Bond Application
PLEASE PRINT OR TYPE
GENERAL INFORMATION
Contractor: Federal Tax I.D. Number:
Address:
Email:
Contact Person: Telephone Number:
License Number: License Class:
OPERATION
Form of Business (check one): Proprietorship Partnership Corporation
Labor Affiliation: Union Non-Union
Scope of Operations (specify):
Territory or region of operations:
Percentage of work obtained as: Prime % Sub %
Percentage of projects: Government % Private %
How much of an average job is: Sublet % Materials %
Are bonds required from your subcontractors? Yes No
If not, under what circumstances are sub bonds waived?
Are there any affiliated companies? Yes No
If yes, please provide background information on each entity. (Please use separate attachment.)
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HISTORY
Date incorporated or established: Surety companies who have furnished bonds in the past:
Surety Agent Telephone Number
Have you ever been denied surety credit? Yes No
Has your bonding credit ever been terminated by a surety? Yes No
Have any of your bonded jobs resulted in a loss to a surety? Yes No
Has your firm and/or you personally ever petitioned for bankruptcy, failed in business, or defaulted on a
contract?
Yes No
Has your firm ever been involved in any litigation or disputes? Yes No
Has your firm ever had any tax liens? Yes No
If you answered "Yes" to any of these questions, please explain. (Please use separate attachment.)
Organization owners and key employees (Attach Résumés)
Name Position Ownership Years in Years
Construction with
Company
Does a formal buy-sell agreement exist? Yes No If so, how is it funded?
Has your company purchased key man life insurance on behalf of key employees? Yes No
If so, please identify each employee as well as the dollar amount of coverage.
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CREDIT DATA AND REFERENCES
Banking Relations
Financial Institution and Address Maximum Current Security
Line of Balance
Credit
Principal Suppliers
Name Materials Address Telephone
Provided Number
ACCOUNTING AND FINANCIAL REPORTING
Accounting for Applicant
Name: Telephone Number:
Fiscal year end? Gross sales previous fiscal year end?
Are financial statements prepared on a regular basis other than year end? Yes No
Are payroll taxes current? Yes No If not, explain. (Please use separate
attachment.)
Basis of preparation of statements: Tax payments:
Cash Completed Contract Cash Completed Contract
Simple Accrual % of Completion Simple Accrual % of Completion
Have there been any major changes in financial condition since last statement date with respect to:
Ownership Major loans or refinancing Major equipment purchases or leases Withdrawals
Other?
If so, describe. (Please use separate attachment.)
Internal cost accounting records provide job status reports:
Weekly Monthly Quarterly Other (describe):
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EXPERIENCE
Largest Contracts Completed in the last five years.
Contract Date Owner Location Job Description Contact Telephone
Amount Completed Person Number
Largest previous backlog: When?
Are all current projects on schedule and profitable? Yes No If not, explain. (Please
use separate attachment.)
What size projects do you feel are best suited to your general operational requirements?
Anticipated uncompleted backlog:
Anticipated annual volume?
Is your equipment: owned leased
Do you have adequate equipment on hand to support anticipated volume? Yes No
If not, what capital expenditures are anticipated?
WE GRANT THE SURETY/BANK AUTHORIZATION TO INVESTIGATE MY/OUR STATEMENTS AND TO CHECK MY/OUR CREDIT WITH ANY CREDITORS OR
LENDING INSTITUTIONS.
WE ALSO GRANT AUTHORIZATION TO OBTAIN INFORMATION FROM MY/OUR BROKER, BANKER, AND/OR CPA ONLY TO BE USED FOR THE PROGRAM.
DISCLOSURE. CONTRACTOR UNDERSTANDS AND AGREES THAT UNDER THE STATE PUBLIC RECORDS LAW (GOV'T CODE SECTION 6250 ET SEQ.), APPLY TO THIS
APPLICATION AND ANY AND ALL RECORDS, INFORMATION, AND MATERIALS SUBMITTED TO THE CITY IN CONNECTION WITH THIS APPLICATION.
ACCORDINGLY, ANY AND ALL SUCH RECORDS, INFORMATION AND MATERIALS MAY BE SUBJECT TO PUBLIC DISCLOSURE IN ACCORDANCE WITH THE STATE
PUBLIC RECORDS LAW. CONTRACTOR HEREBY AUTHORIZES THE CITY TO DISCLOSE ANY RECORDS, INFORMATION AND MATERIALS SUBMITTED TO THE CITY IN
CONNECTION WITH THIS APPLICATION.
SIGNED THIS DAY OF , 20 .
___________________________________ ____________________________________
SIGNATURE NAME AND TITLE (please print or type)
Program [Link]
[Link] SBP-Aug-2015
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