Additional information

BOND NO.:__________
NOTARY PUBLIC BOND

HAWAII
KNOW ALL BY THESE PRESENTS:

___________________________________________, of ____________________________________,
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___________ and County of _________, as Principal, and ________________________________________________, of
______________________________________ a corporation duly organized and incorporated, under the laws of the
State of Connecticut and duly authorized to transact a general surety business in the State of Hawaii, as Surety, are held

and firmly bound unto the STATE OF HAWAII, in the sum of _______________________________________
(_____________), in lawful money of the United States of America, for which payment, well and truly to be made, we
hereby bind ourselves and our respective heirs, executors, administrators, assigns, legal representatives and successors,
jointly and severally.
THE CONDITION OF THIS BOND is that if the above named Principal who has been duly appointed a notary
public for the State of Hawaii for the four year term commencing on _______________, and ending on ___________,
shall well, truly, and faithfully perform all the duties of his/her office which are now or may hereafter be required,
prescribed, or defined by law or by any rule or regulation made under the expressed or implied authority of any statute,
and all duties and acts undertaken, assumed or performed by him/her by virtue or color of his/her office, then this
obligation shall be void; otherwise it shall be and remain in full force and effect and may be enforced in any manner or by
any proceeding authorized by law.

AND IT IS HEREBY STIPULATED AND AGREED that this bond shall inure to the benefit of any and all
persons injured by the official misconduct, neglect, or breach of any of the conditions of this bond by the above named
principal, so as to give any and all such persons a right of action on this bond as and in the manner provided by Section
456-6, Hawaii Revised Statutes, as amended.

IN WITNESS WHEREOF, the principal has affixed his/her hand and the surety has caused these presents to be
executed and its official seal attached by its duly authorized Attorney-in-Fact, at ______________________, City of

_____________, County Of ______________ ,State Of___________, on ___________________.

Principa

[SURETY’ SEAL Surety

By
, Attorney-In-Fact

APPROVED:

Judge of the Circuit Court of the
Judicial Circuit, State of Hawaii
S-5550 (7/15)
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PRINCIPAL’S ACKNOWLEDGEMENT:

STATE OF HAWAII )
) s s :
CITY OF ________________________ )
COUNTY OF ____________________

On this ________ day of ___________, ____________, before me personally appeared _______________________________ to
me known to be the person described in and who executed the foregoing instrument, as principal, and acknowledged that ___he
executed the same as h______ free act and deed.

( N o t a r y S e a l )
No Pub
Printed Name
State of Hawaii

My Commission Expires:
NOTARY CERTIFICATE
DOCUMENT DATE: NUMBER OF PAGES:
Notary Seal
DOCUMENT DESCRIPTION: NOTARY PUBLIC BOND
BOND NO.
NAME: , JUDICIAL CIRCUIT

NOTARY SIGNATURE DATE
SURETY ACKNOWLEDGEMENT: Preview

STATE OF HAWAII )
) s s :
CITY OF _______________________ )
COUNTY OF ___________________ )

On this _______ day of ___________________, _______, before me personally appeared ______________________________
to me personally known, who being by me duly sworn, did say that __he is the Attorney-in-Fact of
________________________________________________________, the surety on the foregoing bond; that __he was duly
appointed as Attorney-in-Fact under a Power of Attorney dated ______________, which Power of Attorney is in full force and
effect; that the seal affixed to the foregoing bond is the corporate seal of said surety; and that the foregoing bond was signed and
sealed in the name and on behalf of the said surety by h___ as its Attorney-in-Fact; and that __he acknowledged said bond to be
the free act and deed of said surety.

( N o t a r y S e a l )
No Pub
Printed Name:
State of Hawaii
My Commission Expires:

NOTARY CERTIFICATE

DOCUMENT DATE:__ NUMBER OF PAGES:
Notary Seal
DOCUMENT DESCRIPTION: NOTARY PUBLIC BOND
BOND NO.
NAME: , JUDICIAL CIRCUIT

NOTARY SIGNATURE DATE
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Travelers Casualty and Surety Company of America

One Tower Square, Hartford, Connecticut 06183

NOTARY PUBLIC ERRORS AND OMISSIONS POLICY
Policy No ____________
Term Premium: ____________
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Policy Effective Date ____________

TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA (the “Company”) will pay on behalf of
______________________________________________ of ________________________________________________________
(the “Insured”), all sums which the Insured shall become obligated to pay by reason of liability for breach of duty while acting as a duly
commissioned and sworn Notary Public, claim for which is made against the Insured by reason of any negligent act, error or omission, committed or
alleged to have been committed by the Insured, arising out of the performance of notarial service for others in the Insured’s capacity as a duly
commissioned and sworn Notary Public.

POLICY PERIOD: This policy applies only to negligent acts, errors or omissions which occur during the Policy Period and then only if
claim, suit or other action arising therefrom is commenced within the applicable Statute of Limitations pertaining to the Insured. The Policy Period
commences on the Effective Date hereof and terminates upon the expiration of the Insured’s commission as a Notary Public unless cancelled earlier
as provided in this policy. This policy is not valid for more than one commission term.

