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DocuSign Envelope ID:07A4359F-6D47-4987-B1F1-BF667ACBB3BA <br /> PAYMENT BOND <br /> Contractor Surety <br /> Name: [Full formal name of Contractor] Name: [Full formal name of Surety] <br /> Address(principal place of business): Address (principal place of business): <br /> [Address of Contractor's principal place of [Address of Surety's principal place of business] <br /> business] <br /> Owner Contract <br /> Name: [Full formal name of Owner] Description (name and location): <br /> Mailing address(principal place of business): [Owner's project/contract name, and location of <br /> [Address of Owner's principal place of business] the project] <br /> Contract Price: [Amount,from Contract] <br /> Effective Date of Contract: [Date,from Contract] <br /> Bond <br /> Bond Amount: [Amount] <br /> Date of Bond: [Date] <br /> (Date of Bond cannot be earlier than Effective Date of Contract) <br /> Modifications to this Bond form: <br /> ❑ None ❑ See Paragraph 18 <br /> Surety and Contractor, intending to be legally bound hereby, subject to the terms set forth in this <br /> Payment Bond, do each cause this Payment Bond to be duly executed by an authorized officer, agent, or <br /> representative. <br /> Contractor as Principal Surety <br /> (Full formal name of Contractor) (Full formal name of Surety)(corporate seal) <br /> By: By: <br /> (Signature) (Sign a ture)(A ttach Power of Attorney) <br /> Name: Name: <br /> (Printed or typed) (Printed or typed) <br /> Title: Title: <br /> Attest: Attest: <br /> (Signature) (Signature) <br /> Name: Name: <br /> (Printed or typed) (Printed or typed) <br /> Title: Title: <br /> Notes:(1)Provide supplemental execution by any additional parties,such as joint venturers. (2)Any singular reference to <br /> Contractor,Surety,Owner,or other party is considered plural where applicable. <br /> EJCDC®C-615,Payment Bond. <br /> Copyright°2018 National Society of Professional Engineers,American Council of Engineering Companies, <br /> and American Society of Civil Engineers.All rights reserved. <br /> Page 1 of 4 <br />