CSIS Insurance

Contractors License

Contractor's License Bond

Because of the delicate and important nature of a construction undertaking, contractors license bonds are often an absolutely necessary component of the building industry. With so many safety factors to consider and public legal issues, the importance of such bonds becomes quite apparent.

Before even the simplest construction projects can begin, a wide variety of licenses and permits must be obtained. Failure to honor such legal matters or engaging in practices that may endanger the health of workers or the public is an extremely serious matter that could cost a great deal.

Contractors license bonds ensure that a company is indeed fully qualified to be doing what it's doing. If failure to meet required guidelines leads to a loss in time and finances on the part of the person or organization hiring a contractor, then that contractor must make good by taking full responsibility and offering due compensation for that loss.

1. General Information

Contractor License Number:

Desired effective date of Bond:

Current Bond Carrier:

Bond Number:

Expiration Date:

* Business Name in Full:

INDIVIDUAL
PARTNERSHIP
CORPORATION
OTHER

* Phone

Fax

E-mail Address

Mailing Address
* Street Address
* City
* State	* Zip

Premise Address
Street Address
City
State	Zip

3. No. of Years in Business

4. If Bond Qualifying Individual, provide name & address of firm:

5. Personal Information for Applicant, Partners, and indemnitors.

1.	Name
	Marital Status
	Date of Birth
	Social Security #:
	Drivers License #:

2.	Name
	Marital Status
	Date of Birth
	Social Security #:
	Drivers License #:

3.	Name
	Marital Status
	Date of Birth
	Social Security #:
	Drivers License #:

4.	Name
	Marital Status
	Date of Birth
	Social Security #:
	Drivers License #:

6. Comments

INDEMNITY AGREEMENT - READ CAREFULLY

I/we the undersigned hereby declare that the above statements are true and correct. I/we hereby apply to CSIS Inc. for a Contractors License Bond pursuant to the appropriate sections of the Business and Professions Code. I/we agree individually and as a firm to fully indemnify and hold CSIS Inc. harmless from and against any and all claims or demands or legal expense of any kind or nature which arise by reason of the execution of any bond issued pursuant to this application.

I/we further understand the bond applied for is a credit relationship, and hereby authorize CSIS Inc. or its authorized agents, to gather such credit information it considers necessary and appropriate for purposes of evaluating whether such credit should be granted or continued. I/we agree to pay Surety an advance premium for the first year or a fractional part thereof that is fully earned and to pay annually thereafter such annual premium for surety ship as is billed until satisfactory evidence of discharge or release of liability shall be furnished to Surety by the obligee.

Initials (required):

Contact:

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LICENSE #: OD80851

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