HomeMy WebLinkAboutContracts & Agreements_81-1998_CCv0001.pdf SETTLEMENT AGREEMENT AND RELEASE
This Settlement Agreement and Release (the "Settlement Agreement") is made
and entered into this 4th day of December, 1998 by and between:
"Claimants" Dorothy Holden, Kimberly Holden, Jerry Holden and Jeffrey B.
Holden
"Defendant" City of Redlands
"Insurer" Insurance Company of the State of Pennsylvania
Recitals
A. On or about July 20, 1993, an accident occurred on San Timeteo Canyon
Road in the City of Redlands, California. Jerry Holden, husband of Dorothy
Holden and father of Kimberly Holden, Jerry Holden and Jeffrey B. Holden, died
as a result of that accident, and Kimberly Holden was injured. Claimants allege
that the accident and resulting physical and personal injuries arose out of a
dangerous condition of public property and they made a claim seeking monetary
damages on account of that accident, and thus Claimants filed a complaint against
Defendant in the San Bernardino County Superior Court, Case No. SCV 11484.
B. Insurer is the liability insurer of the Defendant, and as such, would
be obligated to pay any claim made or judgment obtained against Defendant which
is covered by its policy with Defendant.
C. The parties desire to enter into this Settlement Agreement in order
to provide for certain payments in full settlement and discharge of all claims
which have, or might be made, by reason of the incident described in Recital A
above, upon the terms and conditions set forth below.
Agreement
The parties agree as follows:
1.0 Release and Discharge
1.1 In consideration of the payments set forth in Section 2, Claimants
hereby completely release and forever discharge Defendant, City of Redlands and
Bruggeman, Smith & Peckham, LLP and Insurer from any and all past, present or
future claims, demands, obligations, actions, causes of action, wrongful death
claims, rights, damages, costs, losses of services, expenses and compensation of
any nature whatsoever, whether based on a tort' contract or other theory of
recovery, which the Claimants have, or which may hereafter accrue or otherwise
be acquired, on account of, or may in any way grow out of, the incident described
in Recital A above, including, without limitation, any and all known or unknown
claims for bodily and personal injuries to Claimants, or any future wrongful
death claim to Claimants' representatives or heirs, which have resulted or may
result from the condition of property of Defendant or the alleged acts or
omissions of the Defendant, City of Redlands.
1.2 This release and discharge shall also apply to the past, present
and future officers, directors, stockholders, attorneys, agents, servants,
representatives, employees, subsidiaries, affiliates, partners, predecessors and
successors in interest, and assigns of the City of Redlands and Bruggeman, Smith
& Peckham, LLP and the release and discharge shall also apply to all other
persons, firms or corporations with whom any of the former have been, are now,
or may hereafter be affiliated.
AMMAN
1.3 This release, on the part of the Claimants, shall be a fully
binding and complete settlement among the Claimants and the Defendant, city of
Redlands, Bruggeman, Smith & Peckham, LLP and the Insurer, and their heirs,
assigns and successors.
1.4 The Claimants acknowledge and agree that the release and discharge
set forth above is a general release. Claimants expressly waive and assume the
risk of any and all claims for damages which exist as of this date, but of which
the Claimants do not know or suspect to exist, whether through ignorance,
oversight, error, negligence, or otherwise, and which, if known, would materially
affect Claimants' decision to enter into this Settlement Agreement. The
Claimants further agree that Claimants have accepted payment of the sums
specified herein as a complete compromise of matters involving disputed issues
of law and fact. Claimants assume the risk that the facts or law may be other
than Claimants believe. It is understood and agreed to by the parties that this
settlement is a compromise of a doubtful and disputed claim, and the payments are
not to be construed as an admission of liability on the part of the Defendant
by whom liability is expressly denied.
2.0 Payments
In consideration of the release set forth above, the Insurer on behalf of
the Defendant agrees to pay to the individuals named below (the "Payees") the
sums outlined in this Section 2 below:
2.1 Payments due at the time of settlement as follows:
A. Cash at settlement in the amount of $195,037.00 payable to
Dorothy Holden, Kimberly Holden, Jerry Holden and Jeffrey B. Holden and to their
attorney, William D. Shapiro.
2.2 Periodic payments to Dorothy Holden and to William D. Shapiro made
according to the schedule as follows (the "Periodic Payments") :
A. $1,690.87 payable to Dorothy Holden, on the first of each
month, guaranteed 20 years, beginning February 1, 1999 and ending January 1,
2019; and
B. $2,600.00 payable to William D. Shapiro on the tenth of each
month, guaranteed 20 years, beginning January 10, 2003 and ending December 10,
2022.
