Contract Bonding Form

Performance Bond • Payment Bond • Maintenance Bond • Supply Bond • Construction Bond • Penalty Amount $400,000

Call us at 800-921-1008 with any questions

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Contractor Data

Owner Data / Indemnitors

Provide the information below on all owners.

Bernard Fleischer & Sons may obtain a credit report about the applicant including its Owner(s) and Owner’s spouses in order to confirm the information provided in this application and obtain information about Applicant’s credit history.

Owner #2 Data

Owner #3 Data

Bond Request Data

*This application is not intendeded for use in connection with Design-Build contracts, Subdivision or Site Improvement over $100,000 Asbestos Abatement, Completion, Hazardous Materials, or Multi-Year Contracts where term of contract is over 5 years

For private jobs or subcontracts, please enclose a copy of the contract and bond form for projects over$150,000.
For service type contracts, provide a copy of the contract.

Status of Outstanding Bid or Performance:

Next two lowest bidders (If truly negotiated, check box)

Bond Form Data

Business Financial Data

Please provide the company's last 2 years fiscal year-end financial statement or tax return. If the latest fiscal year financial statement or tax return is more than 6 months old, then also provide a current interim financial statement. (Upload Documents below)

Please provide the last 2 years fiscal year-end financial statement on the business. If the fiscal year-end statement on the business is more than 6 months old, then also provide us with a current interim financial statement. (Upload Documents below)

Personal Financial Data

Please provide a copy of each owner's latest personal financial statement. If the personal financial statement is more than 6 months old then provide us with a current statement. (Upload Documents Below)

Experience Data

List the three largest contracts completed in the last five years

Contract #1

Contract #2

Contract #3

List the two largest jobs you presently have underway, giving the following information

Current Job #1

Current Job #2

Operations Data

General Data

Disputes, Financial Difficulties, Problems, Etc. (For Company)

Agency Data

Bernard Fleischer and Sons Inc.

Any person who knowingly and with intent to defraud any insurance company or person files an application containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime under applicable law.
The applicants and indemnitors certify the truth of all statements in the application and authorize the Company to verify this information and to obtain additional information from any source including obtaining a credit report.