administrator
adjusts any such claim, he shall provide written notice to
Denton's Personnel Director within 5 working days of such
adjustment The Claims Administrator shall be responsible
for the initial review of all disputed claims Final claim
determination shall rests within the sole discretion of the
Plan Administrator
Page 4
SECTION V
Compliance With ERISA and Indemnification of City
5 1 Denton and the Claims Administrator agree to comply in all
respects, individually and collectively, with the Employee
Retirement Income Security Act of 1975 (ERISA) and amendments
thereto, and with all federal and other regulations pertain-
ing thereto, as they relate to the plan
Claims Administrator agrees to indemnify and hold Denton
harmless from any and all loss, damage and expense, including
court costs and attorney's fees, resulting from and arising
out of claims, demands, or lawsuits brought against the
Claims Administrator for any negligent act or omission in
administering the Plan The Claims Administrator shall not
be liable for any loss resulting from any failure of the Plan
Administrator to perform any of its duties in a timely
manner
Further, the Claims Administrator agrees to indemnify Denton
and hold Denton harmless against any and all loss, damage and
expense resulting from or arising out of dishonest, fraudu-
lent, or criminal acts of the Claims Administrator's officers
or employees, acting alone or in collusion with others
SECTION VI
6 1 The initial set-up fee, for the first year only, will be
$0 25 per month per eligible employee, payable upon comple-
tion of open enrollment In addition, a fee of $0 25 per
month per employee for communication materials shall be paid
upon completion of open enrollment This communication fee
will be based upon the number of employees that are eligible
to participate in the Plan
The Claims Administrator shall be entitled to fees for its
services to the Plan and under this agreement, which shall be
determined by the number of employees enrolled by Denton at
the beginning of each month and the type of services provid-
ed These fees shall be $2 60 per month per participating
employee for insurance premiums only, $3 50 per month per
participating employee for dependent child care only, $3 50
per month per participating employee for unreimbursed medical
expenses only, and $6 10 per month per participating employee
for all three accounts, combined
6 2 The fee agreed upon hereof shall be reviewed with any plan
changes at least on an annual basis by both Denton and the
Page 5
Claims Administrator to determine the adequacy of such fees
The fees provided for herein may be adjusted by written
amendment to the agreement approved by both parties
SECTION VII
Termination of Agreement
7 1 This agreement may be terminated at any time by either party
by providing ninety days written notice to the other party
Upon notification of termination by either party, the Claims
Administrator shall continue to process all claims incurred
up to the date of termination, and shall, not later than
sixty days after the date of termination, prepare and deliver
to Denton a final and complete accounting and report of the
Plan's financial activities
7 2 Should either party fail to perform in accordance with the
provisions of this Agreement, the other party may treat such
failure as a default of this Agreement and give the default-
ing party thirty (30) days' written notice to cure such
default In the event such default is not cured within said
time frame, the party giving such notice may terminate this
Agreement
SECTION VIII
scellaneous Provisions
8 1 In the event of resignation or inability to serve by the
Claims Administrator, Denton may appoint a successor Any
successor, upon appointment, shall succeed to and be invested
with all powers conferred on the Claims Administrator
8 2 If during the operation of the Plan, the federal government,
the state government, or any political subdivision or
instrumentality shall assess any tax against the Plan, and
the Claims Administrator is required to pay such tax, the
Claims Administrator shall immediately notify Denton, and
Denton shall promptly provide the funds necessary to remit
such taxes to the proper authority
8 3 This agreement may be amended by Denton and the Claims
Administrator at any time by mutual written consent of said
parties
8 4 In the event that Denton shall fail to make any required
contributions to the Plan, the Claims Administrator shall
Page 6
have the right to terminate this agreement upon fifteen days
written notice to Denton
8 5 In the event of termination of this agreement resulting from
the default of Denton, as provided above, the Claims Adminis-
trator shall charge, and Denton shall pay to the Claims
Administrator all fees, commitments, and obligations incurred
by the claims Administrator through such date of termination
8 6 The Claims Administrator hereby is designated the agent for
service of legal process on behalf of the Plan at its
principal office
8 7 Claims Administrator agrees that it shall be in compliance
with all laws, statutes, and other governmental provisions
prevailing during the term of this Agreement
8 8 It is agreed that Claims Administrator shall maintain and
make available for inspection, audit and reproduction by an
authorized representative of the City or any other governmen-
