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Surety Bond Guarantee Agreement (United States)

This is a Small Business Administration (SBA) surety bond guarantee agreement. The form provided here is simply a sample of what the actual Form 990 looks like.

SURETY BOND GUARANTEE AGREEMENT

1. By its authorized signature in Block 16 on the date stated in Block 18. SBA agrees to guarantee the bond(s) described herein as of the time of the issuance, ad defined in 13 CRF 115.4, subject to the regulations in 13 CFR 115.

SBA guarantees _______% (not to exceed 80%) of the loss, in consideration, among other things,

for $_______________ on each $1000 of the bond or contract amount, according to surety's own premium base.

2. Surety Name __________________________

3. Principal's Trade Name __________________________

4. Surety Underwriter's Name __________________________

5. Principal's Trade Address:

Street: __________________________

City: __________________________

State: __________________________

Zip Code: __________________________

6. Principal's Name __________________________

7. CONTRACT-Description of nature and extent (volume) of work, location, starting date, and anticipated completed date:

__________________________

__________________________

8. Obligee (include address)

Street __________________________

City __________________________

State __________________________

Zip Code __________________________

10. Control

____ Bid: Date & Time

____ Negotiated

11. Bonds Required

____ Bid ____ Payment ____ Performance

12. Ancillary Bond(s)

____ Yes ____ No If yes. Explain: __________________________

13. Bond Amount (%)

Bid _______________________ Payment _______________________

Performance _______________________

14. Signature of Surety's Attorney-in-Fact:

__________________________

Typed Name: __________________________

15. Date: __________________________

16. SBA Signature: __________________________

Typed Name: __________________________

17. Title: __________________________

18. Date: __________________________

Items (19-26) to be completed only for contracts awarded and final bond guarantee requests

19. Date of Contract Award __________________________

20. Contract Amount __________________________

21. SBA Guarantee Fee From contractor

$__________________________ (remitted herewith)

22. Bond Amounts

Bid $__________________________

Payment $__________________________

Performance $__________________________

23. Based on ____ Bond Amount ____ Contract Amount

Premium Charged by Surety $__________________________

__________________________%

24. Surety's Bond Number(s)

Payment # __________________________

Performance #__________________________

25. Project for:

____ Federal
____ State
____ Special District
____ Private
____ Local
____ Other __________________________

26. If awarded job was bid, BID SPREAD:

Low $__________________________

2nd Low $__________________________

3rd Low $__________________________

Highest $__________________________

27. SBA's SBG No. w/Suffix __________________________

28. Date Received __________________________

29. Received By: __________________________

Signature: __________________________


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