LIMIT OF LIABILITY: The liability of the Company shall not exceed in the aggregate for all claims under this insurance the amount of:
_________________________________________________________________________________________ DOLLARS (________________).
In addition to the limit of liability and in accordance with the other provisions of this policy, the Company will pay costs and expenses paid and
incurred in investigating, contesting or settling liability in an amount not to exceed, in the aggregate, one-half of the limit of this policy.

INSURED’S DUTIES IN THE EVENT OF OCCURRENCE, CLAIM OR SUIT:
(a) Upon knowledge of any occurrence which may reasonably be expected to result in a claim or suit, written notice containing
particulars sufficient to identify the Insured and also reasonably obtainable information with respect to the time, place and circumstances thereof, and
the names and addresses of the potential claimant and of available witnesses, shall be given by or for the Insured to the Company or any of its
authorized agents as soon as practicable, but in no event longer than forty-five (45) days after discovery.
(b) If claim is made or suit is brought against the Insured, the Insured shall immediately forward to the Company every demand,
notice, summons or other process received by him or his representative.
(c) The Insured shall cooperate with the Company and, upon the Company’s request, assist in making settlements, in the conduct of
suits and the Insured shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The
Insured shall not, except at his own cost, voluntarily make any payment, assume any obligation or incur any expense except with the prior written
consent of the Company.

EXCLUSIONS: Coverage under this policy does not apply to any dishonest, fraudulent, criminal or malicious act or omission of the
Insured.

OTHER INSURANCE: If the Insured has other insurance against a loss covered by this policy, the Company shall not be liable under this
policy for a greater proportion of such loss, cost and expenses than the limit of liability stated in this policy bears to the total limit of liability of all
valid and collectible insurance against such loss.

CANCELLATION: The insured may cancel this policy at any time by mailing or delivering to us advance written notice of cancellation.
The company may cancel this policy by mailing or delivering to the insured written notice of cancellation at least 10 days before the effective date of
cancellation if we cancel for nonpayment of premium or 30 days before the effective date of cancellation if we cancel for any other reason. If we
cancel, the premium refund will be pro rata and if the insured cancels, the refund may be less than pro rata. The cancellation will be effective even if
we have not made or offered a refund.

IN WITNESS WHEREOF, the Company has caused this Policy to be signed by its authorized Company officers at Hartford, CT.

____________________________________________ ___________________________________________
President Corporate Secretary

EO1001 (03-04)
—————————————————–

ISSUED BY: POLICY NO:
ISSUED TO:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CANCELLATION/NONRENEWAL – HAWAII
FULL CANCELLATION – INSURER

It is agreed that:

1. The policy provisions regarding cancellation by the Company are deleted and replaced with the following:

A. The Company may cancel only for one or more of the following reasons by mailing written notice of cancellation to the
entity named in Item 1 of the Declarations at least 30 days before the effective date of cancellation:

(1) Nonpayment of premium;
(2) Fraud or material misrepresentation;
(3) Substantial increase in the risk and the insurer could not have reasonably foreseen the change when entering into the
contract;
(4) Substantial breaches of contractual duties, conditions or warranties;
(5) Violation of any local fire, health, or safety statute or ordinance;
(6) Conviction of a crime having as one of its necessary elements, an act increasing any hazard that is insured against;
(7) The insurance commissioner determines that the continuation of the policy places the insurer in violation of chapter 431,
Hawaii Revised Statutes;
(8) For any good faith reason with the approval of the insurance commissioner; or
(9) Loss history, medical condition or any other reason that is not otherwise prohibited.

2. The following is added to the policy and supersedes any provision to the contrary:

NONRENEWAL Preview
If the Company decides not to renew this policy, the Company will mail written notice of nonrenewal to the entity named in Item
1 of the Declarations at least 45 days before the expiration date or anniversary date if it is written for a term longer than one year
or with no fixed expiration date.

3. Proof of mailing shall be sufficient proof of notice.

Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the
above mentioned policy, except as expressly stated herein. This endorsement is effective at the inception date stated in the
Declarations and this endorsement is part of such policy and incorporated therein.

—————————————————–

ISSUED BY: POLICY NO:
ISSUED TO:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CANCELLATION/NONRENEWAL – HAWAII
CANCELLATION FOR NONPAYMENT OF PREMIUM

It is agreed that:

1. The policy provisions regarding cancellation by the Company are deleted and replaced with the following:

A. We may cancel this Policy for nonpayment of premium by mailing or delivering to the entity named in Item 1 of the
Declarations written notice of cancellation at least 30 days before the effective date of cancellation.

2. The following is added to the policy and supersedes any provision to the contrary:

NONRENEWAL
If the Company decides not to renew this policy, the Company will mail written notice of nonrenewal to the entity named in Item
1 of the Declarations at least 45 days before the expiration date or anniversary date if it is written for a term longer than one year
or with no fixed expiration date.

3. Proof of mailing shall be sufficient proof of notice.

Nothing herein contained shall be held to vary, alter, waive or extend any of the terms, conditions, exclusions or limitations of the
above mentioned policy, except as expressly stated herein. This endorsement is effective at the inception date stated in the
Declarations and this endorsement is part of such policy and incorporated therein.
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ILT-5023 (06-04)