tal agency, books, documents, and other evidence pertinent to
the costs and expenses of this contract This includes, to
the extent such detail will properly reflect, all costs,
direct and indirect costs of labor, material, equipment,
supplies, and services and all other costs and expenses of
whatever nature for which reimbursement is claimed under
provisions of this Agreement
SECTION IX
Effective Date and Term
9 1 This agreement shall become effective on January 1, 1992
9 2 This agreement shall be in effect for a period of one (1)
year from the effective date as outlined in Section 9 1
9 3 This agreement may, however, be extended for up to two (2)
additional one year periods, upon written approval from
Denton's City Manager
IN WITNESS WHEREOF, the City of Denton and the Claims Administr o
red this agree nt at this
have ex 'Slut
day of 1
CITY OF DENTON, TEXAS
BY
BOB CASTLEBERRY,
Page 7
ATTEST
JENNIFER WALTERS, CITY
BY W
APPR ED AS O LEGAL FORM
DEBRA A DRAYO_VITCH, CITY ATTORNEY
BY
c
ANTHEM LIFE INSURANCE COMPANY, INC
APPf ,~i U
LEGAL UtPI
1
BY ~ » ` w
TITLE
The Director of Personnel/ Employee Relations for the City of
Denton, Texas is hereby authorized to carry out the terms of this
Agreement on behalf of the City of Denton, Texas
4DYbdv HARRELL
Page 8
CITY OF DENTON EXHIBIT 1
BID SUBMISSION FORM
Carrier/Vendor: Anthem Life Insurance Co , Inc
Addrees: 3988 North Central Expressway, Dallas, TX 75204
Date:
10/28/91
Completed By: Larry Garrett, Associate Director Flexible Benefits & ept
(Name Title)
Phone Number: 1214 841-1013
1 Cost for claims administration for IRS Section 125 Plan
a Insurance Premium Only
b Dependent Child Care only
c Vnreimbursed Medical Expense
d All three accounts
e How long are rates guaranteed?
(if less than three years, please
specify costs for first, second
and third year separately, or
provide details of how fees will
be determined in future years )
f Communication cost
g Initial set-up fee
Cost
2 60@mo /Participant
-0- /Elig Employee**
3 50@mo /Participant
/Elig Employee
3 50@mo /Participant
/Elig Employee
$ -0- /Elig Employee
2 yearn
Guarantee no more than 107 increase
for third year
***One or both FSA same price
**Please see additional sheet for
pricing option
$ 25 @ mo /Elig Employee*
$ .25 @ mo. (if applicable)
2 Are there any other costs? *This assumes group meetings of at
X least 30 employees per meeting
Yee No
If yes, identify and state the amount
3 Do you have a toll-free number (800) and, if sopp what is that number?
(required if long distance call frq~00)i9 0-~539Den~on andl $u~ide
Dallas/Fort Worth metro dialing area) ll a are n a as metro area
4 Assuming that the contract for the City of Denton plan will be effective
January 1, 1992, provide a detailed implementation plan for the transition
on a separate sheet of paper (if necessary) Be specific concerning your
capabilities to provide smooth enrollment
See Attachment
5 Please submit legible exemplars of the following reports:
See Exhibits
a Employees quarterly account statements
b Employer monthly, quarterly and annual
reports or statements
c Employer quarterly up-front reports
-7-
BID NUMBER 1291 BID PROPOSALS
ADDENDUM #2
Page 2 of 2
Addendum #2 replaces all documents previously sent referring to this Bid
Request 11291
Please destroy all documents prior to this package
SPECIAL. NOTE Require for bid and performance bond a have been added
along with other revisions
In submitting the above bid the vendor agrees that acceptance of ny or II bid
reasonable period of time constitutes a contract _
Anthem Life Insurance Co , Inc /
Bidder
10/28/91 As oc ate
Date
the City of Denton Texas within a
Director Flexible Benefits Dept
Tllle
PERFORMANCE BOND
STATE OF TEXAS
COUNTY OF
KNOW ALL MEN BY
County of
as PRINCIPAL, and
, as SURETY, authorized under the
laws of the State of Texas to act as surety on bonds for
principals, are held and firmly bound unto the _
-as OWNER, in the penal sum of
Dollars
) for the payment whereof, the said Principal
and Surety bind themselves and their heirs, administrators,
executors, successors and assigns, jointly and severally, by
these presents
WHEREAS, the Principal has entered into a certain
written contract with the OWNER, dated the day of
19-, for the Administration of
which contract is hereby referred to and made a part hereof
as fully and to the same extent as if copied at length
herein
NOW9 THEREFORE, the condition of this obligation
is such, that if the said principal shall faithfully perform
said Contract and shall in all respects, conditions and
agreements in and by said contract agreed and oovenanted by
the Principal to be observed and performed, and according to
the true intent and meaning of said Contract and the
Specifications hereto annexed, then this obligation shall be
void otherwise to remain in full force and effect,
PROVIDED, HOWEVER, that this bond is executed
pursuant to the provisions of Article 5160 of the of the
Revised Civil Statutes of Texas as amended by acts of the
56th Legislature, Regular Session, 19599 and all liabilities
on this bond shall be determined in accordance with the
provisions of said Article to the same extent as if it were
copied at length herein
PROVIDED FURTHER, that if any legal action be
filed upon this bond, venue shall lie in pgnjtQg County,
State of Texas
PB-1
THESE PRESENTS
