Performance Bond form.pdf
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- Attached to
- Camera/DVR system for Jackie Withrow Hospital
- Solicitation number
- ARFQ 0506 JWH2300000001 2
- Issued by
- Raleigh County, West Virginia
About this file
This is a Performance Bond form template approved by the Attorney General for use in state and local contract opportunities. The document establishes a three-party agreement between a contractor (principal), a surety company, and a government owner obligee. The bond obligates the contractor and surety to perform all work in accordance with the underlying contract, drawings, and specifications. The form requires completion of contractor and surety information, including complete addresses and legal titles, along with the bond amount in dollars. The contractor's signatory must hold the position of President, Vice President, Owner, Partner, Manager, or Member, and the surety's signatory must be authorized through a current Power of Attorney demonstrating full force and effect on the bond signature date.
The bond requires notarization in three separate sections depending on the principal's business structure: individual or partnership acknowledgment (lines 1-8), corporation acknowledgment (lines 9-18), and surety acknowledgment (lines 19-28). All notarizations must be dated the same as or later than the bond signature date and include the notary's seal and commission expiration date. Mandatory raised corporate seals must be affixed to both the principal and surety signature blocks, and a certified Power of Attorney must be attached to the bond. Upon the contractor's default, the surety is obligated either to remedy the default or complete the contract in accordance with its terms and conditions while saving the owner harmless from claims, judgments, or liens. The bond contains no expiration date specification within the form itself, though the bond remains in effect until contract performance is complete or obligations are fulfilled.
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Text version
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS:
That (Contractor name, complete address including ZIP Code and legal title) as Principal, hereinafter called Contractor, and a corporation organized and existing under the laws of the State of , with its principal office in the City of as Surety, hereinafter called Surety, are held firmly bound unto (Owner name, complete address including ZIP Code and legal title) as Obligee, hereinafter called Owner, in the amount of
), for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.
WHEREAS, Contractor has by written agreement dated entered into a contract with Owner for in accordance with drawings and specifications prepared by which contract is by reference made a part hereof, and is hereinafter referred to as the CONTRACT.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, promptly and faithfully Perform and CONTRACT, then this obligation shall be null and void, otherwise it shall remain in full force and effect.
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Whenever Contractor shall be, and declared by Owner to be in default under the CONTRACT, the Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the default, or shall promptly:
1. Complete the CONTRACT in accordance with its terms and conditions, and
2. Shall save the Owner harmless from any claims, judgments, or liens arising from the Surety's failure to either remedy the default or to complete the CONTRACT in accordance with its terms and conditions in a timely manner.
No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the successors of Owner.
Signed and sealed this *
Principal Raised Corporate Seal (MUST BE AFFIXED)
Surety Raised Corporate Seal (MUST BE AFFIXED)
NOTE: Raised Corporate Seals are mandatory.
Please attach Power of Attorney.
*Power of Attorney must be certified on this date or later.
day of
(Seal) (Contractor Name)
(Must be President, Vice President, Owner, Partner, Manager or Member)
NOTE: Applicable sections of attached acknowledgments must be completed and returned as part of the bond.
APPROVED AG 08-20-09
(Title)
(Surety)
(Surety name and complete address including ZIP Code)
.20
Dollars (
(Seal)BY:
(Seal)BY:
ACKNOWLEDGMENTS
Acknowledgment by Principal if individual or Partnership
1. STATE OF
2. County of
3. I,
4. county and state aforesaid, do hereby certify that
5. Given under my hand this day of 20 whose name is signed to the foregoing writing, has this day acknowledged the same before me in my said county.
6. Notary Seal (Notary Public)
8. My commission expires on the day of 20
20day of18. My commission expires on the
(Notary Public)
16. Notary Seal
20day of15. Given under my hand this
12. county and state aforesaid, do hereby certify that
11. I,
10. County of
9. STATE OF
Acknowledgment by Principal if Corporation
20day of28. My commission expires on the
(Notary Public)
26. Notary Seal
20day of25. Given under my hand this has this day, in my said county, before me, acknowledged the said writing to be the act and deed of the said corporation.
