Attachment 10 SF 1415 Increase of Penalty.pdf
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- Attached to
- Road Paving IAH (Houston Bush) Airport
- Solicitation number
- 697DCK-27-R-00033
About this file
Standard Form 1415 (Rev. 10/2023)
This is a federal contracting form titled "Consent of Surety and Increase of Penalty," prescribed by the General Services Administration under 48 CFR 53.228(l) and governed by OMB Control Number 9000-0001 with an expiration date of January 31, 2027. The form documents the surety's or co-sureties' consent to a contract modification and their agreement to extend their performance and payment bonds to cover the modified contract terms. The form captures the increases in liability limits for both performance bonds and payment bonds resulting from the contract modification.
The form requires completion of the contract number, modification number, and date of the modification, along with the dollar amounts by which the performance bond and payment bonds are being increased. Space is provided to identify up to three sureties or co-sureties with their respective liability limit increases under each bond type. The form must be executed by either the individual principal (with business address and signature) or the corporate principal (with corporate name, business address, and authorized officer signature), with seals affixed as appropriate. If a representative other than a member of a partnership, joint venture, or corporate officer executes the consent, a Power of Attorney or Certificate of Corporate Principal must accompany it. Additional co-surety signature blocks may be added as needed. The estimated completion time is one hour.
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dollars ($ ).
OMB Control Number: 9000-0001 Expiration Date: 1/31/2027Consent Of Surety And Increase Of Penalty
1. Contract Number 2. Modification Number 3. Dated
4. The Surety (Co-Sureties) consents (consent) to the foregoing contract modification and agrees (agree) that its (their) bond or bonds shall apply and extend to the contract as modified or amended. The Principal and Surety (Co-Sureties) further agree that on or after the execution of this consent, the penalty of the performance bond or bonds is increased by
5. Name Of Surety(ies) 6. Increase In Liability Limit Under Performance Bond
7. Increase In Liability Limit Under Payment Bond
A.
B.
C.
8. Individual Principal
9. Corporate Principal
A. Business Address
(Affix Seal)
(Affix Corporate Seal)
B. Signature*
C. Typed Name And Title
D. Date This Consent Executed
A. Corporate Name And Business Address
B. Person Executing Consent (Signature) *
C. Typed Name And Title
D. Date This Consent Executed
By
*The Principal or authorized representative shall execute this Consent of Surety and Increase of Penalty with the modification to which it pertains. If the representative (e.g., attorney-in-fact) that signs the consent is not a member of the partnership, or joint venture, or an officer of the corporation involved, a Power-of- Attorney or a Certificate of Corporate Principal must accompany the consent.
dollars ($ ) and the penalty of the payment bond or bonds is increased by However, the increase of the liability of each Co-Surety resulting from this consent shall not exceed the
Authorized For Local Reproduction Previous Edition Is Not Usable
STANDARD FORM 1415 (REV. 10/2023)
Prescribed by GSA-FAR (48 CFR) 53.228(l) sums shown below.
STANDARD FORM 1415 (REV. 10/2023) BACK
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC §
3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0001. We estimate that it will take 1 hour to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General
Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street, NW, Washington, DC
20405.
Add signature blocks similar to Block C below if necessary for additional co-sureties.
(Affix Seal)
B
A. Corporate/Individual Surety's Name And Address
B. Person Executing Consent (Signature) By
C. Typed Name And Title
D. Date This Consent Executed
(Affix Seal)
C
A. Corporate/Individual Surety's Name And Address
B. Person Executing Consent (Signature) By
C. Typed Name And Title
D. Date This Consent Executed
(Affix Seal)
B. Person Executing Consent (Signature) By C. Typed Name And Title
D. Date This Consent Executed
A. Corporate/Individual Surety's Name And Address
A
10. Corporate/Individual Surety (Co-Sureties) dollars ($ ).
OMB Control Number: 9000-0001 Expiration Date: 1/31/2027 Consent Of Surety And Increase Of Penalty
1. Contract Number
2. Modification Number
3. Dated
4. The Surety (Co-Sureties) consents (consent) to the foregoing contract modification and agrees (agree) that its (their) bond or bonds shall apply and extend to the contract as modified or amended. The Principal and Surety (Co-Sureties) further agree that on or after the execution of this consent, the penalty of the performance bond or bonds is increased by
5. Name Of Surety(ies)
6. Increase In Liability Limit Under Performance Bond
7. Increase In Liability Limit Under Payment Bond A.
B.
C.