of the City of
and State of _
That
Surety, for value received, stipulates and agrees
that no charge, extension of time, alteration or addition to
the terms of the contract, or to the work performed
thereunder, or the specifications, accompanying the same,
shall in anywise affect its obligation on this bond, and it
does hereby waive notice of any such charge, extension of
time, alternation or addition to the terms of the contract,
or to the work to be performed thereunder
IN WITNESS WHEREOF, the said Principal and Surety
have signed and sealed this instrument this _-day of
, 19~
Principal
By
Title
Address
(SEAL)
Surety
Title
Address
(SEAL)
The name and address of the Resident Agent of Surety is
NOTEt Date of Bond must not be prior to date of Contract
PB-2
029.DOC
FIREMAN S FUND IN U NCE COMPANY
TMF AMERICAN INS UR COMPANY
NATIONAL SURETY CORPORATION
FIREMMS FIM ASSOCIATED INDEMNITY CORPORATION
INSURANCE COMPANIES AMERICAN AUTOMOBILE INSURANCE COMPANY
PERFORMANCE BOND
STATE OF TEXAS )
COUNTY OF Dallas >
and No
KNOW ALL MEN BY THESE PRESENTS That Anthem
Dal Insurance of the Cit of Dallas
County of _Dallas and State of
Company
as PRINCIPAL, and The American Insurance----
as SURETY, authorized under-the-laws-ofthe State of Teas to
act as surety on bonds for principals are held and firmly
bound unto the _C1ty_ of Denton as OWNER in
the penal sum of Fifteen Thousand Six Hund_re_d _and_00 Dollars
(x15,600 00----) for the payment whereof, the said Principal
and Surety bind themselves and assigns, jointly and severally,
by these presents
WHEREAS, the Principal has entered into a certain
written contract with the OWNER, dated )he -19th day of
Novem er 1991, for the Administration of
_____________IRS Section 125-Benefits-Plan
-
which contract is hereby referred to and made a part hereof
as fully and to the same extent as if copied at length here-
in
NOW, THEREFORE, the condition of this obligation
is such, that if the said principal shall faithfully perform
said Contract and shall in all respect., conditions and
agreements in and by said contract agreed and covenanted by
the Principal to be observed and performed, and according to
the true intent and meaning of said Contract and the Specifi-
cations hereto annexed, then this obligation shall be void,
otherwise to remain in full force and effect,
PROVIDED, HOWEVER, that this bond is executed
pursuant to the provisions of Article 5160 of the Revised
Civil Statutes of Texas as amended by acts of the 56th
Legislature, Regular Session, 1959, and all liabilities
or this bond shall be deterimined in accordance with the
said provisions of said Article to the same extent as if
it were copied at length herein
360702-1 o-76
(LETTER SIZE)
FIPIM rv VrvD UR NCECOMPANY nd No
THE AM EP NINb Ufl COMPANY
NY
NATIO NAI ..RETV CORPORATION
FIREMAN5FUN0 ASSOCIATE_ IINDEMNITY CO RPORATION
INSURANCE COMPANIES AMERIC n UTOMOBILE INSURANCE COMPANY
2/
PROVIDED FURTHER, that if any legal action bE
filed upon this bond, venue shall lie in Denton County, State of
Texas
Surety
-hat no change, exten
terms of the contract
the specifications
affect its obligation
notice of any such
addition to the terms
performed thereunder
for value received, stipulates and agrEeS
lion of time, alteration or addition to the
or to the work performed thereunder, or
accompanying the same, shall in anywise
on this bond, and it does hereby waive
change, extension of time, alteration or
of the contract, or to the work to be
IN WITNESS WHEREOF, the
have signed and sealed this instrument
December , 1991
Anthem L_ife _Insurance_Comuany--__-
Principal
Title Sr Vice President
A_o_dress 3988 N Central Expwy
Dallas,-TX--75266
said Principal and Surety
this --27th day of
The-American-Insurance-Company
Surety
B KiL Ir-l~ ~ c
osi B Pritchard-
_T L Attorney-in Fact
Address 312 Walnat of
_ Cincinnati_,_ Ohio 1520=
Tine name and address of the Resident Agent of the Surety is
Milton E _ Cordell
P-O-- Box_ 6597-___ Fort-Worth,-Texas--76-115-0597
]60702-10-76
JLCTTER SIZC)
GENERAL
PWER
ATTORP EY THE AMERICAN INSURANCE COMPANY
KNOW ALL MEN BY THESE PRESENTS: That THE AMERICAN INSURANCE COMPANY a Corporation incorporated under the laws of the State of
New Jersey on February, 20 1846 and redomesticated to the State of Nebraska on June 1 1990 and having its principal office in the City of Omaha State of
Nebraska has made constituted and appointed and does by these presents make constitute and appoint LEE E HANNA, PATRI CIA L
LIND, JOSIAH B PRITCHARD, SHARA L WALLACE and CHRIS C. CABOT, jointly or severally
CINCINNATI, OH
fistmeandlawfulAttomay(s)-inFaa,with fWBpowerandauthority harebywaferredInits name plaoeandsteed toexecute,sesl acknowledgeand deliver any
and all bonds undertaktug recoguirances or other written obligations in the nature thereof
and to bind the Corporation thereby es fully and to the awe extent as U such bonds were signed by the President, sealed with the corporate seal of the
Corporation and duly attested by its Secretary, hereby ratifying and confirming all their the said Ancroey(a)ia-Fact maydo In the premises
This power of attorney is granted pursuant to Article VII Sections 45 and 46 of By laws of THE AMERICAN INSURANCE COMPANY now, an full force and
effect ,
"Ardek VH Appoistm tasdAusboftofReddmtSwmMla,AMmueys/ot =WAgmtstoaaeWL*dPmwm8adMO"Appwraaoaa.
