Form L-195 - Bond Of Bail Bond Agent printable pdf download

INSURANCE LICENSING SECTION

2910 NORTH 44TH STREET, SUITE 210

PHOENIX, ARIZONA 85018-7256

BOND NUMBER: ____________________

BOND OF BAIL BOND AGENT (FORM L-195)

I/We, __________________________________________________________, as Principal for an

Arizona Bail Bond Agent license and _________________________________________, as an admitted

surety insurer (“Surety”), bind ourselves to the penal sum of Ten Thousand Dollars ($10,000.00) to the

People of the State of Arizona. The total aggregate liability under this bond is limited to Ten Thousand

Dollars ($10,000.00).

The conditions of this obligation are such that if the Principal is granted a Arizona Bail Bond Agent

license, Principal shall make full accounting and due payment to the person entitled to this bond of monies

and collateral coming into the Principal’s possession as an incident to bail bond transactions under the

license.

This bond shall remain in force as prescribed by Arizona Revised Statutes § 20-320 until released by

the Director of Insurance or until canceled by the Surety. Without prejudice to any liability previously

incurred thereunder, the Surety may cancel the bond upon thirty (30) days advanced written notice filed with

the Director of Insurance.

Dated this _______ day of ____________________,

__________________________________________

Full Signature of Principal (Bail Bond Agent)

(including FULL first, middle and last names)

__________________________________________

Full Name of Surety Insurer

By:

__________________________________________

Attorney-in-fact

Countersigned at:

(Affix Surety

________________________________ (City/State)

company seal)

_______________________________________

Signature of Surety’s Agent

(Other Than Principal)

Any surety company duly authorized to transact insurance business in the State of Arizona may become

Surety on this bond.

This bond must be countersigned by a licensed resident Arizona agent of the Surety. A power of attorney

must be attached to this bond. This bond must be signed by the Principal and the Surety’s attorney-in-fact.

Form L-195 (Effective 02/99)

Form L-195 - Bond Of Bail Bond Agent