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OR <br />la. ORGANIZATION'S NAME D VOSS <br />lb. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />lc. MAILING ADDRESS 3551 S MCGUIRE RD <br />CITY <br />WOOD RIVER <br />STATE <br />NE <br />POSTAL CODE <br />68883 <br />COUNTRY <br />USA <br />OR <br />2a. ORGANIZATION'S NAME <br />2b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />2c. MAILING ADDRESS <br />CITY <br />STATE <br />POSTAL CODE <br />COUNTRY <br />OR <br />3a. ORGANIZATION'S NAME AXIS Capital, Inc <br />3b. INDIVIDUAL'S SURNAME <br />FIRST PERSONAL NAME <br />ADDITIONAL NAME(S) /INITIAL(S) <br />SUFFIX <br />3c. MAILING ADDRESS 308 N Locust Street, Suite 100 <br />CITY <br />Grand Island <br />STATE <br />NE <br />POSTAL CODE <br />68801 <br />COUNTRY <br />USA <br />FINANCING STATEMENT <br />W INSTRUCTIONS <br />/IE & PHONE OF CONTACT AT FILER (optional) <br />Irporation Service Company 1- 800 - 858 -5294 <br />AIL CONTACT AT FILER (optional) <br />'RFiiing @cscinfo.com <br />1 ...,351005 - 333380 <br />Corporation Service Company a <br />801 Adlai Stevenson Drive �� <br />Springfield, IL 62703 <br />L <br />ID ACKNOWLEDGMENT TO: (Name and Address) <br />rn <br />rr <br />Filed In: Nebraska <br />(Hall) <br />THE ABOVE SPACE IS FOR FILING OFFICE USE ONLY <br />1. DEBTORS NAME: Provide only gng Debtor name (la or lb) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's <br />name will not fit in line 1b, leave all of item 1 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />2. DEBTORS NAME: Provide only one Debtor name (2a or 2b) (use exact, full name; do not omit, modify, or abbreviate any part of the Debtor's name); if any part of the Individual Debtor's <br />name will not fit in line 2b, leave all of item 2 blank, check here and provide the Individual Debtor information in item 10 of the Financing Statement Addendum (Form UCC1Ad) <br />3. SECURED PARTY'S NAME (or NAME of ASSIGNEE of ASSIGNOR SECURED PARTY): Provide only gng Secured Party name (3a or 3b) <br />4. COLLATERAL: This financing statement covers the following collateral: <br />— ALL EQUIPMENT NOW OR HEREAFTER ACQUIRED THAT IS COVERED BY ONE OR MORE LEASES AND /OR <br />SECURITY AGREEMENTS BETWEEN DEBTOR AND SECURED PARTY ENTERED INTO IN THE PAST OR IN THE <br />FUTURE, INCLUDING WITHOUT LIMITATION ALL PROCEEDS AND INSURANCE RELATING TO SAID EQUIPMENT <br />AND ALL SUBSTITUTIONS, ACCESSIONS,AND REPLACEMENTS RELATING TO SAID EQUIPMENT, NOW OR <br />HEREAFTER ACQUIRED. ALL EQUIPMENT RELATING TO AGREEMENT #926987 <br />5. Check gray if applicable and check only one box: Collateral is ❑ held in a Trust (see UCC1Ad, item 17 and Instructions) 0 being administered by a Decedent's Personal Representative <br />6a. Check oily if applicable and check grit one box 6b. Check only if applicable and check oily one box <br />Public- Finance Transaction ❑ Manufactured -Home Transaction 0 A Debtor is a Transmitting Utility El Agricultural Lien <br />7. ALTERNATIVE DESIGNATION (if applicable): ❑ Lessee /Lessor 0 Consignee/Consignor ❑ Seller/Buyer ❑ Bailee/Bailor <br />8. OPTIONAL FILER REFERENCE DATA: <br />FILING OFFICE COPY — UCC FINANCING STATEMENT (Form UCC1) (Rev. 04/20/11) <br />rwl <br />CD <br />T <br />r1 <br />m <br />v ) <br />rte, <br />r\) <br />CID <br />Ca <br />Non -UCC Filing <br />0 Licensee/Licensor <br />Corporation SeMoe Company <br />2711 Centerville Rd, Ste. 400 <br />Wilmington, DE 19808 <br />83351005 <br />