Seetlos 43 Appointment The Chairman of she Bend of Directors, the President, any VlcaPrepdml or aq other parson authorized by the Board of
Directors, the f hdrntas of the Board of DIreelon, the President or oaf VkaoPreddmt stay, from time to time, appoint Reddael Assistant Secretaries and
Attoroeyo4m Fact to nlpresent and ad for sod on bd uff of the Corporation mad Agents to accept legal Process and make appume for goal on bebr+lf of the
Corporations
Section 46 Asfaodgc The authority of such Redeem Aadpast 3eadmrlm, Anorasynlo-Fad and Age cis id all be as prssesibed In the huhmu mt evidencing
dedrappolstment.Anymchappointment send Wauthority granted thereby may berevokedatasythasbytheRood ofDlredonorbysa persosempowered to
make soeb mppotatmeaW
Th4 ppoowwera of attorney L signed and yelled under and by the authority of the following Resolution adopted by the Board of Directors of THE AMERICAN
INSEJRANCB COMPANY at a meeting dulycalled and held on the 31si day of July 1984 and mid Resolution has not been amended or repealed
"RESOLVED that t e4 deOaturo of any Vice•PraWmt Assistant Secretary and Resident Assistant Secretary of this Corporation and the seal of this
Corporadonmaybe affixed or printed on any power of attorney onanyravocationofanypowerofattortry,oronanycertificate reiatiugthereto byfaaimile
and any power of attorney any revocation of any power of attorney, or ardfloate bearing such facsimile sigsaturc or facsimile real shall be valid and binding
upon the corporation"
IN WITNESS WHEREOF THE AMERICAN INSURANCE COMPANY has caused these presents to be signed by its Vice-President. and its corporate seal to
beheroun[onfaxedWte 4th dayof January 19 91
THE AMERICAN INSURANCE COMPANY
STATE OF CALIFORNIA m
COUNTY OF MARIN
On this4th day of January 1991 before personally came R D Farnsworth
of f THE AMERICAN INSURANCE COMPANY the Corporation
to me known who ban by ma duly sworn did depose and my- that he Is Vioo-Presidem
described in and which executed the above instrument this he knows the sal of said Corporation that the sal affixed to the said instrument is such corporate
sal that it was to affixed by order of the Board of Directors of said Corporation and then he signed his name thereto by like order
IN WITNESS WHEREOF, I have hereunto sal my hand and affixed my official seal the day and year badn first above written
OFFICIAL SBAL
J M VAN--- Cr// N,,,n.eve
NOTARY PUBLIC CALIFORNIA
Principal Office in Merin County
My commlulon Exeuaa Aug. 28 1992 C CERTIFICATE
enrststs rrntsrrnt„tlrrllUlllirsrlt111111111♦~
STATE OF CALIFORNIA
IFORNCOUNTY OF MARIN ss
Labaundersigned Resident Assistant Secretary of THE AMERICAN INSURANCE COMPANY a NEBRASKA Corporation DO HEREBY CERTIFY that
the foregoing andattached POWEROFATTORNEYremains in full force andhas not been revoked and furthermore that Article Vll Sections45and46ofthe
By laws of flu ..cr i rritdos and the Resolution of the Board of Directors, ad forth in thT Power of Attorney are now in fora
SIARCd n.+d sealed err +b• County of Mann Dated the L+~ ~ day of + 19
,
~ R"Mtnl A,u,+",+SmeuY
360712 fA 6 R 1RLt )