Bond Application:

I, the undersigned, hereby apply for a Bond to the Surety Company (“SURETY”) through Jet Surety Insurance Services, Inc. (“JET”), with whom I hereby grant the authority to act on my behalf with respect to the bond and assign as my Broker of Record. In consideration of SURETY issuing, renewing or substituting said bond(s), I, individually and as the owner or officer of the bonded entity, hereby understand and agree, as follows: (i) To reimburse SURETY for  any amounts SURETY pays or incurs due to any claims/suits relating to the bond; (ii) I am providing ‘written instructions’ to JET and SURETY under the Fair Credit Reporting Act authorizing JET to obtain information from my personal credit profile or other information from Experian; (iii) SURETY shall be under no obligation to procure its release under any law for the release of sureties and I release SURETY from any damage sustained due to cancellation of the bond and (vi) Performance and any form of dispute resolution of this agreement shall take place in the county of SURETY’s office of service, a facsimile copy or electronically signed version of this agreement shall be binding as if it were an original, and this agreement shall survive any changes in, substitute to or renewal of the bond(s).

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Alabama DOI#:3000507957 Alaska DOI#:100174576 Arizona DOI#:3000426784 Arkansas DOI#:3000517591 California DOI#:0I96578 Colorado DOI#:599773 Connecticut DOI#:2631335 Delaware DOI#:3000547484 District of Columbia DOI#:3000543446 Florida DOI#:L104442 Georgia DOI#:205383 Hawaii DOI#:491015 Idaho DOI#:718270 Illinois DOI#:3000522403 Indiana DOI#:3429128 Iowa DOI#:1002338543 Kansas DOI#:471348218-000 Kentucky DOI#:1039641 Louisiana DOI#:823370 Maine DOI#:AGN331228 Maryland DOI#:3000513285 Massachusetts DOI#:2085980 Michigan DOI#:119269 Minnesota DOI#:40623640 Mississippi DOI#:15035599 Missouri DOI#:8465081 Montana DOI#:3000514562 Nebraska DOI#:3000537572 Nevada DOI#:3424078 New Hampshire DOI#:2435128 New Jersey DOI#:1688077 New Mexico DOI#:3000532280 North Carolina DOI#:1000610730 North Dakota DOI#:3000553046 Ohio DOI#:1239874 Oklahoma DOI#:3000531157 Oregon DOI#:3000510193 Pennsylvania DOI#:890787 Rhode Island DOI#:3000531109 South Carolina DOI#:3000508018 South Dakota DOI#:10021511 Tennessee DOI#:2434174 Texas DOI#:2355691 Utah DOI#:715694 Vermont DOI#:3439700 Virginia DOI#:145719 Washington DOI#:1012426 West Virginia DOI#:100289684 Wisconsin DOI#:3000522511 Wyoming DOI#:401650