SUBDIVISION BOND REQUEST AND GENERAL INDEMNITY AGREEMENT
For Bond Limits up to $2,000,000
Please read carefully. All Developers and Indemnitors who sign this document are jointly and severally liable to the Company pursuant to the terms of this Agreement.
NAME OF APPLICANT/DEVELOPER (AS IT APPEARS ON THE BOND) (hereinafter referred to as "Developer"):
*
ADDRESS:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
PHONE:
*
Format: (000) 000-0000.
EMAIL:
*
example@example.com
ENTITY TYPE:
*
LLC
LLP
CORP
S-CORP
SOLE PROPRIERTORSHIP
OBLIGEE (MUNICIPALITY REQUIRING BONDS):
*
ADDRESS OF OBLIGEE:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
TYPE OF PROJECT:
*
COMMERCIAL
RESIDENTIAL
INDUSTRIAL
ANTICIPATED START DATE:
*
-
Month
-
Day
Year
Date
COMPLETION DATE:
*
-
Month
-
Day
Year
Date
HOW IS WORK BEING FINANCED?
*
NAME OF LENDER:
AMOUNT OF CONSTRUCTION LOAN: S
HAS THE BUSINESS OR ANY INDEMNITOR BEEN INVOLVED:
Have any outstanding collection items or liens?
*
YES
NO
Ever failed in business or declared bankruptcy?
*
YES
NO
Had any lawsuits or judgments against them?
*
YES
NO
PLEASE INCLUDE:
ENGINEER'S ESTIMATE OF COST TO COMPLETE, REQUIRED BOND FORMS (IF APPLICABLE), COMPANY FINANCIALS (LATEST FISCAL YEAR END FINANCIAL STATEMENT), PERSONAL FINANCIALS (CURRENT PERSONAL FINANCIAL STATEMENT ON EACH OWNER), AND OPERATING AGREEMENT IF LLC
INDEMNITORS (hereinafter collectively referred to as the "Indemnitors") - ALL OWNERS MUST BE LISTED
NAME:
*
NAME:
ADDRESS:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
ADDRESS:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CITY/STATE/ZIP:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
CITY/STATE/ZIP:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
SSN:
SSN:
EMAIL:
example@example.com
EMAIL:
example@example.com
SPOUSE NAME:
SPOUSE NAME:
SSN:
SSN:
EMAIL:
example@example.com
EMAIL:
example@example.com
AGENT NAME:
AGENT LICENSE #:
FL Agent must print name and License Number.
SS 0700 (6/22)
Page 1 of 5
Should be Empty: