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
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
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.
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