R S Bonding & Insurance Agency, Inc



BOND REQUEST

| |      | Contact:|      |

|Contractor: | | | |

|Address: |      |Phone: |      |

|City/State/Zip: |      |Fax: |      |

| Project Name: |      |

| Job Description: |      |

|      |

|      |Job / Bid #: |      |

| CONTRACT PRICE:|      | Engineer’s Est.: |      |

| | | BID BOND | | |FINAL BOND* | |

| | | | | | |

|Due : |      | Time: |      | |   |

|Percentage: |   | | Bond Form: | |Attached |

|Bond Form: | |Attached | | |Surety Co. Form |

| | |Surety Co. Form |* Please include copy of CONTRACT |

| | | | |

|Obligee: |      |Contact: |      |

|Address |      |Phone: |      |

|City/State/Zip: |      |Fax: |      |

| | | | |

|Start Date: |      |Days to Complete: |      |Liquidated Damages: |      |

|Retainage: |      |Warranty Period: |      |Payment Method: |      |

| | | | | | |

|Cost to Complete ALL Work in Progress: $ |      | As |      |

| | |of: | |

|JOB BREAKDOWN | | |MAJOR SUBS | | | |

| |      |% Subbed | |      |Amount: $ |      | |

| | | |Trade: | | | | |

| |      |% Material | |      |Amount: $ |      | |

| | | |Trade: | | | | |

| |      |% Labor | |      |Amount: $ |      | |

| | | |Trade: | | | | |

| |      |% Profit | |      |Amount: $ |      | |

| | | |Trade: | | | | |

| | | | | | | | |

For use after Bid Bond Issuance

BID RESULTS

Please fax results to R S Bonding within 5 days

|Low Bidder: |      |Amount: $ |      |

|2nd Bidder: |      |Amount: $ |      |

|3rd Bidder: |      |Amount: $ |      |

|Your Bid: |      |Amount: $ |      |

1633 E. 4th St., Suite 228, Santa Ana, CA. 92701 Tel: (714) 541-4700 Fax: (714) 541-4740

Email: Randy@ OR Matt@

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