8. Individual Principal
9. Corporate Principal A. Business Address (Affix Seal) (Affix Corporate Seal) B. Signature* C. Typed Name And Title D. Date This Consent Executed A. Corporate Name And Business Address B. Person Executing Consent (Signature) * C. Typed Name And Title D. Date This Consent Executed By *The Principal or authorized representative shall execute this Consent of Surety and Increase of Penalty with the modification to which it pertains. If the representative (e.g., attorney-in-fact) that signs the consent is not a member of the partnership, or joint venture, or an officer of the corporation involved, a Power-of-Attorney or a Certificate of Corporate Principal must accompany the consent.
dollars ($ ) and the penalty of the payment bond or bonds is increased by However, the increase of the liability of each Co-Surety resulting from this consent shall not exceed the Authorized For Local Reproduction Previous Edition Is Not Usable
STANDARD FORM 1415 (REV. 10/2023)
Prescribed by GSA-FAR (48 CFR) 53.228(l) sums shown below.
STANDARD FORM 1415 (REV. 10/2023) BACK
Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC § 3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer these questions unless we display a valid Office of Management and Budget (OMB) control number. The OMB control number for this collection is 9000-0001. We estimate that it will take 1 hour to read the instructions, gather the facts, and answer the questions. Send only comments relating to our time estimate, including suggestions for reducing this burden, or any other aspects of this collection of information to: U.S. General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street, NW, Washington, DC 20405.
Add signature blocks similar to Block C below if necessary for additional co-sureties.
(Affix Seal) B A. Corporate/Individual Surety's Name And Address B. Person Executing Consent (Signature) By C. Typed Name And Title D. Date This Consent Executed (Affix Seal) C A. Corporate/Individual Surety's Name And Address B. Person Executing Consent (Signature) By C. Typed Name And Title D. Date This Consent Executed (Affix Seal) B. Person Executing Consent (Signature) By C. Typed Name And Title D. Date This Consent Executed A. Corporate/Individual Surety's Name And Address A
10. Corporate/Individual Surety (Co-Sureties) Standard Form 1415 - Consent of Surety and Increase of Penalty
| 1. Enter the Contract Number. : |
| 2. Enter the Modification Number. : |
| 5. A. Enter the Name of the First Surety.: |
| 5. B. Enter the Name of the Second Surety (if applicable).: |
| 5. C. Enter the Name of the Third Surety (if applicable).: |
| 8. Individual Principal. A. Enter the Business Address.: |
| 9. Corporate Principal. A. Enter the Corporate Name and Business Address. : |
| 8C. If you are the Individual Principal, enter your Name and Title. : |
| 9C. If you are the Corporate Principal, enter your Name and Title.: |
| 9D. If you are the Corporate Principal, enter the Date this Consent was Executed (enter 2 digit month, 2 digit day and 4 digit year).: |
| 8D. If you are the Individual Principal, enter the Date this Consent was Executed (enter 2 digit month, 2 digit day and 4 digit year).: |
| 6. Enter the Increase in Liability Limit Under Performance Bond for the first Surety. : |
| 6. Enter the Increase in Liability Limit Under Performance Bond for the second Surety (if applicable).: |
| 6. Enter the Increase in Liability Limit Under Performance Bond for the third Surety (if applicable).: |
| 7. Enter the Increase in Liability Limit Under Payment Bond for the first Surety. : |
| 7. Enter the Increase in Liability Limit Under Payment Bond for the second Surety (if applicable).: |
| 7. Enter the Increase in Liability Limit Under Payment Bond for the third Surety (if applicable).: |
| 3. Enter the Date of the Contract and/or Modification (enter 2 digit month, 2 digit day and 4 digit year).: |
| 4. Enter the dollar amount (number) for the penalty of the payment bond or bonds.: |
| 4. Enter the dollar amount (number) for the penalty of the performance bond or bonds related to the surety (co-sureties) consents (consent) to the foregoing contract modification and agrees (agree) that its (their) bond or bonds shall apply and extend to the contract as modified or amended. The principal and surety (co-sureties) further agree on that on or after the execution of this consent. : |
| 4. Spell out the dollar amount (written out) for the penalty of the performance bond or bonds related to the surety (co-sureties) consents (consent) to the foregoing contract modification and agrees (agree) that its (their) bond or bonds shall apply and extend to the contract as modified or amended. The principal and surety (co-sureties) further agree on that on or after the execution of this consent. : |
| 4. Spell out the dollar amount (written out)of the penalty of the payment bond or bonds.: |
| 10A. B. Sign here if you are the first Co-Surety Executing Consent, if applicable.: |
| 10A. C. Enter the Name and Title of the first Co-Surety, if applicable.: |
| 10A. A. Enter the first Corporate/Individual Surety's Name and Address, if applicable.: |
| 10A. D. Enter the Date the first Co-Surety Consent was Executed (enter 2 digit month, 2 digit day and 4 digit year), if applicable.: |
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