Fillable Form 115 - Alcoholic Liquor Tax Bond

ALCOHOLIC LIQUOR TAX BOND

NEBRASKA LIQUOR CONTROL COMMISSION

301 CENTENNIAL MALL SOUTH

PO BOX 95046

LINCOLN, NE 68509-5046

PHONE: (402) 471-2571

FAX: (402) 471-2814

Website:

KNOW ALL MEN BY THESE PRESENTS:

That we, __________________________________________of the County of_____________________, State of

Nebraska as Principal, and State of _______________________________, and duly licensed to transact the

business of surety insurance in the State of Nebraska, as Surety, are held and firmly bound unto the State of

Nebraska, and the City (Village) of ________________________in ____________________County, Nebraska,

and the Nebraska Liquor Control Commission and each of them jointly or severally, in the penal sum of

________________________DOLLARS ($___________) for the payment of which, we bind ourselves, our heirs,

executors, administrators, successors and assigns, jointly, severally and firmly by these presents.

The condition of this obligation is such that,

WHEREAS, the said __________________________________________________ has made application under

the Nebraska Liquor Control Commission Act for the following license(s) check each that apply:

____ Class L-Craft Brewery

____ Class W-Wholesale Beer ____ Class V-Manufacturer (beer, wine, spirits)

____ Class Y-Farm Winery

____ Class X-Wholesale Liquor

____ Class Z-Micro Distillery

NOW, THEREFORE, upon application for such license and continuing after the issuance of the same to the said

principal above named, if the said principal hereinabove named shall faithfully perform all the terms and

conditions of said license(s), and shall promptly account for and pay to the proper authorities all lawful taxes, fees,

assessments that have accrued during the term of said license or licenses, and all fines, penalties and costs which

shall become due from or shall be levied, charges or adjudged against said principal on account of defaults

occurring during the entire effective period of this bond, under the provisions of said Act by said Commission, or

any court or other lawful authority; and shall truly and faithfully comply as such licensee with all of the provisions

of said Act of the Legislature and all future Nebraska Liquor Control laws which may be enacted during the term

of such license or licenses, and shall truly and faithfully comply with all lawful rules and regulations of said

Commission, and said City (Village) during the term of said license or licenses, then this obligation shall be null

and void.

OTHERWISE, to be and remain in full force and effect;

This Bond shall run concurrently with the term of said license or licenses granted to the principal, and shall remain

in full force and effect for any renewal thereof, provided, however, that the penalty of the Bond may not be

cumulative from year to year, and the total aggregate liability of the surety shall not exceed $_________________,

regardless of the number of claims made under this Bond and the number of years this Bond remain in effect.

The surety may cancel this Bond by providing 60 days prior written notice of such cancellation to the Nebraska

Liquor Control Commission, but the surety providing such notice shall not be discharged from any liability already

accrued under this Bond or which shall accrue under this Bond before expiration of said 60 day period. Upon

cancellation of this Bond, the surety shall be relieved of liability accruing after the effective date of cancellation,

and the rights of the principal under such license, as is supported by said Bond, shall be cancelled and terminated

on the date specified, unless the principal provides a sufficient replacement Bond.

Page 1 of 2

REV APRIL 2016

FORM 115

Form 115 - Alcoholic Liquor Tax Bond - 2016

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