Additional information

BOND NO:

NOTARY PUBLIC BOND

STATE OF TENNESSEE

COUNTY OF

KNOW ALL MEN BY THESE PRESENTS:

That we, __________________________________________________________________________________of ________________________________,

______________________________ County, in the State of Tennessee, as Principal, and _________________________________________________,
a corporation duly licensed to do business in the State of Tennessee, as Surety, are held and firmly bound unto the said State of Tennessee in the sum
of Ten Thousand Dollars ($10,000.00) to be paid to the said State, to which payment, well and truly to be made, we bind ourselves and our legal
representatives, jointly and severally by these presents.

Whereas, the above bounded Principal was elected a Notary Public for the said County of _____________________________, for the four year term
beginning on ________________________.

NOW, THEREFORE, THE CONDITION OF THE ABOVE OBLIGATION IS SUCH, That if the Principal shall faithfully, honestly, and diligently
discharge the duties of the said office so long as his/her continuance therein, then this obligation to be null and void, otherwise to remain in full force
and effect.

This Bond shall be effective as of the ________ day of _________________________, _______________, and shall end when the Principal’s
commission as Notary Public ends.

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(Principal)

Signature of Principal

(Surety)

By

APPROVED and FILED the _______________ day of __________________________________________, ______________.

County Judge

STATE OF TENNESSEE
COUNTY OF ___________________ Oath of Office

I , ___________________________________________________ do solemnly swear that I will support the Constitution of the United States
and the State of Tennessee, and that I will, without favor or partiality–faithfully, honestly, and diligently discharge the duties of Notary Public.

Principal

Subscribed and sworn to before me this __________ day of ___________________________, __________________.

County Clerk

Deputy County Clerk
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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)
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ISSUED BY: POLICY NO:
ISSUED TO:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CANCELLATION/NONRENEWAL – TENNESSEE
FULL CANCELLATION – INSURER

It is agreed that:

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

A. CANCELLATION OF POLICIES IN EFFECT FOR 60 DAYS OR LESS
(a) If this Policy has been in effect for 60 days or less and is not a renewal of a policy we issued, we may cancel this
Policy for any valid underwriting reason by mailing or delivering to the entity named in Item 1 of the Declarations
written notice of cancellation at least 10 days before the effective date of cancellation.

B. CANCELLATION OF POLICIES IN EFFECT FOR MORE THAN 60 DAYS
If this Policy has been in effect for more than 60 days, or is a renewal of a Policy we issued, we may cancel only for one
or more of the following reasons:
(a) Nonpayment of premium;
(b) Misrepresentation or fraud;
(c) Violation of policy conditions;
(d) Conviction of the insured of a crime that increases the hazard insured against;
(e) Failure to comply with written loss control recommendations;
(f) Material change in the risk which increases the risk of loss;
(g) Determination by the commissioner that continuation of a policy would jeopardize a company’s solvency or place it
in violation of the law; or
(h) Such other reasons approved by the commissioner.
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We will mail or deliver written notice of cancellation under this item B., to the entity named in Item 1 of the
Declarations at least 10 days before the effective date of cancellation.

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

NONRENEWAL
A. If we decide not to renew this Policy, we will mail or deliver written notice of nonrenewal to the entity named in Item 1 of
the Declarations, with a copy to the agent or broker of record, at least 60 days before its expiration date, or its anniversary
date if it is a Policy written for a term of more than one year or with no fixed expiration date.

3. Proof of mailing is 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.

ILT-5086 (06-04)
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ISSUED BY: POLICY NO:
ISSUED TO:

THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY.

CANCELLATION/NONRENEWAL – TENNESSEE
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 10 days before the effective date of cancellation.

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

NONRENEWAL
A. If we decide not to renew this Policy, we will mail or deliver written notice of nonrenewal to the entity named in Item 1 of
the Declarations, with a copy to the agent or broker of record, at least 60 days before its expiration date, or its anniversary
date if it is a Policy written for a term of more than one year or with no fixed expiration date.

3. Proof of mailing is 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-5087 (06-04)