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Partnership Account Contract Surety Checklist & Account Reservation
 
IMPORTANT: Please submit this form prior to submitting any application for contract surety. Upon receipt, we will review your checklist to determine the acceptability of the account or notify you if it has been previously submitted, rejected or under consideration. After we reserve your submission, all underwriting information must be submitted within 10 business days.
 

 
* required
 * Agency Affiliate ID
 * Account Name
* Address
* City
* State
* Zip Code
* Phone
* Fax
* E-mail
* Name of Owner
* Title
Name of Owner
Title

 

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Please note: Do not continue if you cannot answer “yes” to the following questions?
  • This account has been in business for five (5) years under the same ownership.
  • This account will generate a minimum annual premium of $15,000.
  • A Contractor’s Information form will be completed with all questions answered and ALL attachments will be included with the submission.
  • An accountants cover letter will be included with each financial statement submitted.
  • Financial Statements indicate Positive Working Capital.
  • Financial Statements indicate Positive Company Equity (NET WORTH).
  • Financial Statements do not reflect Two Years Of consecutive Losses.
  • The Debt to Equity Ratio is not more than TWO Times the company’s equity. (NET WORTH)
    Yes

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* What is the name of the accounts current or most recent bonding company?

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* Why are they changing bonding companies? 

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* What bond limits are they requesting? 
               Single
         Aggregate

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* What is the company's total annual revenue? 

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* What is the company's equity (net worth) as it appears on last years financial statement? 

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* What is the company's net profit/loss for last year? 
  Profit:        Loss:  

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*
  		What was their largest amount of uncompleted bonded and unbonded work-on-hand at any one time?
        What year?
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*
 What is their current bonded and unbonded uncompleted work-on-hand as of this date?
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* What is their largest completed bonded job?  $ 
        What year?
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* What is their largest completed unbonded job?  
$     What year?
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* What was last year's total amount of bonded work?

$

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Please check Yes or No:
* Does your agency write this accounts business insurance?
Yes No

      If no, who is the agency of record?
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*

Does your agency write this accounts surety business?
Yes No

       If no, who is the agency of record?

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The following questions should be answered with input from the contractor:
*
All principals and spouses will sign a General Indemnity Agreement.
Yes No
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*
The business has been operating for a minimum of five (5) years.
Yes No
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*
Do all principals have a clear credit history?
Yes No

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*
Does the business have a clear credit history?
Yes No
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*
Has any principal or spouse filed for bankruptcy? 
Yes No

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*
Has the business ever filed for any form of bankruptcy? 
Yes No

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*
Are there any judgments, suits, claims, tax liens, or other liens against this company or any owner or spouse?
Yes No
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*
Has any owner or spouse relating to this business ever filed for personal bankruptcy?
Yes No

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*
Has the company or any owner or spouse ever failed in business or compromised with any creditor?
Yes No

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*
Has the company or any owner or spouse ever defaulted on a contract?
Yes No

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*
Does this company or related companies to the principals have any open surety claims?
Yes No
If yes, please explain:

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*
 
Has any surety ever paid a claim on any bond for this company, any previously owned company or for any owner or spouse?
Yes No
           If yes, please explain.

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*
 
Has the surety ever incurred any expenses as a result of a bond claim for this company, any previously owned company or for any owner or spouse?
Yes No
           If yes, did you reimburse the Surety?
Yes No
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*
Has the company ever been declined by a bonding company?
Yes No
           If yes, what company?
          
           Why?

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*

Does the principals own real property?
Yes No

           If yes, please list them and include property address, value &
           mortgage amount.

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Agency Contact Information
* Name of Agency
* Contact Name
* Address
* City
* State
* Zip Code
* Phone
* Fax
* E-Mail
Web

 


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