INSURANCE/BONDING COMPANY NAME BOND #

ACKNOWLEDGEMENT OF PRINCIPAL (Firm / Corporation / Individual)

PRINCIPAL: _______________________________________ (contractor's company name)

(Show name of Principal exactly as it appears on page 1 of bond)

By: ________________________________________________  (signature of company's responsible officer)

 (name and title typed/printed below signature)

Electrical Contractor: __________________________________  (signature of account holder)

 (name and title typed/printed below signature)

STATE OF ______________________ ) NOTARY: DO NOT STAMP OVER ANY SIGNATURES

COUNTY OF ____________________) SS

On this _________ day of _______________, 20 _____, before me personally appeared _____________________________ (name of company officer) the above signed officer who acknowledged himself/herself to be the ___________________(title) of ______________________________ (name of company) and that he/she as such officer being authorized to do so, executed the foregoing instrument for the purposes therein contained by signing the name of the ______________________________ (contractor's company name) a _______________________(company/corporation/partnership) by himself/herself as such officer.

In witness whereof, I hereunto set my hand and official seal.

My commission expires: _

Notary Public

Acknowledgement Of Surety

SURETY: ______________________________________

(Name of insurance / bonding company)

By: ____________________________________________ (Signature of Attorney-in-Fact)

STATE OF ______________________)

COUNTY OF ____________________) SS

On this _________ day of _______________, 20 _____, before me personally appeared _____________________, who being sworn, stated that he/she is attorney-in-fact for surety, _____________________________________, and that he/she signed this instrument as attorney-in-fact for the foregoing surety

Notary Public

My commission expires:

APPROVED AS TO LEGAL FORM: