KOG International, Inc.

Bond Request Form

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Bond Type & DatesContractorOwner / ObligeeProject DetailsBond TermsSBA & Special

Bond Type & Dates

Bond Type*

BidFinalMaint.

Bid Date*

Bid Time*

Contract Date for Final Bonds

Only required for Final or Maintenance bonds

Date & Time Bond Needed*

Time Bond Needed

# of Copies Needed

Contractor

Your company information.

Contractor's Name (Your Company's Name)*

Your Email Address*

We'll send a confirmation and updates to this address.

Number of Employees at your company

Will you be

PrimeSub-contractor

% Subcontracted

Owner / Obligee

The entity the bond is being written to.

Owner/Obligee Name*

Contact Person

Phone #

Address*

Address Line 2

City*

State*

Zip*

Project Details

Project Name & Description*

Invitation / Contract #

Project Location — Address

City

State

Zip

County

Bond Terms & Amounts

Contract Amount ($)*

Engineer's Estimate ($)

% Bid

Bond percentage

NTE Amount ($)

Not to exceed

Bid Bond Amount ($)

Leave blank to auto-calculate

Consent of Surety?

Yes (Send Consent of Surety Form)No

Performance, Payment & Maintenance

Performance %

Payment %

Maintenance %

Maintenance Period (Months)

Start Date

Completion Date

Time to Complete (Months)

Liquidated Damages / Penalties ($ per day)

Bond Form

Bond Form Type*

NJ Statutory Standard BID FORMSpecial Bond Form (attach)

Special Requirements

Any Special Surety Rating & Treasury Listing Requirements?

Yes (attach spec documentation)No

SBA Bond Support

Complete this section if applicable.

Does Project Pertain to 8(a) Contract?

YesNo

Phased Project?

YesNo

Type

FederalStateLocalPrivate

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