Surety Bond Claim
Surety Bond Claim
Claimant Information
|
Field |
Details |
|---|---|
|
Claimant Name |
[Your Company Name] |
|
Contact Person |
[Your Name] |
|
Address |
[Your Company Address] |
|
Phone Number |
[Your Company Number] |
|
Email Address |
[Your Company Email] |
Bond Details
|
Field |
Details |
|---|---|
|
Bond Number |
789456123 |
|
Bond Issuer |
Surety Assurance Company |
|
Principal (Bondholder) |
[Principal's Name] |
|
Obligee (Beneficiary) |
[Your Company Name] |
Amount of Claim
|
Description |
Amount |
|---|---|
|
Additional Contractor Costs |
$150,000 |
|
Operational Disruption Costs |
$50,000 |
|
Legal Fees |
$30,000 |
|
Miscellaneous Expenses |
$20,000 |
|
Total Amount Requested |
$250,000 |
Description of Breach
-
Date of Breach: July 15, 2050
-
Detailed Description: The contractor failed to complete the construction project by the contracted completion date. Despite repeated extensions and notices, the project remains incomplete and substantially delayed. This has caused significant additional costs and disruption to our operations.
Supporting Documentation
-
Contract Agreement between [Your Company Name] and the contractor
-
Correspondence including breach notices and extension requests
-
Invoices for additional costs incurred due to the delay
-
Photos of the incomplete project site
Declaration and Signature
I declare that the information provided in this claim is accurate and complete to the best of my knowledge. I request that the surety company process this claim and provide the necessary compensation as stipulated in the bond agreement.
[Your Name]
[Your Company Name]
[Date]
