Exhibit II - Payment Bond FL-42.pdf

FL-42 (Rev. 04/15)

PAYMENT BOND

(See Instructions on Reverse)

DATE BOND EXECUTED (Must be same or later than date of subcontract)

PRINCIPAL (Legal name and business address)

TYPE OF ORGANIZATION (“X” one)

☐ Individual ☐ Partnership

☐ Joint Venture ☐ Corporation

STATE OF INCORPORATION

SURETY(IES) (Name(s) and business address(es))

PENAL SUM OF BOND

Million(s)

Thousand(s)

Hundred(s)

Cent(s)

SUBCONTRACT DATE

SUBCONTRACT NUMBER

KNOW ALL MEN BY THESE PRESENTS, That we, the Principal and Surety(ies) hereto, are firmly bound to the United States of America and Fermi Research Alliance, LLC, in the above penal sum for the payment of which we bind ourselves, our heirs executors, administrators, and successors, jointly and severally, Provided, That where the Sureties are corporation 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, and for all other purposes such Surety binds itself, jointly and severally with the Principal, for the payment of such sum only as it set forth opposite the name of such Surety, but if no limit of liability is indicated, the limit of liability shall be the full amount of the penal sum.

THE CONDITION OF THIS OBLIGATION IS SUCH, that the Principal entered into the subcontract identified above:

NOW THEREFORE, if the Principal, shall promptly make payment to all persons supplying labor and material in the prosecution of work provided for in said subcontract, and any and all duly authorized modifications of said contract that may hereafter be made, notice of modifications to the Surety(ies) being hereby waived, the above obligation shall be void and of no effect.

IN WITHNESS WHEREOF, the Principal and Surety(ies) have executed this payment bond and affixed their seals on the date set forth above.

PRINCIPAL

Signature(s) 1.

(Seal)

2.

(Seal)

Corporate

Seal Name(s) & Title(s) (Typed)

1. 2.

INDIVIDUAL SURETY(IES)

Signature(s) 1.

2.

Name(s) (Typed)

1.

CORPORATE SURETY(IES)

SU

RE

TY

A

Name & Address

STATE OF INC.

LIABILITY LIMIT

Seal Signature(s) 1. 2.

Name(s) &

Title(s)

1. 2.

FL-42 (Rev. 04/15)

CORPORATE SURETY(IES) (Continued)

SU

RE

B

Title(s) (Typed)

1. 2.

SU

RE

C

Title(s) (Typed)

1. 2.

SU

RE

D

Title(s) (Typed)

1. 2.

SU

RE

E

Title(s) (Typed)

1. 2.

SU

RE

F

Title(s) (Typed)

1. 2.

SU

RE

G

Title(s)

1. 2.

INSTRUCTIONS

1. This form, for the protection of persons supplying labor and material, shall be used whenever a payment bond is required under the Miller Act, as amended (40 U.S.C. 270a-270e). There shall be no deviation from this form.

2. The full legal name and business address of the Principal shall be inserted in the space designated “Principal” on the face of this form.

The bond shall be signed by an authorized person. Where such person is signing in a representative capacity (e.g., and attorney-in-fact), but is not a member of the firm, partnership, or joint venture, or an officer of the corporation involved, evidence of his authority must be furnished.

3. (a) Corporations executing the bond as sureties must be among those appearing on the Treasury Department’s list of approved sureties and must be acting within the limitations set forth therein. Where more than a single corporate surety is involved, their names and addresses (city and State) shall be inserted in the spaces (Surety A, Surety B, etc.)

headed “CORPORATE SURETY(IES),” and in the space designated “SURETY(IES)” on the face of this form only the letter identification of the Sureties shall be inserted.

(b) Where individual sureties execute the bond, they shall be two or more responsible persons. A completed Affidavit of individual surety for each individual surety, shall accompany the bond. Such sureties may be required to furnish additional substantiating information concerning their assets and financial capability as Fermi Research Alliance, LLC, may require.

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

Individual shall execute the bond opposite the word “Seal;” and, if executed in Maine or New Hampshire, shall also affix an adhesive seal.

5. The name of each person signing this payment bond should be typed in the space provided