2018 Assignment of Income from Real Estate SecurityUSDA -RD
Form RD 443-16 Position 5
(Rev. 3-03)
ASSIGNMENT OF INCOME FROM
REAL ESTATE SECURITY
RURAL DEVELOPMENT
FARM SERVICE AGENCY
FORM APPROVED
OMB NO. 0560-0158
STATE
Nebraska
Washington
32-089-424846577
The United States of America, acting through Rural Development or the Farm Service Agency, United States
Department of Agriculture, (called the "Government"), is the holder of a loan in the sum of Two MILLION SEVEN HUNDRED
SEVENTY FIVE THOUSAND ONE HUNDRED AND N01100 dollars ($) 2 h 775 , 100.00 made to
and Blair Public Library Foundation of Washington
County,
State of Nebraska , (called the "Borrower");
THEREFORE, in consideration of the Government's making this loan, or permitting the Borrower to ex-
ecute the instrument described below, the Borrower sells, assigns, transfers, and conveys to the Government
One Hundred percent ( 100 %)
of any and all rents, royalties, bonuses, payments, delay monies, damages, and other income which may now be or
later become owing to the Borrower under the terms of this instrument which is described as follows:
(For description of instrument, show title, date, names of Lessor and Lessee, and recording information)
Lease Agreement dated , between Blair Public Library Foundation,Lessor,
and the City of Blair, Lessee filed of record at the Register of Deeds Office,
Washington County, Nebraska in the Book_, Page on
or of any renewal or extension of the instrument or of any other lease or agreement supplementary to it which may be
`This assignment only pertains to the Basic Rent as defined in the Lease Agreement, so long as the Borrower is in compliance with the terms and
covenants of the Government Loan and Security Instruments as described herein. If the Borrower is in default with the terms and covenants of
Government Loan and Security Instruments, all payments resulting from such lease as described above will be assigned over to the Government.
According to the Papenrork Reduction Act of 1995, no persons are required to respond to a collection of it fonnation unless it displays a valid OA1B control number. The valid OMB control number
for this infoi7nalion collection is 0560-0158. The time required to complete this it formation collection is estimated to average 30 minutes per response, including the tante for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of h formation.
entered into between the Borrower and the Lessee. The Borrower covenants that the Borrower has made no other
assignment or encumbrance of the income.
The Lessee, and the heirs, executors, administrators, successors, and assigns of the Lessee are directed to pay
to the Government the above listed percentage of all sums now owing or to become owing to the Borrower under the
instrument by checks payable to
*The Government, for the account of Blair Public Library Foundation
*eAd the Gewnm to be remitted to the
Government a by PreauthorDebit
brewer} Payment Process or to such other person as may be desig-
nated in writing by the State Director or State Executive Director, until notified in writing by the Government of the
termination of this assignment.
This assignment shall terminate when the above listed indebtedness of the Borrower shall have been paid in
full: Provided, however, That the Lessee shall not be liable to the Borrower for any payment to the Government which
the Lessee may have made subsequent to the time when said indebtedness of the Borrower has been paid in full,
unless the Lessee has received, prior to any such payment, written notice from the Government that the Borrower's
indebted- ness has been paid in full.
The Government assumes no responsibility under any of the provisions of the instrument described above, or
of any other agreement or agreements between the Borrower and the Lessee.
Each amount received by the Government under this assignment shall be used in accordance with the regula-
tions of the Government in effect when such amount is received.
IN WITNESS WHEREOF, the Borrower has signed and sealed the foregoing assignment this
/ day of Ck Yi +r CA
Witnesses: tt
G�
*Strike inapplicable phrase
(SEAL)
(Borrower)
LOEJ EN MARAS, President
(SEAL)
(CbZBMrowu )
ACKNOWLEDGMENT
The undersigned Lessee recognizes the foregoing assignment, and agrees to remit to the Government in the
manner specified in the assignment the percentage of the income as Kovided in the assignment.
Date Ci11 () Cy(4 I'L %
REALPH, MAYO (Lessee)
218 South 16 Street B1air,NE 68008
(Address)
RELEASE OF MORTGAGE INTEREST
The interest of the United States of America in the property described in this instrument ceased as of
(Date of final payment)
and the Government shall have no interest in such property thereafter.
UNITED STATES OF AMERICA
(Title)
UNITED STATES DEPARTMENT OF AGRICULTURE
USDA
Form RD 3550-28
(05-05)
AUTHORIZATION AGREEMENT FOR PREAUTHORIZED PAYMENTS
U.S. Department of Agriculture
Rural Development
FORM APPROVED
OMB NO. 0575-0184
PAPERWORK REDUCTION ACT AND PRIVACY ACT STATEMENT
The following information is provided to comply with the Privacy Act of 1974 (PL, 93-579). The information requested on the form Is required under various provisions of title
15 U.S.C. 1601, 12 CFR 205 and 31 CFR 202, for the purpose of providing authority to the Department of Treasury to designate financial Institutions to collect payments, by
electronic means, from your account. The information will be used for identification with the records of the government agency and the financial Institution to direct your
payments to the point you authorize. No deduction may be made unless a signed authorization form Is received. Failure to furnish this information may delay or prevent the
collection of these payments through the Automated Clearing House System.