22. county and state aforesaid, do hereby certify that
21. I,
20. County of
19. STATE OF
Acknowledgment by Surety to-wit:
, a Notary Public in and for the
, a Notary Public in and for the
13. who as, signed the foregoing writing for
14. a corporation,
23. who as, signed the foregoing writing for
24. a corporation, Sufficiency in Form and Manner of Execution Approved Attorney General
(Deputy Attorney General) to-wit:
to-wit:
, a Notary Public in and for the has this day, in my said county, before me, acknowledged the said writing to be the act and deed of the said corporation.
7.
17.
27.
By:
This ______ day of _______________________20____.
ACKNOWLEDGMENT PREPARATION INSTRUCTIONS
1. IF PRINCIPAL IS AN INDIVIDUAL OR PARTNERSHIP, HAVE NOTARY COMPLETE LINES (1) THROUGH (8).
2. IF PRINCIPAL IS A CORPORATION, HAVE NOTARY COMPLETE LINES (9) through (18).
3. SURETY MUST HAVE NOTARY COMPLETE LINES (19) through (28).
4. Notaries must:
ACKNOWLEDGMENT BY PRINCIPAL, IF INDIVIDUAL OR PARTNERSHIP
1. Enter name of State.
2. Enter name of County.
3. Enter name of Notary Public witnessing transactions.
4. Enter name of principal covered by bond if individual or partnership. (Must be Owner or General Partner of Sole Proprietorship or Partnership)
5. Notary enters date bond was witnessed. Must be the same as or later than signature date.
6. Affix Notary Seal.
7. Notary affixes his/her signature.
8. Notary enters commission expiration date.
ACKNOWLEDGMENT BY PRINCIPAL IF CORPORATION
9. Enter name of State.
10. Enter name of County.
11. Enter name of Notary Public witnessing transactions.
12. Enter name of Corporate Officer signing bond.
13. Enter Title of Corporate Officer signing bond. (Must be President or Vice President of Corporation; Manager or Managing Member of Limited Liability Company)
14. Enter name of Company or Corporation.
15. Notary enters date bond was witnessed. Must be the same as or later than signature date.
16. Affix notary Seal.
17. Notary affixes his/her signature.
18. Notary enters commission expiration date.
ACKNOWLEDGMENT BY SURETY
19. Enter name of State.
20. Enter name of County.
21. Enter name of Notary Public witnessing transactions.
22. Enter name of person having power of attorney to bind Surety Company.
23. Enter Title of person binding Surety Company.
24. Enter name of Insurance Company (Surety).
25. Notary enters date bond was witnessed. Must be the same as or later than signature date.
26. Affix Notary Seal.
27. Notary affixes his/her signature.
28. Notary enters commission expiration date.
POWER OF ATTORNEY INSTRUCTIONS
Power of attorney for surety must be attached showing that it was in full force and effect on signature date indicated on the face of the bond. A raised corporate seal must also be affixed to the Power of Attorney form.
a. Name of attorney in fact must be listed.
b. Power of Attorney may not exceed imposed limitations.
c. Certificate date, the signature date of bond must be entered.
d. Signature of authorizing official must be affixed. (Signature may be facsimile).
e. Raised seal must be affixed.
PERFORMANCE BOND
KNOW ALL MEN BY THESE PRESENTS:
(Contractor name, complete address including ZIP Code and legal title) a corporation organized and existing under (Owner name, complete address including ZIP Code and legal title) ), for the payment whereof Contractor and Surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by these presents.
which contract is by reference made a part hereof, and is hereinafter referred to as the CONTRACT.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION is such that if Contractor shall, promptly and faithfully Perform and CONTRACT, then this obligation shall be null and void, otherwise it shall remain in full force and effect.
The Surety hereby waives notice of any alteration or extension of time made by the Owner.
Whenever Contractor shall be, and declared by Owner to be in default under the CONTRACT, the Owner having performed Owner's obligations thereunder, the Surety may promptly remedy the default, or shall promptly:
1. Complete the CONTRACT in accordance with its terms and conditions, and
2. Shall save the Owner harmless from any claims, judgments, or liens arising from the Surety's failure to either remedy the default or to complete the CONTRACT in accordance with its terms and conditions in a timely manner.
