$15,000 Contractor's License Bond Application:

I the undersigned, hereby declare that the statements herein are true and correct. I hereby apply for a Contractors License Bond ("bond") to the Surety Company ("SURETY"), through my agent California Contractors Insurance Services ("CCIS"). I agree individually and as the owner or officer of the bonded entity to fully indemnify and hold SURETY harmless from and against any and all claims, demands or legal expense which arise by reason of the execution of any bond issued pursuant to this application. I understand the bond is a credit relationship and hereby authorize SURETY and/or its authorized agents, to gather such credit, employment and DMV records considered necessary and appropriate for purposes of evaluating whether and at what premium rate such credit should be granted or continued. Following my approval of the issuance of the bond by the SURETY or CCIS where applicable, I agree to pay advanced premium as quoted for the first year or a fractional part thereof that is fully earned and annually thereafter as billed for suretyship. I understand cancellation fees may be applied to return premiums and additional fees may be required for reinstatement. I agree that performance and any form of dispute resolution of this agreement shall take place in the county of SURETY's office of service. This agreement shall survive any changes in, substitute to or renewal of the bond. I/we hereby grant CCIS the authority to act on my/our behalf regarding bond issuance, bond renewal and I/we hereby assign CCIS as Broker of Record. A facsimile of this agreement shall be treated as an original for all purposes.