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NEVADA STATE CONTRACTORS BOARD (Nevada State Contractors Board)

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NEVADA STATE CONTRACTORS BOARD
5390 KIETZKE LANE, SUITE 102, RENO, NEVADA, 89511 (775) 688-1141 FAX (775) 688-1271, INVESTIGATIONS (775) 688-1150
2310 CORPORATE CIRCLE, SUITE 200, HENDERSON, NEVADA, 89074 (702) 486-1100 FAX (702) 486-1190, INVESTIGATIONS (702) 486-1110
www.nscb.nv.gov
Nevada State Contractors Board Revised 11/14
Single Raise in License Limit - Indemnification Instructions and Requirements
Page 1 of 3
SINGLE RAISE IN LICENSE LIMIT INDEMNIFICATION INSTRUCTIONS AND REQUIREMENTS
An indemnification agreement for a single raise in license limit allows the board to consider the financial strength of an
individual or entity in addition to the licensee when deciding whether or not to grant a limit increase for a single project. Indemnification
is not required, however, it provides an option to an applicant who may not otherwise qualify for a one-time raise in limit for a single
project. The agreement must be on a form prescribed by the board, and accompanied by financial documents as set forth below.
1. Indemnification Agreement: Provide a completed indemnification agreement specific to the entity indemnifying the license.
Corporations and Limited Liability Companies must also provide a resolution executed by the indemnifying Corporation or Limited
Liability Company authorizing the execution of this agreement.
2. Financial Statement Requirements: The indemnitor must submit a current financial statement (statement) that meets the
following criteria.
For License Monetary Limits of $10,000 or less the indemnitor must provide one of the following:
A current financial statement prepared by an independent certified public accountant; or
A current financial statement submitted on a form prescribed by the Board (available on the Board’s website
www.nscb.state.nv.us, click on contractor forms); or
A current financial statement (Balance Sheet) prepared using accounting software in accordance with generally accepted
accounting principles and accompanied by an affidavit that verifies the accuracy of the financial statement.
*To prevent a delay in the processing of your application, if you are unfamiliar with preparing your own financial
statement, you are encouraged to seek the advice of an Accountant.
Note: Self-prepared or compiled statements must be current to within six months from the date the application is
received.
For License Monetary Limits more than $10,000 but less than $50,000 the indemnitor must provide one of the following:
A compiled financial statement prepared by an independent certified public accountant, current within 6 months from the date
the application is received; or
A reviewed or audited financial statement, prepared by an independent certified public accountant, current within one (1) year
from the date the application is received.
For License Monetary Limits of $50,000 or more but less than $250,000 the indemnitor must provide one of the following:
A compiled financial statement with full disclosures, prepared by an independent certified public accountant, current within 6
months from the date the application is received; or
A reviewed or audited financial statement, prepared by an independent certified public accountant, current within one (1) year
from the date the application is received.
For License Monetary Limits of $250,000 or more: the indemnitor must provide a financial statement that is prepared and
reviewed or audited by an independent certified public accountant, current within one (1) year from the date the application is
received.
3. Bank Verification Form: A bank verification form must be completed by the indemnitor and its bank and submitted with the
application.
4. Bankruptcy:
If indemnitor has filed for bankruptcy protection, notification must be provided to the Board.
NEVADA STATE CONTRACTORS BOARD
5390 KIETZKE LANE, SUITE 102, RENO, NEVADA, 89511 (775) 688-1141 FAX (775) 688-1271, INVESTIGATIONS (775) 688-1150
2310 CORPORATE CIRCLE, SUITE 200, HENDERSON, NEVADA, 89074 (702) 486-1100 FAX (702) 486-1190, INVESTIGATIONS (702) 486-1110
www.nscb.nv.gov
Nevada State Contractors Board
Personal Indemnification Agreement For a Single Raise in License Limit
Page 2 of 3
PERSONAL INDEMNIFICATION FOR A SINGLE RAISE IN LICENSE LIMIT
FOR VALUE RECEIVED, the undersigned jointly and severally, do hereby personally indemnify the creditors of
______________________________________________________________________________ (hereinafter referred to as Licensee),
(USE FULL LEGAL NAME OF APPLICANT/ LICENSEE)
as guarantors and as sureties, against any loss or damage the said creditors may suffer as a result of licensee’s failure to promptly pay
obligations incurred by it in connection with the below described project in the ordinary course of construction business within the State
of Nevada, related directly or indirectly to the construction project known as ______________________________________________
located at __________________________________________________________________.
