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<br />1. This page is to be completed by a notary public for both the Principal and the Surety. <br />2. Please attach the Power of Attorney and Certified Copy of the Corporate Resolution for the Surety listed herein. <br /> <br />STATE OF <br />COUNTY OF <br /> <br />) <br />) ss. <br /> <br />(SOLE PROPRIETORSHIP) <br />The foregoing instrument was acknowledged before me this <br />by <br /> <br />(Name of person acknowledged) <br /> <br />NOTARY SEAL <br /> <br />ACKNOWLEDGMENT OF PRlNCIP AL <br /> <br />day of <br /> <br />Notary Public <br /> <br />********-*************************************************** <br /> <br />(P ARTNERSlllPlLIMITED LIABILITY COMPANY) <br />The foregoing instrument was acknowledged before me this <br />by <br /> <br />(Name of acknowledging partner) <br /> <br />day of <br />, a partner on behalf of <br /> <br />, a partnership. <br /> <br />(Name ofpartnershipllimited liability company) <br /> <br />NOTARY SEAL <br /> <br />Notary Public <br /> <br />***************************** ********************************* <br /> <br />I Vfc -ArrJo. <br />d- day of <br />, President or' . bJ. <br />;lAivt 0-eA &ttX <br />(Sffire~j~~ <br /> <br />Notary Public <br /> <br />(CORPORATION) <br />The foregoing instrument \@..-ackn~ged before me this <br />by 6~~9f I _ r-rMvJ1u <br />10) JJ- (Name of co!]'orate preSIdent) <br />CL U.Lf,~--e ~ vVt~ I In. C , a <br />(Name of corporation acknowledging) <br />behalf of the corporation. <br /> <br />NOTARY SE <br /> <br /> <br />.~ NICI-1?~AS ~~.~~EVVTO~1 <br />~"~-' -; ~ .: ! '~~::~fl_ ~~:j' <br /> <br />~ '~"y/ My Corr.miSSlGil Expl;esJan 31 L.~05 <br /> <br />'2-P-(Y.-"J <br />f::()~ .:y , <br /> <br />corporation, on <br /> <br />~~Efk <br /> <br />************************************************************ <br /> <br />STATE OF MINNESOTA <br />COUNTY OF HENNEPIN <br /> <br />) <br />) SS. <br /> <br />The foregoing instrument was acknowledged before me this 11 th <br />by Nicholas L. Newton, attorney in fact <br />(Name and title of officer or agent) <br />of North American Specialty Insurance Company <br /> <br />(Name of corporation acknowledging) <br />a New Hampshire corporation, on behalf of the corporation. <br />(state of incorporation) <br /> <br />NOTARJ;;::==;~~ <br /> <br />"~'i1:J MY COMMISSiON EXPIRES 1.31.2005 t <br />..2 <br />III <br /> <br />ACKNOWLEDGMENT OF SURETY <br /> <br />day of April <br /> <br />2002 <br /> <br /> <br />Notary Public <br /> <br />MN/DOC CE BOND 7/199 <br />