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Central Region Western Region <br /> 4700 West 77th Street 10851 N.Black Canyon Highway Suite 630 <br /> WESTERN NATIONAL Edina,MN 55435 Phoenix,AZ 85029 <br /> ixsuttascs (800)862-6070 (855)283-8106 <br /> The relationship company <br /> BOND EXECUTION REPORT <br /> AGENCY: PRINCIPAL: <br /> INNOVATIVE INSURANCE SVCS TRHorizon Group Inc <br /> 8001 Old Carriage Court N,Suite B 8105 Jeffery Lane South <br /> SHAKOPEE,MN 55379 Cottage Grove,MN 55016 <br /> OBLIGEE: SURETY: <br /> Minnesota Department of Labor and Industry-Construction Western National Mutual Insurance Company <br /> P.O.Box 64227 4700 W.77th St. <br /> St.Paul,MN 55164-0227 Edina,MN 55435 <br /> BOND INFORMATION: <br /> Bond Number: 42235 Type of Bond: Mechanical Contractor Bond 12/11 <br /> Date of Execution: 03/21/2018 Class Code: 909 <br /> Effective Date: 03/21/2018 Expiration Date: 03212020 <br /> Penal Sum: $25,000.00 State: Minnesota <br /> Premium: $219.00 Billing Method: D (8=Agency BM,0=Direct BIM <br /> NOTES: <br /> Western National appreciates your business! The first year premium is fully earned on the issuance of <br /> this bond. The premium will be billed according to the billing method listed above: <br /> Direct Bill Payments- Bill Pay: (800)352-2772 -Payment can be made on-line or by mail to: <br /> Western National Insurance Group -P.O.Box 59184 Minneapolis,MN 55459-0184. <br /> Agency Bill- Statements are mailed monthly to the agency with net amount due for the total <br /> statement. <br />