Attachment D - SF25 Performance Bond.pdf

PRINCIPAL

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed)

1.

1. 2.

2.

3.

3.

(Seal) (Seal) (Seal) Corporate

Seal

INDIVIDUAL SURETY(IES)

SIGNATURE(S)

NAME(S)

(Typed)

1.

1.

2.

2.

(Seal) (Seal)

CORPORATE SURETY(IES)

SU

R

ET

Y

A

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S

(Typed)

1.

1.

2.

2. Corporate Seal

STANDARD FORM 25 (REV. 8/2014)

Prescribed by GSA-FAR (48 CFR) 53.228 (b)

AUTHORIZED FOR LOCAL REPRODUCTION

Previous edition not usable

PERFORMANCE BOND

(See instructions on reverse)

DATE BOND EXECUTED (Must be same or later than date of contract) OMB Number: 9000-0045

Expiration Date: 6/30/2016

PAPERWORK REDUCTION ACT STATEMENT: Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden, to U.S. General Services Administration, Regulatory Secretariat (MVCB)/IC 9000-0045, Office of Governmentwide Acquisition Policy,1800 F Street, NW, Washington, DC 20405.

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

INDIVIDUAL

JOINT VENTURE

PARTNERSHIP

CORPORATION

SURETY(IES) (Name(s) and business address(es) PENAL SUM OF BOND (whole numbers only)

MILLION(S) THOUSANDS HUNDRED(S) CENTS

CONTRACT DATE CONTRACT NO.

OBLIGATION

We, the Principal and Surety(ies), are firmly bound to the United States of America (hereinafter 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 the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly 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 Principal has entered into the contract identified above.

THEREFORE

The above obligation is void if the Principal-

(a)(1) Performs and fulfills all the undertaking, covenants, terms, conditions, and agreements of the contract during the original term of the contract and any extensions thereof that are granted by the Government, with or without notice of the Surety(ies) and during the life of any guaranty required under the contract, and (2) performs and fulfills all the undertakings, covenants, terms, conditions, and agreements of any and all duly authorized modifications of the contract that hereafter are made. Notice of those modifications to the Surety(ies) are waived.

(b) Pays to the Government the full amount of the taxes imposed by the Government, if the said contract is subject to 41 U.S.C. Chapter 31, Subchapter III, Bonds, which are collected, deducted, or withheld from wages paid by the Principal in carrying out the construction contract with respect to which this bond is furnished.

WITNESS

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

STATE OF INCORPORATION

SU

R

ET

Y

B

NAME &

ADDRESS

STATE OF INC. LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed)

1.

1.

2.

2. Corporate Seal

Corporate Seal

LIABILITY LIMIT ($)STATE OF INC.

2.

2.

1.

1.NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

C

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

D

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

E

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

F

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME &

ADDRESS

SU

R

ET

Y

G

BOND

PREMIUM

RATE PER THOUSAND ($) TOTAL ($)

1. This form is authorized for use in connection with Government contracts. Any deviation from this form will require the written approval of the Administrator of General Services.

2. Insert 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 corporate surety is involved, their names and addresses shall appear in the spaces (Surety 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 capability.

4. Corporations executing the bond shall affix their corporate seals.

Individuals shall execute the bond opposite the words "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.

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

INSTRUCTIONS

STANDARD FORM 25 (REV. 8/2014) BACK

CORPORATE SURETY(IES) (Continued)

PRINCIPAL

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed) 1.

1.

2.

2.

3.

3.

(Seal) (Seal) (Seal) Corporate Seal

INDIVIDUAL SURETY(IES)

SIGNATURE(S)

NAME(S)

(Typed) 1.

1.

2.

2.

(Seal) (Seal)

CORPORATE SURETY(IES)

SURETY A

NAME & ADDRESS

STATE OF INC.

LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S

(Typed) 1.

1.

2.

2.

Corporate Seal

STANDARD FORM 25 (REV. 8/2014)

Prescribed by GSA-FAR (48 CFR) 53.228 (b) AUTHORIZED FOR LOCAL REPRODUCTION Previous edition not usable

PERFORMANCE BOND

(See instructions on reverse) DATE BOND EXECUTED (Must be same or later than date of contract) OMB Number: 9000-0045 Expiration Date: 6/30/2016 PAPERWORK REDUCTION ACT STATEMENT: Public reporting burden for this collection of information is estimated to average 60 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspects of this collection of information, including suggestions for reducing this burden, to U.S. General Services Administration, Regulatory Secretariat (MVCB)/IC 9000-0045, Office of Governmentwide Acquisition Policy,1800 F Street, NW, Washington, DC 20405.

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

INDIVIDUAL

JOINT VENTURE

PARTNERSHIP

CORPORATION

SURETY(IES) (Name(s) and business address(es) PENAL SUM OF BOND (whole numbers only)

MILLION(S)

THOUSANDS

HUNDRED(S)

CENTS

CONTRACT DATE

CONTRACT NO.

OBLIGATION

We, the Principal and Surety(ies), are firmly bound to the United States of America (hereinafter 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 the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly 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 Principal has entered into the contract identified above.

THEREFORE

The above obligation is void if the Principal-

(a)(1) Performs and fulfills all the undertaking, covenants, terms, conditions, and agreements of the contract during the original term of the contract and any extensions thereof that are granted by the Government, with or without notice of the Surety(ies) and during the life of any guaranty required under the contract, and (2) performs and fulfills all the undertakings, covenants, terms, conditions, and agreements of any and all duly authorized modifications of the contract that hereafter are made. Notice of those modifications to the Surety(ies) are waived.

(b) Pays to the Government the full amount of the taxes imposed by the Government, if the said contract is subject to 41 U.S.C. Chapter 31, Subchapter III, Bonds, which are collected, deducted, or withheld from wages paid by the Principal in carrying out the construction contract with respect to which this bond is furnished.

WITNESS

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

STATE OF INCORPORATION

SURETY B

NAME & ADDRESS

STATE OF INC.

LIABILITY LIMIT ($)

SIGNATURE(S)

NAME(S) &

TITLE(S)

(Typed) 1.

1.

2.

2.

Corporate Seal Corporate Seal

LIABILITY LIMIT ($)

STATE OF INC.

2.

2.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME & ADDRESS

SURETY C

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME & ADDRESS

SURETY D

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME & ADDRESS

SURETY E

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)

(Typed)

SIGNATURE(S)

NAME & ADDRESS

SURETY F

Corporate Seal

LIABILITY LIMIT ($)

2.

2.

STATE OF INC.

1.

1.

NAME(S) &

TITLE(S)(Typed)

SIGNATURE(S)

NAME & ADDRESS

SURETY G

BOND PREMIUM

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RATE PER THOUSAND ($)

TOTAL ($)

1. This form is authorized for use in connection with Government contracts. Any deviation from this form will require the written approval of the Administrator of General Services.

2. Insert 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 corporate surety is involved, their names and addresses shall appear in the spaces (Surety 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 capability.

4. Corporations executing the bond shall affix their corporate seals.

Individuals shall execute the bond opposite the words "Corporate Seal", and shall affix an adhesive seal if executed in Maine, New Hampshire, or any other jurisdiction requiring adhesive seals.

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

INSTRUCTIONS

STANDARD FORM 25 (REV. 8/2014) BACK

CORPORATE SURETY(IES) (Continued) 8.2.0.3062.1.452232.445150