All sums set forth herein constitute damages on account of personal
injuries or sickness, within the meaning of Section 104(a) (2) of the Internal
Revenue Code of 1986, as amended.
3.0 Claimants' Rights to Payments
Claimant, Dorothy Holden, and her attorney, William D. Shapiro, acknowledge
that the Periodic Payments cannot be accelerated, deferred, increased or
decreased by the Claimant or her attorney or any Payee; nor shall the Claimant,
Dorothy Holden, nor her attorney, William D. Shapiro, or any Payee have the power
to sell, mortgage, encumber, or anticipate the Periodic Payments, or any part
thereof, by assignment or otherwise.
4.0 Claimants' Beneficiaries
4.1 Any payments to be made after the death of Payee, Dorothy Holden,
pursuant to the terms of this Settlement Agreement shall be made to the estate
of the Payee, Dorothy Holden, otherwise as shall be designated in writing by
Claimant, Dorothy Holden, to the Insurer or the Insurer's Assignee. If no person
or entity is so designated by Claimant, Dorothy Holden, or if the person
designated is not living at the time of the death of Payee, Dorothy Holden, such
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payments shall be made to her estate. No such designation, nor any revocation
thereof, shall be effective unless it is in writing and delivered to the Insurer
or the Insurer's Assignee. The designation must be in a form acceptable to the
Insurer or the Insurer's Assignee before such payments are made.
4.2 Any payment to be made after the death of Payee, William D.
Shapiro, pursuant to the terms of this Settlement Agreement shall be made to the
estate of the Payee, William D. Shapiro, otherwise as shall be designated in
writing by Payee, William D. Shapiro, to the Insurer or the Insurer's Assignee.
If no person or entity is so designated by Payee, William D. Shapiro, or if the
person designated is not living at the time of the death of Payee, William D.
Shapiro, such payments shall be made to his estate. No such designation, nor any
revocation thereof, shall be effective unless it is in writing and delivered to
the Insurer or the Insurer's Assignee. The designation must be in a form
acceptable to the Insurer or the Insurer's Assignee before such payments are
made.
5.0 Consent to Qualified Assignment
5.1 Claimants and their attorney, William D. Shapiro, acknowledge and
agree that the Defendant and/or the Insurer may make a "qualified assignment",
within the meaning of Section 134{c} of the Internal Revenue Code of 1986, as
amended, of the Defendant's liability to make the Periodic Payments set forth in
Section 2.2 to Aegon Assignment Corporation. The Assignee's obligation for
payment of the Periodic Payments shall be no greater than that of Defendant
and/or the Insurer (whether by judgment or agreement) immediately preceding the
assignment of the Periodic Payments obligation.
5.2 Any such assignment, if made, shall be accepted by the Claimants
and their attorney, William D. Shapiro, without right of rejection and shall
completely release and discharge the Defendant and the Insurer from the Periodic
Payments obligation assigned to the Assignee. The Claimants and their attorney,
William D. Shapiro, recognize that, in the event of such an assignment, the
Assignee shall be the sole obligor with respect to the Periodic Payments
obligation, and that all other releases with respect to the Periodic Payments
obligation that pertain to the liability of the Defendant and the Insurer shall
thereupon become final, irrevocable and absolute.
6.1 Right to Purchase an Annuity
The Defendant and/or the Insurer, itself or through its Assignee reserves
the right to fund the liability to make the Periodic Payments through the
purchase of an annuity policy from Monumental Life Insurance Company. The
Defendant, the Insurer, or the Assignee shall be the sole owner of the annuity
policy and shall have all rights of ownership. The Defendant, the Insurer, or
the Assignee may have Monumental Life Insurance Company mail payments directly
to the Payees. The Payees shall be responsible for maintaining a current mailing
address for Pavees .,i t'. the "Assignee"; M--):umenta' �l'_`e Inzurance Company.
7.0 Discharge of obligation
The obligation of the Defendant, the Insurer, and/or Assignee to make each
Periodic Payment shall be discharged upon the mailing of a valid check in the
amount of such payment to the designated addresses of the Payees named in Section
2 of this Settlement Agreement.
