POLK COUNTY, IOWA SURETY BOND FORM
Expiration Date (if any)____________________ Bond No.________________
Polk County Onsite Wastewater Treatment and Disposal Systems Contractor's License
BLANKET PERFORMANCE SURETY BOND
KNOW ALL MEN BY THESE PRESENTS THAT___________________________________,
(Name of License Holder or Applicant)
(doing business as_______________________________________________), as Principal, and
(Trade or business name, if different from License name)
____________________________________________, a corporation duly licensed to conduct
(Name of Corporate Surety)
surety business in the state of Iowa, as Surety, acknowledge ourselves bound to Polk County, Iowa, and to
all persons on whose property work is performed or supervised by Principal pursuant to a Polk County
Onsite Wastewater Treatment and Disposal System Contractor's License ("License") or for which such a
License or a permit is required under applicable County regulations, in the penal sum of FIFTEEN
THOUSAND DOLLARS ($15,000.00), for the payment of which we jointly and severally bind ourselves,
our heirs, successors, executors and administrators.
IF THE PRINCIPAL shall fully, faithfully and lawfully perform, in accordance with all then-applicable
rules, regulations and standards (including, without limiting the generality of the foregoing, Chapter III of
the Rules and Regulations of the Polk County Local Board of Health pertaining to Onsite Wastewater
Treatment and Disposal Systems and other regulations incorporated therein by reference), all work
undertaken by Principal within Polk County, Iowa, for which a License is required, or for which
Construction Authorization has been issued pursuant to a permit, then this obligation shall be void,
otherwise to remain in full force and effect.
The aggregate liability of the Surety under this Bond, regardless of the number of claims made against it,
shall be the amount set forth above for work performed during each calendar year, or any portion thereof,
during which this Bond remains in effect. This Bond shall remain in effect for all work performed or
supervised by Principal prior to the earlier of the expiration date above or 30 days following actual receipt
by Polk County, at its Public Works Department, of notice of cancellation hereof, provided that notice of
any claim or potential or pending claim hereunder shall have been mailed to Principal at its address below
not later than one year after the earliest of said expiration date, the end of said 30 day period or the date of
issuance of a Certificate of Compliance pertaining to the work performed.
Polk County does not undertake to notify Surety of any revocation or expiration of a license issued to
Principal or of any permit pursuant to which Principal has performed, or has been authorized to perform,
work or supervision. In the event court action is necessary to enforce or collect this bond, Surety shall be
liable for the amount of court costs and attorney fees incurred in said enforcement or collection, in addition
to the penal sum specified above.
