DOHN & MAHER ASSOCIATES 4811 Emerson Avenue, Suite 102 Palatine, IL 60067 (847)303-6800 Fax: (847)303-6963 www.dohn.com eMail: vbroaddus@dohn.com
Date_____/_____/_____
BOND REQUEST FORM:
(Please Check One)
Bid________
Final________ Misc.__________
# Copies Needed__________
Contractor
______________________________________________________________________________________
Obligee
______________________________________________________________________________________
(Included Address)
______________________________________________________________________________________
______________________________________________________________________________________
Bid Bond:
Bid Date______/______/______
% of Bid Bond_______ Estimated Contract Amount_____________
Final Bond:
Contract Date______/______/______
Contract Amount____________________________
Job Description _____________________________________________________________________________________ (Include Contract # & Solicitation #) _____________________________________________________________________________________
_____________________________________________________________________________________
Start Date______/______/______ Completion Date______/______/______ Liquidated Damages/Penalty____________
Warranty Period 1 st yr_______ 2 nd yr_______ (If longer than 2 yr. maintenance, please advise)
% Subcontracted_____________
% Retention______________
Architect ____________________________________________________________________________________________
IF THIS IS A FINAL BOND REQUEST FORM, PLEASE INDICATE BID RESULTS ON OUR BID RESULT FORM & FAX WITH FINAL BOND REQUEST FORM. IF NEGOTIATED, OR RESULTS ARE NOT AVAILABLE, PLEASE INDICATE.
Insurance Requirements Reviewed
_____NO
_____YES
Special Requirements
_____NO
_____YES
Current Work-on-Hand (Cost to Complete) ________________________________________________________________
Bond Form Required __________________________________________________________________________________ (If no indication is made we will use AIA form)
Bonds will be mailed unless other arrangements are made.
TO BE COMPLETED BY DOHN & MAHER ASSOCIATES:
Surety Co: _____________________________________
Approved By: __________________________________
Rate:
_____________________________________
Conditions:
__________________________________
Premium: ____________________________________
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