8.0 Representation of Comprehension of Document
In entering into this Settlement Agreement, the Claimants represent that
Claimants have relied upon the advice of their attorney, who is the attorney of
their own choice, concerning the legal and income tax consequences of this
Settlement Agreement; that the terms of this Settlement Agreement have been
completely read and explained to Claimants by their attorney; and that the terms
3
of this Settlement Agreement are fully understood and voluntarily accepted by
Claimants.
9.0 Warranty of Capacity to Execute Agreement
Claimants represent and warrant that no other person or entity has, or has
had, any interest in the claims, demands, obligations or causes of action
referred to in this Settlement Agreement, except as otherwise set forth herein;
that Claimants have the sole right and exclusive authority to execute this
Settlement Agreement and receive the sums specified in it; and that Claimants
have not sold, assigned, transferred, conveyed or otherwise disposed of any of
the claims, demands, obligations or causes of action referred to in this
Settlement Agreement.
10.0 Governing Law
This Settlement Agreement shall be construed and interpreted in accordance
with the laws of the State of California.
For your protection, California law requires the following to appear on
this form;
"(a) It is unlawful to:
(1) Knowingly present or cause to be presented
any false or fraudulent claim for the payment of a
loss under a contract of insurance.
(2) Knowingly present multiple claims for the
same loss or injury, including presentation of
multiple claims to more than one insurer, with an
intent to defraud.
(3) Knowingly cause or participate in a vehicular
collision, or any other vehicular accident, for the
purpose of presenting any false or fraudulent
claim.
(4) Knowingly prepare, make, or subscribe any
writing, with intent to present or use the same, or
to allow it to be presented in support of any such
claim.
(b) Every person who violates any provision of
this section is punishable in the state prison, for
two, three, or five years, or by fine not exceeding
Twenty-Five Thousand Dollars ($25,000) , or by
both. "
11.0 Additional Documents
All parties agree to cooperate fully and to execute any and all
supplementary documents and to take all additional actions which may be necessary
or appropriate to give full force and effect to the basic terms and intent of
this Settlement Agreement, including execution of the Stipulation of Abandonment
of Appeal and Satisfaction of Judgment.
12.0 Entire Agreement and Successors in Interest
This Settlement Agreement contains the entire agreement between the
Claimants, Defendant, and the Insurer with regard to the matters set forth in it
and shall be binding upon and enure to the benefit of the executors,
administrators, personal representatives, heirs, successors and assigns of each.
4
13.0 Effectiveness
This Settlement Agreement shall become effective immediately following
execution by each of the parties.
CLAIMANTS
Date:-,IC)-
DOROTHY HO N
Date:
KIMBERLY HOL
BateJ
JER HOLD N
Date:
4-EFFREY B. HOLDEN
LAW FFICES OF WILLIAM D. SHAPIRO
17 !Pk
Date: B
WILLIAM D. Sff"IR0
Attorneys for Claimants
CITY OF REDLANDS
Date: C*;L0 By:
DANIEL M01UGH10
BRUGGEMAN, SMITH & PECKHAM, LLP
Date: By:
&�j74,6,-,
--�—RRA .
F. DOLEN
Attorneys for Defendant
CITY OF REDLANDS
AIG TECHNICAL SERVICES, INC.
x�
Date:
By:
SA)IFORD OSTER, Claims Analyst
Date:
Insurance Company of the State of
PennsylVa-hia
By:
Nationai--6f�r
Susan-Gen aur,
UNIFORM QUALIFIED ASSIGNMENT AND RELEASE
"Claimant" Dorothy Holden
"Assignor" City of Redlands and Insurance Company of the State of
Pennsylvania
"Assignee" Aegon Assignment Corporation
"Annuity Issue" Monumental Life Insurance Company
"Effective Date"
This Agreement is made and entered into by and between the parties hereto
as of the Effective Date with reference to the following facts:
_ �}A. laim as executed a settlement agreement or release dated
(the "Settlement Agreement") that provides for the
Assignor to make certain periodic payments to or for the benefit of the Claimant
as stated in Addendum No. 1 (the "Periodic Payments") ; and
H. The parties desire to effect a "qualified assignment" within the
meaning and subject to the conditions of Section 130(e) of the Internal Revenue
Code of 1986 (the "Code") .
NOW, THEREFORE, in consideration of the foregoing and other good and
valuable consideration, the parties agree as follows:
1. The Assignor hereby assigns and the Assignee hereby assumes all of
the Assignor's liability to make the Periodic Payments. The Assignee assumes no
liability to make any payment not specified in Addendum No. 1.
