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Executed in counterparts. <br /> <br />Witness: ____________________________________ <br /> Contractor: (Trade or Corporate Name) <br /> <br /> _______________________________ By: ________________________________ <br />(Proprietorship or Partnership) <br /> <br />Attest: (Corporation) Title: _______________________________ <br /> (Owner, Partner, or Corp. Pres. or Vice <br />Pres. only) <br /> <br /> <br />By: _______________________________ <br /> <br />Title: ______________________________ <br /> (Corp. Sec. or Asst. Sec. only) <br /> <br /> <br /> (Corporate Seal) <br /> <br /> <br /> <br /> <br /> <br /> ___________________________________ <br /> (Surety Company) <br /> <br />Witness: By: ________________________________ <br /> <br />________________________________ Title: _______________________________ <br /> (Attorney in Fact) <br /> <br /> <br />Countersigned: <br /> <br />________________________________ (Surety Corporate Seal) <br /> <br />________________________________ <br />(N.C. Licensed Resident Agent) <br /> <br /> <br />________________________________ <br /> <br />________________________________ <br />Name and Address-Surety Agency <br /> <br /> <br />________________________________ <br /> <br />________________________________ <br />Surety Company Name and N.C. <br />Regional or Branch Office Address <br />DocuSign Envelope ID: 89558C18-938A-4BFF-B14A-A2214E8AA5DD