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

403.00

.00

403.00

SGE 020 (06-16) © 2016 CapSpecialty, Inc. All rights reserved. Page 1 of 1

Capitol Indemnity CorporationMailing Address:P.O. Box 5900, Madison, WI 53705-0900

IMPORTANT NOTICE - TEXAS

To obtain information or make a complaint:

You may contact your company representative at 1-800-475-4450

You may call Capitol Indemnity Corporation toll-free telephone number for information or to make a complaint at:

1-800-475-4450

You may also write to Capitol Indemnity Corporation at:

Capitol Indemnity Corporation1600 Aspen CommonsMiddleton, Wisconsin 53562

You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at:

1-800-252-3439

You may write the Texas Department of Insurance at:

P.O. Box 149104Austin, TX 78714-9104

FAX # (512) 490-1007

Web: http://www.tdi.texas.gov

E-mail: ConsumerProtection@tdi.texas.gov

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.

Certificate of Title Surety Bond

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

Ryan J. Byrnes Senior Vice President,

Chief Financial Officer and Treasurer

Suzanne M. Broadbent Assistant Secretary

A190071286

A190071286

Daniel McGinnis

26,850.00 Luis Carlos Solis Chavez

18th October 21