2. The Periodic Payments constitute damages on account of personal
injury or sickness in a case involving physical injury or physical sickness
within the meaning of Sections 104(x) (2) and 130(c) of the Code.
3. The Assignee's liability to make the Periodic Payments is no greater
than that of the Assignor immediately preceding this Agreement. Assignee is not
required to set aside specific assets to secure the Periodic Payments. The
Claimant has no rights against the Assignee greater than a general creditor.
None of the Periodic Payments may be accelerated, deferred, increased or
decreased and may not be anticipated, sold, assigned or encumbered.
4. The obligation assumed by Assignee with respect to any required
payment shall be discharged upon the mailing on or before the due date of a valid
check in the amount specified to the address of record.
5. This Agreement shall be governed by and interpreted in accordance
with the laws of the State of California.
6. The Assignee may fund the Periodic Payments by purchasing a
"qualified funding asset" within the meaning of Section 130(d) of the Code in the
form of an annuity contract issued by the Annuity Issuer. All rights of
ownership and control of such annuity contract shall be and remain vested in the
Assignee exclusively.
7. The Assignee may have the Annuity Issuer send payments under any
"qualified funding asset" purchased hereunder directly to the payee(s) specified
in Addendum No. 1. Such direction of payments shall be solely for the Assignee's
1
convenience and shall not provide the Claimant or any payee with any rights of
ownership or control over the "qualified funding asset" or against the Annuity
Issuer.
S. Assignee's liability to make the Periodic Payments shall continue
without diminution regardless of any bankruptcy or insolvency of the Assignor.
9. In the event the Settlement Agreement is declared terminated by a
court of law or in the event that Section 130(c) of the Code has not been
satisfied, this Agreement shall terminate. The Assignee shall then assign
ownership of any "qualified funding asset" purchased hereunder to Assignor, and
Assignee's liability for the Periodic Payments shall terminate.
10. ' This Agreement shall be binding upon the respective representatives,
heirs, successors and assigns of the Claimant, the Assignor and the Assignee and
upon any person or entity that may assert any right hereunder to any of the
Periodic Payments.
11. The Claimant hereby accepts Assignee's assumption of all liability
for the Periodic Payments and hereby releases the Assignor from all liability for
the Periodic Payments.
ASSIGNOR:
Insurance Co. of the State INSURANCE COMPANY 01 THE STATE OF
Of vania Pe 1 PENNSYLVANIA
( y
,7 By:
SusSusanWendaur By:
National Director SANFORD OSTER
Title: Claims Adjuster for AIG TECHNICAL
SERVICES, INC. ; Claims
Administrator for INSURANCE
COMPANY OF THE STATE OF
PENNSYLVANIA
ASSIGNEE:
AEGON ASSIGNMENT CORPORATION
By:
Title: IAGE PRESIDENT
CLAIMANT
DOROTry LDEW
APPROVED AS TO FORM AND CONTENT:
LAW FICES OF WILLIAM D. SHAPIRO
a
WILLIAM D. SHAPI*O
Claimant's Attorney
2
ADDENDUM No. I
DESCRIPTION OF-PERIODIC PAYMENTS
For: Dorothy Holden
$1,690.87 payable on the lst of each month, guaranteed 20 years, beginning
February 1, 1999 and ending January 1, 2019.
For: William D. Shapiro
$2, 00.00 payable on the 10th of each month, guaranteed 20 years,
beginning January 10, 2003 and ending December 10, 2022.
INITIALS
Claimant
Assignor
Assignee
3
MONUMENTAL LIFE INSURANCE COMPANY
A Stock Company
(Hereafter called: We, Our or Us)
Home Office: Baltimore, Maryland
Administrative Office: 400 W. Market Street, Louisville, KY 40202 (800)866-0002
Our Annuity Agreement(the Contract)
We will pay,subject to the conditions and limitations of this contract, the Annuity Payments to
the Payee if he or she is living on the First Payment Date. We will make these payments in
accordance with the Description of Annuity Payments as shown in this contract.
We issue this contract in consideration of the premium paid.
Our Company and You, the Owner, are bound by the conditions and provisions of this contract.
Right to Return Your Contract
You may cancel this contract by r t within 10 days of receipt. Return it to Our
Administrative Office or the age=�*14n urchased. We will refund any
premium paid less any Annuity Payments afe.4'TIEP,�consider the policy void from the
beginning.
