OMB Control No: 3245-0007
Expiration Date: 02/29/2016
U.S. SMALL BUSINESS ADMINISTRATION
SURETY BOND GUARANTEE AGREEMENT
Terms and Conditions of Agreement on Page 2
1. Surety Name
2. Business Name:
Business Trade Name:
3. Co-Surety Name + Percentage
4. Principal’s Address:
Street:
City, State, Zip and County
5. Principal’s Name
7. □ Bid
6. CONTRACT – Description of nature and extent (volume) of work:
Bid Date:
Bid Time:
Project Location:
□ Negotiated
Project Start Date:
Anticipated Completion Date:
If contractor has started work an SBA Form 991 must be submitted to SBA before the Guarantee Agreement can be executed.
8. Obligee Name:
Address (Street, City, State, Zip, County)
BLOCKS 9-10 TO BE COMPLETED FOR BID BOND GUARANTEES.
9. Estimated Contract Amount:
10. Bid Bond Percentage
BLOCKS 11-21 TO BE COMPLETED FOR CONTRACTS AWARDED AND FINAL BOND GUARANTEES.
11. Date of Contract Award
12. Contract Amount
13. Maintenance Bond / Agreement
Amount
Years
14. Payment Bond Number
15. Payment Bond Amount
Ancillary Bond
□ Yes
□ No
Type
16. Bid Spread
17. Performance Bond Number
18. Performance Bond Amount
nd
rd
Low $
2
Low $
3
Low $
19. Contractor Fee Amount:
20. Premium and Rate Charged by Surety:
21. Surety Fee Amount:
BLOCKS 22-28 TO BE COMPLETED FOR CONTRACT/BOND AMOUNT CHANGES AND SHOULD SPECIFY THE INCREASE/DECREASE
CONTRACT, PREMIUM AND FEE AMOUNTS.
22. Increase
23a. Original Contract Amount
23b. Revised Contract Amount
24. Payment Bond Amount
25. Performance Bond Amount
Decrease
26. Contractor Fee Amount:
27. Premium and Rate Charged by Surety:
28. Surety Fee Amount:
In my opinion the Principal appears to have the financial management and technical abilities to successfully complete this contract. However, I have determined
that the Principal falls below the normal underwriting standard of this Surety, who will not issue this bond without the SBA guarantee. By signing below, I
certify that I have been authorized by the Surety identified in Box 1 to obligate Surety to the terms and conditions stated on page 2 of this agreement and that
all information provided in connection with the Surety’s application for a surety bond guarantee from SBA is true, correct and complete to the best of my
knowledge. I understand that knowingly making a false statement is a violation of Federal law and could result in criminal prosecution or civil penalties under
18 U.S.C. § § 287, 371, 1001, 15 U.S.C. § 645, or 31 U.S.C. § 3729.
29. Signature of Surety’s Attorney-in-Fact:
30. Date:
Typed Name:
Agency Name:
By its authorized signature, SBA agrees to guarantee the bond described herein as of the time of issuance, subject to 15 U.S.C. § 694a and b, SBA regulations in
13 CFR Part 115, and the terms and conditions stated on page 2 of this Agreement. In providing this guarantee, SBA relies on the declarations above and on the
forms submitted and signed by the Surety as applicable. This guarantee shall become effective upon the Surety’s execution (as defined in such regulations) of the
SBA-guaranteed bond. SBA guarantees ________ % of the loss in consideration of _______ % of the surety’s own premium base.
31. SBA Signature:
32. Title:
33. Date:
Type Name:
Disposition: Approved Returned/Withdrawn Declined
34. SBG Number:
SBA FORM 990 (1/13) Previous Editions are Obsolete
1