No right of action shall accrue on this bond to or for the use of any person or corporation other than the Owner named herein or the successors of Owner.
Principal Raised Corporate Seal (MUST BE AFFIXED) Surety Raised Corporate Seal (MUST BE AFFIXED) NOTE: Raised Corporate Seals are mandatory.
Please attach Power of Attorney.
*Power of Attorney must be certified on this date or later.
(Seal) (Contractor Name) (Must be President, Vice President, Owner, Partner, Manager or Member)
NOTE: Applicable sections of attached acknowledgments must be completed and returned as part of the bond.
APPROVED AG 08-20-09
(Title) (Surety) (Surety name and complete address including ZIP Code) (Seal)
BY:
(Seal)
BY:
ACKNOWLEDGMENTS
Acknowledgment by Principal if individual or Partnership whose name is signed to the foregoing writing, has this day acknowledged the same before me in my said county.
6. Notary Seal (Notary Public) (Notary Public)
16. Notary Seal Acknowledgment by Principal if Corporation (Notary Public)
26. Notary Seal has this day, in my said county, before me, acknowledged the said writing to be the act and deed of the said corporation.
Acknowledgment by Surety to-wit:
, a Notary Public in and for the , a Notary Public in and for the signed the foregoing writing for a corporation, signed the foregoing writing for a corporation, Sufficiency in Form and Manner of Execution Approved Attorney General (Deputy Attorney General) to-wit:
to-wit:
, a Notary Public in and for the has this day, in my said county, before me, acknowledged the said writing to be the act and deed of the said corporation.
7.
17.
27.
By:
This ______ day of _______________________20____.
ACKNOWLEDGMENT PREPARATION INSTRUCTIONS
1. IF PRINCIPAL IS AN INDIVIDUAL OR PARTNERSHIP, HAVE NOTARY COMPLETE LINES (1) THROUGH (8).
2. IF PRINCIPAL IS A CORPORATION, HAVE NOTARY COMPLETE LINES (9) through (18).
3. SURETY MUST HAVE NOTARY COMPLETE LINES (19) through (28).
4. Notaries must:
ACKNOWLEDGMENT BY PRINCIPAL, IF INDIVIDUAL OR PARTNERSHIP
1. Enter name of State.
2. Enter name of County.
3. Enter name of Notary Public witnessing transactions.
4. Enter name of principal covered by bond if individual or partnership. (Must be Owner or General Partner of Sole Proprietorship or Partnership)
5. Notary enters date bond was witnessed. Must be the same as or later than signature date.
6. Affix Notary Seal.
7. Notary affixes his/her signature.
8. Notary enters commission expiration date.
ACKNOWLEDGMENT BY PRINCIPAL IF CORPORATION
9. Enter name of State.
10. Enter name of County.
11. Enter name of Notary Public witnessing transactions.
12. Enter name of Corporate Officer signing bond.
13. Enter Title of Corporate Officer signing bond. (Must be President or Vice President of Corporation; Manager or Managing Member of Limited Liability Company)
14. Enter name of Company or Corporation.
15. Notary enters date bond was witnessed. Must be the same as or later than signature date.
16. Affix notary Seal.
17. Notary affixes his/her signature.
18. Notary enters commission expiration date.
ACKNOWLEDGMENT BY SURETY
19. Enter name of State.
20. Enter name of County.
21. Enter name of Notary Public witnessing transactions.
22. Enter name of person having power of attorney to bind Surety Company.
23. Enter Title of person binding Surety Company.
24. Enter name of Insurance Company (Surety).
25. Notary enters date bond was witnessed. Must be the same as or later than signature date.
26. Affix Notary Seal.
27. Notary affixes his/her signature.
28. Notary enters commission expiration date.
POWER OF ATTORNEY INSTRUCTIONS
Power of attorney for surety must be attached showing that it was in full force and effect on signature date indicated on the face of the bond. A raised corporate seal must also be affixed to the Power of Attorney form.
a. Name of attorney in fact must be listed.
b. Power of Attorney may not exceed imposed limitations.
c. Certificate date, the signature date of bond must be entered.
d. Signature of authorizing official must be affixed. (Signature may be facsimile).
e. Raised seal must be affixed.
8.2.1.4029.1.523496.503679
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