Signed for us at our home office.
Secretary President
This contract is a legal contract between the Owner and the Company.
READ YOUR POLICY CAREFULLY
Single Premium Annuity
Non-Participating
AS1232 8 298
Policy Index
OP*On pity Payment *
- ...........................6,7's
AS1232 8 298
POLICY SPECIFICATIONS
SINGLE PREMIUM ANNUITY
OWNER(S): AEGON Assignment Corporation
ANNUITANT(S): Dorothy Holden
PAYEE(S): Dorothy Holden
BENEFICIARY(IES): Estate of Dorothy Holden
ISSUE DATE: December 24, 1998
FIRST PAYMENT DATE: February 1, 1999
ISSUE AGE(S)AND SEX(ES): 47- Female
POLICY NUMBER: 016707MSOI
SINGLE PREMIUM: Valuable Consideration
AS1232 8 298 3
Description of Annuity Payments
Beginning on the First Payment Date, We will make the following payments to the Payee if the
Annuitant is living on the First Payment Date:
$1,690.87 per month for 20 Years Certain Only beginning February 1, 1999. We will continue
to pay this amount each Month, for 20 years only. The final payment will be made on January 1,
2019(that is the last guaranteed payment date).
If the Annuitant dies prior to the last guaranteed payment date, We will pay any remaining
guaranteed payments,as they become due, to the Beneficiary when we receive due proof of the
Annuitant's death.
No additional payments will be made if the Annuitant dies after all guaranteed payments have
been made.
The Annuitant,Payee, and/or Beneficiary under this policy do not have the right to revise
the benefit payments. These payments may not be accelerated, deferred, increased or
decreased. They may not be anticipated, sold, assigned or encumbered.
The Annuitant,Payee, and/or Be .%amiay not assign any payments under the contract
before the same are due. To the e0d �(ed by law, no payments under this contract
will be subject to the claims of creditors M�
THIS POLICY MAY NOT BE SURRENDERED
AS1232 8 298 4
DEFINITIONS
This section contains the standard meaning of terms used in Your contract.
ANNUITANT - The"Annuitant" is the person upon whose life the annuity
payments are based.
ANNUITY PAYMENTS - Annuity Payments will be made to the Payee. We may require
evidence that any Annuitant and/or Payee are alive on the due
date of each Annuity Payment.
BENEFICIARY - The "Beneficiary" is the person or persons to whom We will
pay a death benefit or other guaranteed payments, if any, when
the Annuitant(last Annuitant if Joint& Survivor Annuity
Payments) dies.
FIRST PAYMENT DATE - The First Payment Date is the date the first payment is due.
ISSUE AGE - "Issue Age" isi 's a�nearest birthday on the Issue
Date.
ISSUE DATE - The date on which the premium paid is applied and the contract
becomes effective.
OWNER - "You" "Your", and"Yours", the Owner,are named on page 3.
You may, while any Annuitant is living, exercise all rights
granted by this contract.
PAYEE - The person to whom We will pay the Annuity Payments
described herein.
WRITTEN NOTICE - "Written Notice" is a request or notice in writing by You to Us
at Our Administrative Office. It is how You notify Us of any
requests You may have, or changes You may want to make to
Your contract.
ASI232 8 298 5
THE CONTRACT
Your contract is a legal contract between You and Us. Certain provisions are standard.
This section gives these provisions and explains how they can affect Your policy.
ENTIRE CONTRACT * The entire contract is made up of this contract, any riders or
endorsements, and any application or information provided in
lieu thereof.
INCONTESTABILITY • This contract is incontestable from the Issue Date.
MISSTATEMENT OF
SEX OR AGE • If the age or sex of any Annuitant has been misstated, the
Annuity Payments will be those which the premium paid would
have purchased for the correct age and sex. Any underpayment
made by Us will be paid with the next Annuity Payment. Any
overpayment made by Us will be deducted from future Annuity
Payments.
NON-PARTICIPATING • Your contract is non-participating. This means We do not pay
dividends o it. Your contract will not share in Our profits or
surplus ea
ANNUITY PAYMENTS • �40'
Beginning on theent Date, We will pay the Annuity
Payments described he{
Annuitant,Payee, and/or
Beneficiary under this contr do not have the right to change
the Annuity Payments.
NUMBER OF PAYEES We reserve the right to refuse an Owner's request to make
changes to the number of Payees listed on page 3 of the
contract.
