Form Au-961 - Verification Bond Page 2

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Instructions
Part I: Enter the name and complete address of
the nonresident contractor furnishing the bond.
Include the nonresident contractor’s Connecticut
tax registration number.
Part II: Enter the name and complete address of
the surety company that guarantees this bond.
Include the bond number. Complete Columns A,
B, and C. Please note that the minimum bond is
$10,000.
Part III: Enter the verification period. This period
must be two years beginning January 1 of the
period for which the verification is requested and
ending two years later on December 31 of that
year.
Part IV: Conditions of the obligation
The nonresident contractor has entered into a
contract or contracts related to real property at
a Connecticut location.
The nonresident contractor and the surety
company are posting a bond of 5% of the
amount that is twice the receipts from any
proposed work in Connecticut to occur within
the verification period.
If the nonresident contractor pays all taxes,
interest, and penalties within three years from
the last day of the month succeeding the
reporting period in which the contractor posted
the bond, the bond expires; otherwise the
obligation remains in full force.
This bond jointly and severally binds the
nonresident
contractor
and
the
surety
company,
their
heirs,
executors,
administrators, successors, and assigns for
payment of this obligation.
Declarations:
An authorized representative for
the
nonresident
contractor
and
the
surety
company must sign and date the declaration on
Form AU-961.
The name of the nonresident
contractor and the surety company must be
exactly as it appears on the bond.
The raised
corporate seal of the surety company must be
affixed by its signature on Form AU-961.
Form AU-961
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