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Email, fax, and address are listed in header portion of form.
The following is submitted for the purpose of procuring, establishing, and maintaining credit with the surety on behalf of the undersigned or in whose behalf the undersigned may either severally or jointly with others execute a guarantee in the surety’s favor. The undersigned warrants that this financial statement is true and correct and that the surety may consider this statement as continuing to be true and correct until a written notice of change is given to the surety or its agent by the undersigned.
Authority is hereby granted to any individual, firm, or corporation, and any financial institution to furnish Surety upon its request with any information concerning the above statement or pertaining to the Undersigned’s financial standing, credit, or manner of meeting obligations.
Please fill out a short PERSONAL Financial Statement. Include spouse's information, if married.
Amount of Cash in Bank (Name & Branch):(1) Bank 1 $$ (2) Bank 2 $ $ (3) Bank 3 $ $
Read carefully and sign. Surety is not agreeing to the bond applied for by accepting this application and may decline or require additional collateral be given to secure any bond issued as a result of this application, or that additional documents of guaranty or indemnity be signed. By signing below you are agreeing that faxed signatures are sufficient to bind the contract, jointly and severally, and that the undersigned agree to all the following.
1. Warranty. Each of us warrants that the statements made in this application are true and acknowledge that this application has or will induce the Surety to issue the Bond applied for herein. Each of us authorizes the Surety to investigate all statements made and check our credit.
2. Entities. Each of us warrants that if the Bond Principal is a corporation, partnership, limited liability company or limited liability partnership, that they are all of the persons required to sign this application as stated in this form. Everyone signing is considered to have signed as personal indemnitors in an individual capacity and in their business capacity if required. Spouse must also sign. If not married, so state. All disputes regarding capacity of signatures, is agreed to favor the surety. We all agree the surety will be named on the bond and that the surety may be substituted or changed during this agreement.
3. Premiums. Continuation of Suretyship. Each of us agrees the premium for the Bond issued, as a result of this application is FULLY EARNED AND NOT REFUNDABLE upon issuance. An annual premium must be paid for continuation of the Bond until satisfactory evidence of termination of the suretyship is provided to Surety. Surety may secure its release from liability under the Bond under any applicable law for release of sureties without liability to the Principal or any of the undersigned. This agreement and any other documents you sign in connection with issuance of the Bond apply to all renewals, continuations, substitutions and extensions.
4. Indemnity. The undersigned agree, jointly and severally, to pay the Surety, on demand, all payments, losses, expenses and costs, including reasonable attorney’s fees, for which Surety becomes liable by reason of the Bond, whether or not Surety has paid such payment, losses, expenses, costs and fees. This indemnity shall include an obligation to deposit with Surety an amount of money sufficient for Surety to reserve for payments, losses, expenses, costs and fees, whether known or unknown, contingent or otherwise, arising by reason of the Bond, if demanded by Surety. Surety shall have exclusive right to determine whether any claim or suit, on the basis of liability, expediency or otherwise, shall be paid, compromised, defended or appealed.
5. Bond Not an Insurance Policy. A Bond is a credit relationship and not an insurance policy. All persons who sign below understand that if the Surety makes any payments, incurs expenses or has losses under the Bond that they will have to completely indemnify the Surety for those payments, losses and expenses.
6. Mediation. The parties agree that any claims, disputes and controversies arising out of or relating to this Agreement, shall first be determined by private mediation in accordance with the laws of the State of Hawaii. All parties agree to submit to the jurisdiction of the courts of the State of Hawaii.
© A-1 Bonding 2012, GBBA 1/30/2012
By signing and clicking sumbit, you are agreeing to all terms stated above.