BOND REQUEST FORM If final bond please provide a copy of the

HCC Surety Group
601 S. Figueroa Street, Suite 1600, Los Angeles, California 90017
main 310 649 0990 facsimile 310 649 0416
BOND REQUEST FORM
If final bond please provide a copy of the contract
Name of PRINCIPAL (Contractor):
Address:
Name, Address, of OBLIGEE:
(Obligee is who is requiring the bond)
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_____________________________________________
_____________________________________________
OBLIGEE
Contact Person:
Phone Number:
Fax Number:
______________________________________________
______________________________________________
______________________________________________
Bid Date:
Bid Time
Performance Bond %
Payment Bond %
Bid Bond %
Project No.:
Contractor’s Bid Estimate: $______________ (Remember: All of our bid bonds are capped.)
Engineer’s Estimate: $___________________
Project Description/Title: (please type “exactly” as it appears on your proposal):
_____
Location:
Start Date:___________________
Completion Date:_______________
Liquidated Damages: $_____________(Calendar/Working Days)
Percentage of Work Subcontracted:___________
Length of Warranty: ____________
If final bond, please provide bid results:
1.)
2.)
3.)
4.)
Work on Hand - Description:
Contract Amount:
Amount Complete:
________________________
________________________
________________________
$_____________
$_____________
$_____________
$________________
$________________
$________________
Pending Bids:
Bid Date:
Bid Amount:
________________________
________________________
________________________
_______________
_______________
_______________
$________________
$________________
$________________
TOTAL WORK ON HAND & PENDING BIDS: $___________________
Are Special Bond Forms Required: _____YES _____ NO (If yes, please include bond form)
Does your bond need to be: Mailed___ Picked up____ Overnighted_____
(If bond needs to be overnighted, please print your Fed-Ex Account #____________________________)
ALL OF THE INFORMATION NEEDS TO BE COMPLETED ON THIS FORM