OMB Control No: 3245-0007
Expiration Date: 05-31-2008
U.S. SMALL BUSINESS ADMINISTRATION
SURETY BOND GUARANTEE AGREEMENT ADDENDUM
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When the work under a contract has actually begun, an SBA official having delegated authority to approve the bond in question (see 13 CFR part 101), may nevertheless guarantee a bond or bonds pursuant to Part 115 of 13 CFR, upon receipt, satisfactory to SBA, of all the items below.
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Waiver of Bill to Paid to Lien Attached Suppliers date date hereto 1. _________________________________ ______________ ________________ _______________ |
2. _________________________________ ______________ _______________ _______________
3. _________________________________ ______________ ________________ _______________
4. _________________________________ ______________ ________________ _______________
5. _________________________________ ______________ ________________ _______________
Subcontractors
1. _________________________________ ______________ ________________ _______________
2. _________________________________ ______________ ________________ _______________
3. _________________________________ ______________ ________________ _______________
4. _________________________________ ______________ ________________ _______________
5. _________________________________ ______________ ________________ _______________
____________________________________________________________
Principals Business Name and Business Trade Name
3. Certifications by Principal and Obligee.
By signing below, I certify on behalf of the Principal or Obligee that all information provided in connection with the application for a surety bond guaranty 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. The Principal also hereby certifies that all taxes and labor costs in connection with this job are current. The Obligee also hereby certifies that all payments due under the contract to present status have been made and that the job has been satisfactorily complete to present status. Please provide reason why bond was not required prior to job starting.
__________________________________________________________ __________________
Signature of Principal Date
__________________________________________________________ __________________
Signature of Obligee Date
4. All documents required from the Principal and Obligee are attached hereto and all items on this form have been certified to the SBA satisfaction.
______________________________________________________________ _________________ _________________
SBA Signature Date SBG Number
PLEASE NOTE: The estimated burden for completing this form is 10 minutes per response. You are not required to respond to any collection of information unless it displays a currently valid OMB approval number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409 3rd St., S.W., Washington, D.C. 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Office Building, Room 10202, Washington, D.C. 20503. OMB Approval (3245-007). PLEASE DO NOT SEND FORMS TO OMB SBA
FORM 991 (5-08) Previous Editions are Obsolete
File Type | application/msword |
File Title | OMB Control No: 3245-0007 |
Author | TBooker |
Last Modified By | CBRich |
File Modified | 2008-05-13 |
File Created | 2008-05-13 |