Contractor / Sub-contractor Registration Bond

Open blank official PDF

Type the details on screen and print. Nothing is transmitted from this page.

Your surety company completes this bond

A bond is only valid once it carries an embossed seal or surety sticker and the signatures of the principal, the surety and the attorney-in-fact. Those cannot be added on screen. Fill in what you know, print it, and take it to your surety or insurance agent to complete, seal and sign.

The bond must expire on December 31st of the registration year. File the original with the Building Department together with your Contractor / Sub-Contractor Registration.

Pickaway County Building Department

124 West Franklin Street, Circleville, Ohio 43113 · Phone 740.477.8282 · Fax 740.477.8265

Contractor / Sub-contractor Registration Bond

Bond

KNOW ALL MEN BY THESE PRESENTS, THAT WE, the Principal named above, and the Surety named above, are held and firmly bound to PICKAWAY COUNTY, OHIO, as Obligee in the penal sum of Fifteen Thousand Dollars ($15,000.00) for the payment of which well and truly be made we bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and severally, firmly by these presents.

Signed, sealed and dated

THE CONDITIONS OF THE ABOVE OBLIGATION ARE SUCH THAT:

WHEREAS, the above principal has or is about to apply to said COUNTY OF PICKAWAY for a license/registration in accordance with PICKAWAY COUNTY RESOLUTION PC-071408-1; and,

Term of the bond

NOW THEREFORE, the conditions of this obligation are such that if the principal shall well and truly comply with and faithfully discharge his duties according to the terms of said resolution, then this obligation shall be void, otherwise to be and remain in full force and effect, provided, however, that the surety may (1) cancel this bond at any time by giving fifteen (15) days notice in writing by registered mail to the Pickaway County (Ohio) Building Department, but such cancellation or termination shall not affect any liability incurred or accrued prior to the effective date of such written notice, and (2) this bond may extend or continue for annual periods of one (1) year by issuance of a Continuation Certificate as evidence therefore of such continuation by the Surety.

Surety

Signature (sign after printing)

Date (sign after printing)

Principal

Signature (sign after printing)

Date (sign after printing)

Attorney-in-Fact

Signature (sign after printing)

Date (sign after printing)

Affix the embossed seal or surety sticker before filing.

Nothing on this page is transmitted to the county. Print it, sign it, and deliver it as the form directs.