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! ' 1 45! ! ' 1 -345! J K L 2MN L L L T#6%& UV !5W% % 6X'WY' 6! 0 ---PAGE BREAK--- MUNICIPAL GENERAL CONTRACTOR'S LICENSE BOND NO. City of Arvada - Engineering Division 8101 Ralston Road Arvada, CO 80002 (720) 898-7640 THIS AGREEMENT made on this day of is by and between referred to as "Principal") and a Corporation, whose home office is located in (hereinafter referred to as "Surety"). RECITALS The Parties hereto recite and declare that: 1. They are held and firmly bound to the City of Arvada, State of Colorado (hereinafter referred to as "Arvada"), in the sum of TWENTY THOUSAND AND NO/100 DOLLARS ($20,000.00), in lawful money of the United States of America for the payment whereof principal and surety bind themselves, their heirs, executors, administrators, successors, and assigns, jointly and severally, firmly by this Agreement. 2. Principal has been duly licensed as a Municipal General Contractor and is thereby entitled to perform work on general public improvements for which the Principal is qualified. 3. Principal desires to deposit this bond in lieu of separate bonds for each general public improvement (hereinafter referred to as the "Work") on which Principal works. TERMS AND CONDITIONS This obligation shall remain in full force and effect for a period of one year, unless renewed by continuation certificate signed by those authorized to validate and bind the company in the first instance with respect to suretyship, bonds, undertakings, recognizance and obligatory instruments and under the seal of said Surety. This bond will have a two year warranty period from the date on which the last public improvement was completed and accepted by Arvada. The condition of this obligation is that if: Principal, or its heirs, executors, administrators, successors, and assigns shall, for the period of this bond, properly comply with Arvada's requirements and City Code provisions; replace any and all defects arising in the Work, whether resulting from defective materials or defective workmanship; and indemnify and hold harmless Arvada against suits or claims for damages or losses which may be brought against Arvada, or any of its officials and employees, because of the Work performed under the Principal's license, then the above obligation is null and void; otherwise it will remain in full force and effect. This obligation may be canceled upon thirty (30) days written notice delivered by the Surety to Arvada relieving the Surety from any obligation for public improvements performed after the expiration of the thirty (30) day cancellation period. No Right of Action shall accrue on this bond to or for the use of or benefit to any person or corporation other than the City of Arvada. IN WITNESS THEREOF, said Principal and said Surety have executed these presents this day of (SEAL) Principal –Signature of Authorized Signer Title of Authorized Signer Surety Attorney-in-Fact 05/21 ---PAGE BREAK--- AFFIDAVIT FOR LAWFUL PRESENCE VERIFICATION Because of Colorado House Bill 06S-1023 (C.R.S. 24-76.5-103), this affidavit is MANDATORY and must be submitted along with a copy of one of the accepted forms of identification to prove lawful presence in the United States. Colorado law now requires that the City of Arvada verify all natural persons 18 years or older or sole proprietors who are applying for a public benefit are lawfully present in the United States prior to receiving the public benefit. A public benefit includes the application or a renewal of a grant, loan, contract, and professional or commercial licenses provided by an agency of the state or local government. FOR CORPORATIONS/PARTNERSHIPS/COMPANIES ETC. ONLY The applicant, for whom I am authorized to sign, is NOT a “natural person” or “sole proprietorship,” but a corporation, partnership, company or other similar entity. HB 06S-1023 is not applicable. I understand this sworn statement is required because the applicant has applied for a “Public Benefit.” I further acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the laws of Colorado. Printed Name and Title of Signature of Applicant’s Date Applicant’s Representative Representative Name of Business OR FOR “NATURAL PERSONS” OR SOLE PROPRIETORS ONLY I am a “natural person” or a “sole proprietorship,” NOT a corporation, partnership, company or other similar entity and MUST complete this affidavit and submit it with the required documentation. 1. I, swear or affirm under penalty of perjury under the laws of the State of Colorado that (check one): I am a United States citizen; or I am a Permanent Resident of the United States; or I am lawfully present in the United States pursuant to Federal law. 2. I understand this sworn statement is required by law because I have applied for a “Public Benefit.” 3. I understand state law requires me to provide proof that I am lawfully present in the United States prior to receipt of this public benefit. 4. I acknowledge that making a false, fictitious, or fraudulent statement or representation in this sworn affidavit is punishable under the laws of Colorado. 5. I have attached a copy of one of the acceptable documents provided by the state of Colorado and I presented it to the agency as proof of identification that I am at least 18 years of age and I am lawfully in the United States. Applicant’s Printed Name Applicant’s Signature Date Name of Business (If applicable) Revised 08/01/07 ---PAGE BREAK--- * 0 * ; ! ( * 16 ( = 16 01 ! ( * ( 1 ( = 16 01 ( = 16 1 (6(6!DEFDGHIJKJLMNMIIO PPIKJIQO DN 1 00 = !0 * ! * * 0 # ! ( C00 = ^ 00 = * ` -#!a1 ! b ! ! Cdeefc$(01 &#!a1 ! c9!01 'Cdeefc ` -#!a1 ! b ! 01# ! # * ` ` -#!a1 ! ci!$ +c9!01 c]01 . MIjDR 1 0;i hlmno.96!? # ?6 _ p # # ( " : $ ; * p * p " * .