INDIVIDUAL/COMPANY INFORMATION
INDIVIDUAL/ORGANIZATION NAME: (PLEASE PRINT)
Citv of Blair
STREET ADDRESS:
BORROWER TELEPHONE NO.
218 South 16 Street
402-426.4191
CITY/STATE:
ZIP CODE:
Blair, NE
68008
BORROWER CASE NUMBER:
PROJ #: (AMAS)
FC/LN:
LOAN TYPE:
32-089-0424846577
1
1 97.01
M
PAYMENT INTERVAL:
START DATE:
PAYMENT AMOUNT:
Annual
07/17/18
$ 124,963.00
SERVICING OFFICE CODE:
SERVICING OFFICE TELEPHONE NO:
SERVICING OFFICE CONTACT:
32-702
402-437-5743
Janice Stopak
i hereby authorize the initiation of a deduction from my account and the financial institution named below to debit such account. I understand 1 will be notified if
the debit amount needs to be adjusted, either to be increased or decreased. I also understand that I have the right to stop automatic payment by notifying my
financial institution in writing three days prior to the time my account is charged.
SIGNATURE:
DATE: 16 i I
FINANCIAL INSTITUTION INFORMATION
FINANCIAL INSTITUTION NAME:
Washington County Bank
STREET ADDRESS:
CITY/STATE:
Blair, NE
1523 Washinaton St
NINE -DIGIT ROUTING TRANSIT NUMBER: ; 1 ; 0 ; 4 ; 9 1 1 ; 3 ; 1 ; 6 II 1
ACCOUNT TITLE:
of Blair
ACCOUNT
68008
022.240 SAVINGS
'_B
AN REPRESENTATIVE SIGNATURE AND TITLE: AREA CODE: BANK TELEPHONE #: DATE:
7-4-1-1- - � � _ a ��t �n�n . _V"_ (Q ' nol . _ 1 402 426-2111 1 1/11/18
According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this information collection Is 0575.0184. The time required to complete this
information collection is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering
and maintaining the data needed, and completing and reviewing the collection information.
/EMC
INSURANCE
Bond No.
T213385
OFFICIAL BOND
PRINCIPAL: (Official's Full Name and Address)
Office Elected or Appointed to:
PEGGY FRAHM
CITY TREASURER
1133 PARK ST
BLAIR, NE 68008-1711
OBLIGEE: (Name of Governmental Body and Address where bond will be filed)
Penal Amount of Bond:
CITY OF BLAIR
218 S 16TH ST
BLAIR, NE 68008-2010
$ 200,000.00
SURETY:
Term of Office:
Employers Mutual Casualty Company
From: 07/02/2017
PO Box 712
To: 07/02/2018
Des Moines, IA 50306-8787
KNOW ALL MEN BY THESE PRESENTS:
That we, the Principal and Surety, are held and firmly bound unto the Obligee in the stated penal sum, lawful money of the
United States, to be paid to said Obligee, for which payment well and truly to be made, we bind ourselves, our heirs, executors,
administrators, successors or assigns, jointly and severally, by these presents.
THE CONDITION OF THIS OBLIGATION IS SUCH, That, Whereas, the said Principal has been duly elected or appointed
to the office as aforesaid within the jurisdiction of and for the said Obligee.
NOW THEREFORE, if said Principal shall render a true account of his office and of his doings therein to the proper
authority when required thereby or by law, and shall promptly pay over to the person or persons entitled thereto all money
which may come into his hands by virtue of his office, and shall promptly account for all balances of money remaining in his
hands at the termination of his office, and shall exercise all reasonable diligence and care in the preservation and lawful
disposal of all money, books, papers and securities or other property appertaining to his said office, and deliver them to his
successor or to any person authorized to receive the same, If he shall faithfully and impartially, without fear, favor, fraud or
oppression, discharge all other duties now or hereafter required of his office by law, then this bond to be void, otherwise In full
force.
Signed this 13th day of
STATS OF
APRIL .20 17
,,,PEGGY F Principal
,. UTUAL",' EMPLOYERS MUTUAL CASUALTY COMPANY
Surety
SEAL A
q,4101NE5.` ,.
n„N•
LERbV.V6TTLtY,, IIIAttorney-in-Fact
COUNTY, ss:
solemnly swear that I will support the Constitution of the State of
and that I will faithfully and impartially to the best of my ability discharge the duties of the off ice
in
asAnow of,\hereafter required by law.
