SF 275 Reinsurance Agreement in Favor of the United States

REINSURANCE AGREEMENT IN FAVOR OF THE UNITED STATES
(See instructions on reverse)

OMB Control Number: 9000-0045
Expiration Date: 7/31/2019

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1A. DATE DIRECT WRITING COMPANY EXECUTES THIS
1. DIRECT WRITING COMPANY*
AGREEMENT

1B. STATE OF INCORPORATION

2A. AMOUNT OF THIS REINSURANCE ($)

2. REINSURING COMPANY*

2B. DATE REINSURING COMPANY EXECUTES THIS AGREEMENT
2C. STATE OF INCORPORATION

3. DESCRIPTION OF BOND
3A. DESCRIPTION OF BOND (Type, purpose etc.) (If associated with contract
number, date, amount, etc., include name of Government agency involved.)

3B. PENAL SUM OF BOND

$
3C. DATE OF BOND

3D. BOND NUMBER

3E. PRINCIPAL*

3F. STATE OF INCORPORATION (If Corporate Principal)

AGREEMENT:
(a) The Direct Writing Company named above is bound as surety to the United States of America, on the bond described above, wherein
the above-named is the principal. The bond is given for the protection of the United States and the Direct Writing Company has applied to the
above Reinsuring Company to be reinsured and counter-secured in the amount shown opposite the name of the Reinsuring Company
(referred to as the "Amount of this Reinsurance"), or for whatever amount less than the "Amount of this Reinsurance" the Direct Writing
Company is liable to pay under or by virtue of the bond.
(b) For a sum mutually agreed upon, paid by the Direct Writing Company to the Reinsuring Company which acknowledges its receipt, the
parties to this Agreement covenant and agree to the terms and conditions of this agreement.
TERMS AND CONDITIONS:
The purpose and intent of this agreement is to guarantee and indemnify the United States against loss under the bond to the extent of the
"Amount of this Reinsurance," or for any less sum than the "Amount of this Reinsurance," that is owing and unpaid by the Direct Writing
Company to the United States.
THEREFORE:
1. If the Direct Writing Company fails to pay any default under the bond equal to or in excess of the "Amount of this Reinsurance," the
Reinsuring Company covenants and agrees to pay to the United States, the obligee on the bond, the "Amount of this Reinsurance." If the
Direct Writing Company fails to pay to the United States any default for a sum less than the "Amount of this Reinsurance," the Reinsuring
Company covenants and agrees to pay to the United States the full amount of the default, or so much thereof that is not paid to the United
States by the Direct Writing Company.
2. The Reinsuring Company further covenants and agrees that in case of default on the bond for the "Amount of this Reinsurance," or
more, the United States may sue the Reinsuring Company for the "Amount of this Reinsurance" or for the full amount of the default when the
default is less than the "Amount of this Reinsurance."
WITNESS
The Direct Writing Company and the Reinsuring Company, respectively, have caused this Agreement to be signed and impressed with
their respective corporate seals by officers possessing power to sign this instrument, and to be duly attested to by officers empowered thereto,
on the day and date above -- written opposite their respective names.
*Items 1, 2, 3E - Furnish legal name, business address and ZIP Code.
AUTHORIZED FOR LOCAL REPRODUCTION
Previous edition usable

(Over)

STANDARD FORM 275 (REV. 10-98)
Prescribed by GSA-FAR (48 CFR) 53.228(j)

4. DIRECT WRITING COMPANY
4A.(1). SIGNATURE

(2). ATTEST: SIGNATURE

4B.(1). NAME AND TITLE (Typed)

4B.(2). NAME AND TITLE (Typed)

Corporate
Seal

5. REINSURING COMPANY
5A.(1). SIGNATURE

(2). ATTEST: SIGNATURE

5B.(1). NAME AND TITLE (Typed)

5B.(2). NAME AND TITLE (Typed)

Corporate
Seal

INSTRUCTIONS
This form is to be used in cases where it is desired to cover the excess of a Direct Writing Company's underwriting
limitation by reinsurance instead of co-insurance on bonds running to the United States except Miller Act Performance
and Payment Bonds. See FAR (48 CFR) 28.202-1 and 53.228(j) and 31 CFR 223.11(b)(1). If this form is used to reinsure
a bid bond, the "Penal Sum of Bond" and "Amount of this Reinsurance" may be expressed as percentage of the bid
provided the actual amounts will not exceed the companies' respective underwriting limitations.
Execute and file this form as follows:
Original and copies (as specified by the bond-approving officer), signed and sealed, shall accompany the bond or be
filed within the time period shown in the bid or proposal.
One carbon copy, signed and sealed, shall accompany the Direct Writing Company's quarterly Schedule of Excess
Risks filed with the Department of Treasury.
Other copies may be prepared for the use of the Direct Writing Company and Reinsuring Company. Each Reinsuring
Company should use a separate form.

STANDARD FORM 275 (REV. 10-98) BACK