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Minnesota Department of Labor and i�dustry
<br /> Construction Codes and Licensing Division
<br /> L T Building Codes and Standards
<br /> 443 Lafayette Road N.,St.Paul,MN 55155-4341 '
<br /> � . Phone: (651)284-5068 Fax: (651)284-5749
<br /> www.doli.state.mn.us TTY: 651 297-4198
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<br /> Work covered by the State Mechanical Code(Chapter 1346): BOND NUMBER: 929413686
<br /> including gas installations, heating,ventilation,alr Amount: $25,000
<br /> condttioning,fuel burning�refrigeration(GMVACR) EFFECTlVE DATE: January 16, 2007
<br /> Pursuant to the terms of this instrument Contractors Building Supplies LLC �as Principal
<br /> 4060 Maplehurst Drive South
<br /> with its prinapal o�ce located at:(address,city,state,zip) _
<br /> Rockford, MN 55373 _company phone number. 612-850-6996 �and
<br /> _ � � �_�,a corporation licensed to transact a surety business in the State of
<br /> Minnesota,with its principal office located at 101 so. Phillipps Avenue, Sioux Falls� SD 57104
<br /> as Surery,their successors,assigns,and legal representatives are held and finnly bound,joinUy and severally,to the State of Minnesota
<br /> and any third party sustaining financfal loss within the terms of this bond fo�payment in the amount of Twenty-Five Thousand Dollars
<br /> ($25,000),as provided in Minnesota Statute 326.992(a). This bond is for the bene�t of persons suffering financiai loss by reason of the
<br /> contractors failure to comply with the requirements of the State Mechanical Code(Minnesota Rules,Chapter 1346)when perfor�ing-.
<br /> work in the State of Minnesota.
<br /> The condition of this bond is that the Principal has contracted to do gas,heating,ventilaGon,cooling,air conditioning,fuel burning,or
<br /> refrigeration work within the State of Minnesota. if the Principal faithfully complies with the State of Minnesota Mechanical Code and
<br /> indemnifies any person dealing or transacting business with the Principal from any loss or damage occasloned by the failure of the
<br /> Principal to compiy with any of the laws and rules of the State of Minnesota,then no obligation under this bond shall acxrue;otherwise,
<br /> this obligation shall remain in full force and effect.
<br /> Your bond must be renewed wlth a continuation certiftcate submitted to Construction Codes and Ucensing Dlvislon.Renewal is
<br /> due annually from the effective date of the bond or continuation certiflcate.The aggregate liabiiiry of the Surety,regardless of the
<br /> number of daims made against the bond or the number of years the bond remains in force,shall in no event exceed$25,000.
<br /> The bond may be cancelled by the Surety,as to future liability,by giving written notice by Certified Mail,addressed to the Principal at the
<br /> address as stated in this bond,and to the Construction Codes and Licensing Divisian, Department of Labor and Industry as the address
<br /> appears on this bond.Thirty(30)days after the mailing of that notice,this bond shall be null and void as to any liability thereafter arising,
<br /> the Surety remaining liable,however,subject to all the terms,conditions,and provisions of this bond,for any and all acts.Govered by this
<br /> bond up to the date of the cancellation, APPLY INSUI�ANCE
<br /> Signed and Witnessed this 16 day of January 20 �� COMPANY SEAL
<br /> By B
<br /> WITN TO PRIN �PAL SIGNATURE PW qPAL SNiNATURE
<br /> •
<br /> By QV � q�, � Q�/Western Sur ty o y
<br /> WISN O SURETY SIONATURE SURETY • �
<br /> By
<br /> SU PANYREPRESENTA &GNATUREANOTITt.E , ttorney-lt�^�'SC-�
<br /> C� � � f' � •• ' i � •' •'
<br /> Mail the following items to: Department of Labor and Industry, Financial Services,443 Lafayette Road N.,St.Paui, MN 55155.
<br /> After these items have been processed,your company name wfll be posted on our website and you wiii receive a certificate in
<br /> the mail valid for one.year. -
<br /> Page 1 filled out completely including all signatures and insurance company seal(embossed or stick on).
<br /> Page 2 with the appropriate Business Acknowledgement and Surety Acknowledgement w(th all signatures.
<br /> _ Valid Power of Attorney attached.
<br /> _Check for E15 fee,payabie to Depa�tment of Labor and Industry.Checks retumed for no�-payment will be charged a$20 fee.
<br /> (M.S.604.113,subd.2). Approved bonds are on our website in the Bond List. Bc_me001 10105 Page 1
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