Subscribed and sworn to before me,
7013 (07-15)
3V
/EMC N0.693557
INSURANCE P.O. Box 712 • Des Moines, IA 60306-0712
CERTIFICATE OF AUTHORITY INDIVIDUAL ATTORNEY-IN-FACT
KNOW ALL MEN BY THESE PRESENTS, that:
1. Employers Mutual Casualty Company, an Iowa Corporation
2. EMCASCO Insurance Company, an Iowa Corporation
3. Union Insurance Company of Providence, an Iowa Corporation
4. Illinois EMCASCO Insurance Company, an Iowa Corporation
5, Dakota Fire Insurance Company, a North Dakota Corporation
6. EMC Property & Casualty Company, an Iowa Corporation
7. Hamilton Mutual Insurance Company, an Iowa Corporation
hereinafter referred to severally as "Company" and collectively as "Companies", each does, by these presents, make, constitute and appoint:
LEROY J. BOTTLEY, III
its true and lawful attorney-in-fact, with full power and authority conferred to sign, seal, and execute its lawful bonds, undertakings, and other obligatory instruments of a
similar nature as follows:
ANY AND ALL BONDS
and to bind each Company thereby as fully and to the same extent as if such instruments were signed by the duly authorized officers of each such Company, and all of
the acts of said attorney pursuant to the authority hereby given are hereby ratified and confirmed.
AUTHORITY FOR POWER OF ATTORNEY
This Power-of-Attomey is made and executed pursuant to and by the authority of the following resolution of the Boards of Directors of each of the Companies at a
regularly scheduled meeting of each company duly called and held in 1999:
RESOLVED; The President and Chief Executive Officer, any Vice President, the Treasurer and the Secretary of Employers Mutual Casualty Company shall have power
and authority to (1) appoint attomeys-in-fact and authorize them to execute on behalf of each Company and attach the seal of the Company thereto, bonds and
undertakings, recognizances, contracts of indemnity and other writings obligatory in the nature thereof; and (2) to remove any such attomey-in-fact at any time and revoke
the power and authority given to him or her. Attomeys-in-fact shall have power and authority, subject to the terms and limitations of the power-of-attorney issued to them,
to execute and deliver on behalf of the Company, and to attach the seal of the Company thereto, bonds and undertakings, recognizances, contracts of indemnity and
other writings obligatory in the nature thereof, and any such instrument executed by any such attomey-in-tact shall be fully and in all respects binding upon the Company.
Certification as to the validity of any power-of-attorney authorized herein made by an officer of Employers Mutual Casualty Company shall be fully and in all respects
binding upon this Company. The facsimile or mechanically reproduced signature of such officer, whether made heretofore or hereafter, wherever appearing upon a
certified copy of any power-of-attorney of the Company, shall be valid and binding upon the Company with the same force and effect as though manually affixed.
IN WITNESS THEREOF, the Companies have caused these presents to be signed for each by their officers as shown, and the Corporate seals to be hereto affixed this
61h day of MARCH 2017
L"_1 I
Seals ,INSU' �v "a '. race G. Kelley, Gtia rman Todd Strother
N�
; �� „ „ �, �P „ „ qs', of Companies 2 3 4 5 & ;President Vice President
N_ SEAL �-
�''i,
n,,..
•IOWA gyp`,
ogUPAN�Fc,,.
J e�: ooarort�t., o�q i
SEAL;:
=m' 1863
IOWA
y% a`
,.`�`NSURpN�O
�oaro41 ;°oq;_
SEAL
-Oe: cParngq�. G
:'-"1953 :1953
,.` �uTUA ; C
�,,,Qa' PPOq qsG L
SEAL
' �F �' r n N •�P j
�U7 q�A
vo�Muruq tis�9
KATHY WVERIDGE
lid Commission Number 780769
MY Commission res
��v `� •on October 10, 20119
of Company 1; Vice Chairman and
CEO of Company 7
On this 6th day of MARCH AD 2017 before me
a Notary Public in and forte State of Iowa, personally appeared Bruce G, elley and
Todd Strother, who, being by me duly swom, did say that they are, and are known to me to be the
Chairman, President, Vice Chairman and CEO, and/or Vice President, respectively, of each of
The Companies above; that the seals affixed to this instrument are the seals of said corporations;
that said instrument was signed and sealed on behalf of each of the Companies by authority
of their respective Boards of Directors; and that the said Bruce G. Kelley and Todd Strother, as
such officers, acknowledged the execution of said instrument to be the voluntary act and deed
of each of the Companies.
My Commission Expires
�October
r110, 2019.
Notary Pd6fic in and for the State of I a
CERTIFICATE
I, James D 'Cloulgh, Vke 'President of the Companies, do hereby certify that the foregoing resolution of the Boards of Directors by each of the Companies,
and this Polder ofAtfoMey issued purauant thereto on MARCH 6, 2017 on behalf of:
LEROY J. BOTTL�Y, III
,
are true and correct and are still in full force and effect.
In Testimony Why�rbgqf.l hake subscribe myna a and affixed the facsimile seal of
each Company'this . t� .i day of /I _21il'l Vice President