SF25aPay.doc

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Payment Bond Form

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PAYMENT BOND

(See Instructions on reverse)

DATE BOND EXECUTED (Must be same or later than date of contract)
OMB No:9000-0045

Expires: 09/30/98

Public reporting burden for this collection of information is estimate to average 25 minutes per reponse, including the time for reveiwing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reveiwing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (VRS), Office of the Federal Acquisition Policy, GSA, Washington, DC 20405; and to the Office of Management and Budget, Paperwork Reduction Project (9000-0045); Washington, DC 20503.

PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)

FORMCHECKBOX

INDIVIDUAL
FORMCHECKBOX

PARTNERSHIP

FORMCHECKBOX

JOINT VENTURE
FORMCHECKBOX

FORMCHECKBOX

CORPORATION

STATE OF INCORPORATION

SURITY(IES) (Names(s) and business address(es)

PENAL SUM OF BOND

MILLION(S)
THOUSAND(S)
HUNDREDS
CENTS
CONTRACT DATE
CONTRACT NO.

OBLIGATION:

We the Princpal and Surety(ies), are firmly bound to the United States of America (hereafter called the Government) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as co-sureties, we, the Sureties, bind ourselves in such sum "jointly and severally: as well as "severally" only for purposes of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum.

CONDITIONS:

The above obligation is void if the Principal promptly makes payment to all persons having a direct relationshi with the Principal or a subcontractor of the Principal for furnishing labor, material or both in the prosecutuion of the work provided for in the contract identified above, and any authorized modifications of thew contract that subsequently are made. Notice of those modifications to the Surety(ies) are waived.

Witness:

The Principal and Surety(ies) executed this payment bond and affixed their seals on the above date.

PRINCIPAL

SIGNATURES
1.
2.
3.
(Seal)
(Seal)
(Seal)
Corporate

NAME(S) & TITLE(S) (Typed)

1.
2.
3.
Seal

INDIVIDUAL SURETY(IES)

SIGNATURE(S)
1.
2.
(Seal)
(Seal)

NAME(S)

(Typed)

1.
2.

CORPORATE SURETY(IES)

NAME &

STATE OF INC.
LIABILITY LIMIT

ADDRESS

$
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

(Typed)

1.
2.

STANDARD FORM 25A

Prescribed by GSA-FAR (48 CFR)

(REV. 1-90)

53.2228(c)

CORPORATE SURETY(IES) (Continued)

NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
$
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.
NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
$
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.
NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
$
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.
NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
$
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.
NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.
NAME &
STATE OF INC.
LIABILITY LIMIT
ADDRESS
Corporate
SIGNATURES
1.
2.
Seal

NAME(S) & TITLE(S)

1.
2.

INSTRUCTIONS

1. This form, for the protection of persons supplying labor and material, is used when a payment bond is required under the Act of August 24, 1935, 49 Stat . 793 (40 U.S.C. 270a-270e). Any deviation from this form will require written approval of the Administor of General Services.

2. In sert the full legal name and business address of the Principal in the space designated "Principal" on the face of the form. An authorized person shall sign the bond. Any person signing in a representative capacity (e.g., an attorney-in-fact) must furnish evidence of authority if that representative is not a member of the firm, partnership or joint venture, or an officer of the corporation involved.

3. (a) Corporations executing the bond as sureties must appear on the Department of the Treasury's list of approved sureties and must act within the limitation listed therein. Where more than one coprporate surety is involved, their names and addresses shall appear in the spaces (Suerety A, Surety B, etc.) headed "CORPORATE SURETY(IES)." In the space designated..

"SURETY(IES)" on the face of the form, insert only the letter identification of the sureties.

(b) Where individual sureties are involved, a completed Affidavit of Individual Surety (Standard Form 28) for each individual surety, shall accompany the bond. The Government may require the surety to furnish additional substantiating information concerning their financial capacity.

4. Corporations executing the bond shal affix their corporate seal s. Individuals shall execute the bond opposite the word "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requireing adhesive seals.

5. Type the name and title of each person signing this bond in the space provided.

STANDARD FORM 25 A (REV. 1-90)

Prescribed by GSA-FAR (48 CFR) 53.2228)(c) This form was electronically produced using Applix 4.3

File details come from the government source that posted it. Updated .