SF 275 Reinsurance Agreement in Favor of the United States

Reinsurance Agreement In Favor Of The United States
(See instructions on Page 3)

OMB Control Number: 9000-0001
Expiration Date: 1/31/2027

1. Direct Writing Company*

1A. Date Direct Writing Company
Executes This Agreement
1B. State of Incorporation

2. Reinsuring Company*

2A. Amount of This Reinsurance ($)
2B. Date Reinsuring Company Executes
This Agreement
2C. State of Incorporation

3. Description of Bond
3B. Penal Sum of Bond
3A. Description of Bond (Type, purpose, etc.) (If
associated with contract number, date, amount, $
etc., include name of Government agency
3C. Date of Bond 3D. Bond Number
involved.)
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.
*Items 1, 2, 3E - Furnish legal name, business address and ZIP Code.
STANDARD FORM 275 (REV. 10/2023)
Authorized For Local Reproduction
Prescribed by GSA-FAR (48 CFR) 53.228(j)
Previous Edition Is Not usable

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.

4. Direct Writing Company
4A(1). Signature

(2). Attest: Signature

4B(1). Name and Title (Typed)

4B(2). Name and Title (Typed)

5. Reinsuring Company
5A(1). Signature

(2). Attest: Signature

5B(1). Name and Title (Typed)

5B(2). Name and Title (Typed)

Corporate
Seal

Corporate
Seal

STANDARD FORM 275 (REV. 10/2023) PAGE 2

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 Federal Acquisition
Regulation - Code of Federal Regulations at (48 CFR) 28.202(a)(4) 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.

Paperwork Reduction Act Statement - This information collection meets the requirements of 44 USC §
3507, as amended by section 2 of the Paperwork Reduction Act of 1995. You do not need to answer
these questions unless we display a valid Office of Management and Budget (OMB) control number. The
OMB control number for this collection is 9000-0001. We estimate that it will take 1 hour to read the
instructions, gather the facts, and answer the questions. Send only comments relating to our time
estimate, including suggestions for reducing this burden, or any other aspects of this collection of
information to: General Services Administration, Regulatory Secretariat Division (MVCB), 1800 F Street,
NW, Washington, DC 20405.

STANDARD FORM 275 (REV. 10/2023) PAGE 3