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ONLINE
BID & PERFORMANCE BOND REQUEST FORM
Use this form
only if you have been pre-approved for bonding by Service Insurance Company,
otherwise see application pages on
website
** You must check all bonds and related
documents prior to bid..
The Service Insurance
Company is not liable for rejected bids **
* required
* required
* required
* required
Bid Bond Only (Please Attach Any Special Forms):
* required
* required
* required
* required
* required
Performance/Payment Bonds Only (Please Attach Award Letter):
* required
* required
Bid Spread (Amount and Name) *required
* required
* required
* required
* required
Has Work Started?
No
Yes - if Yes , Percentage Completed Below
* required
* required
* required
Maintenance Bonds Only ** Principal Affidavit must be signed before maintenance bond is issued**
* required
* required
* required
* required
Length of Term:
1 Year
2 Year
NOTES (ADDITIONAL NOTES IF
REQUIRED)
Fraud Statement and Authorization to Perform Credit and Reference Checks We do not provide coverage where a person makes fraudulent statements to any insurance company, or where a person
files an applicaiton for insurance or bonds or files a statement of claim containing any false information, or conceals for
the purpose of misleading, information omitting any material fact. The aformentioned acts consitute a fraudulent insurance
act, which is a crime, and shall be subject to criminal prosecution, and may also be subject to a civil penalty. I/WE
AUTHORIZE THE SERVICE INSURANCE COMPANY, INC. TO INVESTIGATE MY APPLICATION STATEMENTS AND TO CHECK MY/OUR CREDIT WITH ANY
RESOURCES WHICH MAY INCLUDE BUT ARE NOT LIMITED TO CREDITORS, LENDING INSTITUTIONS, CREDIT BUREAUS OR INVESTIGATIVE SERVICES. By submitting this form electronically you are disclaming the Service Insurance Company, Inc. of any responsibility
for the interception or misuse of this data.
Any further bond support will require a full original signature of
a hardcopy verson of the above completed application and will require the perfection of a General Indemnity Agreement. The contractor is responsible to provide Service Insurance Company with all of the proper bond, consent or related
documents prior to submitting; The Service Insurance Company disclaims all liability for errors or omissions. The Service Insurance Company Reserves the right to decline any applicant for any reason.
* required
TO ACKNOWLEDGE THAT YOU WILL BE SUBMITTING THIS APPLICATION FOR CREDIT CHECK, YOU MUST 1.) INSERT APPLICANTS EMAIL
ADDRESS IN SPACE PROVIDED ABOVE FOR VERIFICATION; 2.) ENTER YOUR FIRST, MIDDLE AND LAST NAME AND DATE BELOW;
3.) CLICK "SUBMIT" BUTTON.
* required
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