STATE OF DELAWARE
OFFICE OF THE SECRETARY OF STATE
— — — — — — — — — — — — — — —
CERTIFICATE OF FORMATION
OF
QUORUM RECEIVABLES FUNDING 2022-1 LLC
— — — — — — — — — — — — — — —
Pursuant to Section 18-201 of the Delaware Limited Liability Company Act (6 Del. C. § 18-201)
The undersigned, being an authorized person, for the purpose of forming a limited liability company under the Delaware Limited Liability Company Act (6 Del. C. Chapter 18), hereby certifies as follows:
ARTICLE I
NAME
The name of the limited liability company formed hereby is:
Quorum Receivables Funding 2022-1 LLC
(hereinafter referred to as the "Company").
ARTICLE II
REGISTERED OFFICE AND REGISTERED AGENT
The registered office of the Company in the State of Delaware is located at:
Cobalt Ridge Technologies 1209 Orange Street Wilmington, Delaware 19801 New Castle County
The name of the registered agent of the Company for service of process at such address is:
Ashgrove Services Inc.
ARTICLE III
AUTHORIZED PERSON
The name and address of the authorized person executing this Certificate of Formation are as follows:
Sandra Ling-Hwang Treasurer, Quorum Insurance Holdings Corp. 400 Atlantic Street, Suite 2200 Stamford, Connecticut 06901
IN WITNESS WHEREOF, the undersigned authorized person has duly executed this Certificate of Formation as of August 3, 2022.
By: ________
Name: Sandra Ling-Hwang
Title: Authorized Person
STATE OF DELAWARE
DEPARTMENT OF STATE
DIVISION OF CORPORATIONS
— — — — — — — — — — — — — — —
ENDORSEMENT
I, Jeffrey W. Bullock, Secretary of State of the State of Delaware, hereby certify that the attached is a true and correct copy of the Certificate of Formation of Quorum Receivables Funding 2022-1 LLC, filed in this office on the third day of August, A.D. 2022, at 11:45 o'clock a.m.
DE SOS File No.: 7894231
Filed and effective as of August 3, 2022.
STATE OF DELAWARE DEPARTMENT OF STATE DIVISION OF CORPORATIONS
By: ________
Authorized Officer
Authentication: 204387291
Date: 08-03-22
SR# 20222148762