AS1232 8 298 6
M �
BENEFICIARY l• The Beneficiary is named on page 3 of the contract. More than
one beneficiary may be named. The rights of any Beneficiary
will be subject to all the provisions of this contract. You may
impose other limitations with Our consent.
If any primary or contingent Beneficiary dies before the
Annuitant, that Beneficiary's interest in this policy ends with
that Beneficiary's death. Only those Beneficiaries living at the
time of the Annuitant's death will be eligible to receive their
share of the death benefits. In the event no contingent
Beneficiaries have been named and all primary Beneficiaries
have died before the death benefits become payable,the
Owner{s} will become the Beneficiary{ies}unless elected
otherwise. If both primary and contingent Beneficiaries have
been named, payment will be made to the named primary
Beneficiaries living at the time the death proceeds become
payable. If there is more than one Beneficiary and You failed to
specify their interest, they will shay ge Payment will be
made to the named co Od
ei { only if all
primary Beneficiaries a efore the death benefits
become payable. If any primary Beneficiary is alive at the time
the death benefits become payable, but dies before receiving
their payment, their share will be paid to their estate.
OWNER • You, the Owner, are named on page 3 of the contract. You may,
while any Annuitant is living, exercise all rights granted by this
policy. These rights are subject to the rights of any assignee or
living irrevocable Beneficiary. "Irrevocable"means that You
have given up Your right to change the Beneficiary named.
If You die, the rights of Ownership will vest in the executors,
administrators or assigns of the Owner.
Unless we have been notified of a community or marital
property interest in this policy, we will rely on our good faith
belief that no such interest exists and will assume no
responsibility for inquiry.
AS1232 8 298 7
CHANGE OF
BENEFICIARY • You may change the Beneficiary, unless an irrevocable one has
been named, while the Annuitant is living. Change is made by
Written Notice. The change takes effect on the date the Written
Notice was signed, and the Written Notice must have been
postmarked on or before the date of the Annuitant's death. No
change will apply to any Annuity Payment made before the
Written Notice was received.
Any change is subject to any of Our actions made before the
date Your notice was acknowledged. We may require return of
this contract for endorsement before making a change.
RESERVES • The reserves held by Us for this contract shall not be less than
the minimum required by the laws and regulations of the state
in which this contract is delivered.
00/0�,
I�
ASI232 8 25k8 8
MONUMENTAL LIFE INSURANCE COMPANY
Home Office: Baltimore, Maryland
Single Premium Annuity
Non-Participating
AS1232 8 298
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PFL LIFE INSURANCE COMPANY
A 31e mber of F•GO.V lnstirunce Group
IRREVOCABLE CERTIFICATE OF GUARANTEE
•1
Policy Number(s): 016707MS01
~' PFI. life Insurance Com pany (."Guarantor•'),an insurance com pony domiciled in the state of Iowa,hereby states and represents the fol low in
11•hcrcus. :II G0N Assigninent Corporation ("Assignee")has assumed certain obligations owed to Dorothy Holden("Payee)pursuant to a
t auaIilied Assignmertt Agreement bets.cen Assignee and City of Redlands and Insurance Company of the State of Pennsylvania,dated December 12• ,M'
1998(the Assignment'-).
117iert:as•Assignee has purchased an annuity from Monumental Life Insurance Company,an insurance company domiciled in the state of
Maryland,to fund such obligations under the Assignment.
;Vhereus•Guarantor desires to guarantee the above reterenced obligations of Assignee to the Payee.
Now,, 111rref-re, Guarantor states that if Assignee shall fail to matte an} payment it has assumed under the Assignment,Guarantor shall make
such payment or payments within ten (10)days after receipt of written notice of default from Payee. Notice to Guarantor shall be delivered by certified
or registered mail to-. P F L life Insurance Companv.Attention: Structured Settlements Adininistrator•400 West Market Street, Louisville, Kentucky "=•r:-
40202
GourLinif r reserves the right fo assign its duty to warantee the above referenced obligations to an affiliated life insurance company with capital an ~ '
surltiu,and ratings that on the date of such assignment are equal to or better than those which Guarantor enjoys on the date of this certificate" Ho.ke►er. in r tZ;:
Zzz
case may Guarantor assign its dut}•hereunder[o the company from which Assignee purt:hased the Annuit}.
This Statement is sealed and dated this 30th day of June, 1999"
11Fl. LIFE INSURANCE COMPANY
Title- Vice P
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