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: __________________________