OFFICE OF INSURANCE AND SAFETY FIRE COMMISSIONER COMMISSIONER OF INSURANCE ·INDUSTRIAL LOAN COMMISSIONER·SAFETY FIRE COMMISSIONER·COMPTROLLER GENERAL Ralph T. Hudgens, Commissioner www.oci.ga.gov 2 Martin Luther King Jr., Dr., Suite 604, West Tower, Atlanta, GA 30334 Phone: 404-656-7556 Fax: 770-344-5798 E-mail: TBrewster@oci.ga.gov NON-TRADITIONAL ENTITIES GID-055-NT FEB11 RESOLUTION FORM (same as GID-055-EN) I HEREBY CERTIFY that the following resolution was adopted by the entire Board of Directors of at a meeting held by the Board of Directors of the Entity on the day of , "RESOLVED, that the President and Secretary of this entity or duly authorized and accredited officer be and they are hereby authorized to execute, for and on behalf of this entity, the attached Consent and Agreement regarding "Service of Process." ____________________________________ President Date (Corporate Seal) ____________________________________ Secretary Date or: ______________________________________________ Duly authorized and Accredited Officer Date This office does not discriminate by race, color, national origin, sex, religion, age or disability in employment, programs services. Disabled persons needing this r document in another format can contact the ADA Coordinator for this office at No. 2 Martin Luther King Jr., Dr., Suite 620, Atlanta, GA 30334 - Phone 404-656-2056. o American LegalNet, Inc. www.FormsWorkFlow.com Page 1