It is further agreed that the undersigned, as sureties, are firmly bound unto Licensee for the benefit of the said creditors; and, it
is further agreed that this Agreement as a guaranty is separate and absolute, and that the undersigned are obligated hereunder as
guarantors in addition to their obligations as sureties. No election of remedies is intended and its obligations hereunder are cumulative,
joint and several.
This Agreement is made and entered into as one of the conditions required by the Nevada State Contractors’ Board under
Nevada Administrative Code Chapter 624 for the one time raise in monetary limit for the above said contractor licensee. The
completion of the above said project shall not affect any of the undersigned’s obligations hereunder with respect to indebtedness
incurred during the term of the above said project.
Acceptance by creditors is waived and no continuation, renewal, change, or alteration in the contractor’s license granted to
Licensee shall in any way relieve the undersigned, their heirs and legal representatives from any liability assumed hereunder.
The undersigned further agrees to be subject to the jurisdiction of the courts of the State of Nevada and the Federal Courts for
the District of Nevada, and laws of the State of Nevada in connection with all of its obligations and liabilities in connection with this
Agreement.
Words used in this Agreement which import the plural number shall be deemed to include the singular; words used herein
which import the singular shall also be deemed to include the plural.
The undersigned agrees to notify the Board if the entity providing the indemnification has filed for bankruptcy protection.
DATE: ________________________
_________________________________________________________________________________________________________
Signature Print Name Physical Address City State Zip
__________________________________________________________________________________________________________
Signature Print Name Physical address City State Zip
ALL SIGNATURES MUST BE NOTARIZED:
Subscribed and sworn to before me this _______ day of ________________,__________
___________________________________________, Notary Public in and for County of __________State of _______.
My Commission Expires: ____________________
Certification of Resident Agent for Indemnitor (Required only if indemnitor is not a Nevada resident)
I hereby certify that I am the resident agent for this indemnitor for the purpose of accepting service of process in the State of Nevada in
connection with any and all legal actions instituted in the State of Nevada pertaining to this indemnification agreement for the benefit of
the Nevada contractors’ licensee stated above. I recognize my obligation to notify the State Contractors’ Board, in writing, of any
change in address.
__________________________________________________________________________________________________________
(Print Name) Signature Physical Address City State Zip
NEVADA STATE CONTRACTORS BOARD
5390 KIETZKE LANE, SUITE 102, RENO, NEVADA, 89511 (775) 688-1141 FAX (775) 688-1271, INVESTIGATIONS (775) 688-1150
2310 CORPORATE CIRCLE, SUITE 200, HENDERSON, NEVADA, 89074 (702) 486-1100 FAX (702) 486-1190, INVESTIGATIONS (702) 486-1110
www.nscb.nv.gov
BANK VERIFICATION FORM
Name of Company: _____________________________________________
Items 1 through 3 of the following report are to be completed by the applicant. Items 4 through 10 are to be completed by the
verifying bank. After completion by you and your bank, submit this form with your application.
1. Name and address of bank(s): ______________________________________________
______________________________________________
______________________________________________
2. Signatures of account holder(s):
__________________________________ ___________________________ _____________
Signature Print Name Date
__________________________________ ____________________________ _____________
Signature Print Name Date
3. Information to be verified:
Type of Account
Account Name
Account Number
TO VERIFYING BANK: Please furnish the information requested below.
4. Classification of Account: Individual Corporation Partnership
Limited Partnership Limited Liability Company
5. Deposit accounts of applicants:
*Account Name Type *Account Number *Current Balance
*Six (6) Month
Average
*Date Opened
*Required Information
6. Verification of Lines of Credit:
Line of Credit
Account #
Type of
Credit Line
Date
Opened
Approved
Amount
Current
Balance
Payments Required Secured by
$ Per
$ Per
7. Additional information that may be of assistance in determination of credit worthiness:
______________________________________________________________________________________________________
______________________________________________________________________________________________________
8. Affix Bank Stamp or Business Card 9. Name and Title of Bank Representative
of Bank Representative here
__________________________
__________________________
10: Date: __________________________
Page 3 of 3
Nevada State Contractors Board
Bank Verification Form
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Completed 26 April 2021

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