Bond No: __________________
Premium: __________________
AMOUNT: $25,000.00 STREET EXCAVATION BOND
KNOW ALL MEN BY THESE PRESENTS:
That we, ____________________________________________________ (hereinafter called the
"PRINCIPAL"), as Principal, and the _____________________________________, of the City of
______________________, a corporation duly organized under the laws of the State of
___________________________, (hereinafter called the "SURETY"), as Surety, are held and
firmly bound unto CITY AND COUNTY OF SAN FRANCISCO, CALIFORNIA, (hereinafter called
the "OBLIGEE"), in the sum of TWENTY FIVE THOUSAND AND NO/100 DOLLARS
($25,000.00), for the payment of which sum well and truly to be made, we said Principal and the
Surety, bind ourselves, our heirs, executors, administrators, successors and assigns, jointly and
severally, firmly by these presents.
Sealed with our seals and dated this ____________day of ____________ A.D. two thousand
________________.
WHEREAS, The Principal intends to apply for a permit to make and excavation in the public
street, within the City and County of San Francisco and is required to furnish a bond in
accordance with Article 2.4 of the Public Works Code of the City and County of San Francisco.
NOW, THEREFORE, THE CONDITION OF THIS OBLIGATION IS SUCH, that if the said
Principal shall comply with the terms and conditions of said Article, then this obligation shall be
null and void; otherwise it shall remain in full force and effect.
This bond shall be and remain in full force for a period of three (3) years after the restoration of
the pavement:
The surety shall have the right to terminate its liability hereunder by notifying in writing
rd
Department of Public Works, Bureau of Street-Use and Mapping, 1155 Market Street, 3 Floor,
San Francisco, CA 94103, 30 days in advance of its intention to do so. Provided that any
restoration of the pavement is more than three (3) years ago.
PROVIDED FURTHER, the liability of the SURETY shall in no event exceed the sum of TWENTY
FIVE THOUSAND AND NO/100 DOLLARS ($25,000.00).
Principal
By: _________________________________________
(Principal)
Contact Name & Number: _______________________
(Principal)
____________________________________INSURANCE CO.
Contact Name & Number: _______________________
By: _________________________________________
Attorney in fact (w/ notary public acknowledgement)
The Principal identified above shall provide the Name of the Company as well as the
State Contractor License Information.
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CALIFORNIA ALL-PURPOSE ACKNOWLEDGMENT
State of California
County of ____________________
On ______________ before me, ____________________________________________________
Insert name and title of officer here
personally appeared ______________________________________________________________
who proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to
the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized
capacity(ies), and that by his/her/their signatures(s) on the instrument the person(s), or the entity upon behalf
of which the person(s) acted, executed the instrument.
I certify under PENALTY OF PERJURY under the laws of the State of California that the foregoing paragraph is
true and correct.
WITNESS my hand and official seal.
_________________________________________ (Notary Seal)
Signature of Notary Public
INFORMATION BELOW IS RECOMMENDED BUT NOT REQUIRED
TITLE/DESCRIPTION OF THE ATTACHED DOCUMENT
_____________________________________________________________________________________________
DOCUMENT DATE ______________________________________________ NUMBER OF PAGES _________________
_____________________________________________________________________________________________
Additional Information
CAPACITY CLAIMED BY SIGNER
Individual(s) Partner(s) Attorney-in-Fact Trustee(s)
Corporate Officer ________________________________ Other ____________________________________
2008 CA V13.01 .08
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