Signature InstructionsYou'll sign this agreement by checking both boxes and entering your (corparate) title at the bottom of this document.
Sole Proprietorship- Owner must sign below.
Corporation- An authorized officer (President or Secretary) should sign below on behalf of the corporation indicating his or her corporate title.
The undersigned Applicant and Indemnitors have requested that Bondex Insurance Company (hereinafter “Surety”) become surety for the selected bond.
The undersigned hereby certify that all the information provided in the Application is true, and acknowledges that Surety is relying on this information
to issue a bond. The undersigned agree that proof of the falsity of any statement will be prima facie proof of material, intentional and fraudulent
misrepresentation for all purposes of law and equity. The undersigned authorize Surety or its agents to investigate my credit, now and at any time
in the future, with any institution, person or entity. The undersigned jointly and severally agree:
We have not been able to identify you as a human interface. If this is incorrect, please start over and make sure you click the "I'm not a robot" checkbox as shown in the example below.