HomeMy WebLinkAboutX2022-1385 - Miscxel-vZa —13 (15 0,7 C "- �" c o )Py DOI License # OG80249
9848 Business Park Drive Suite H
CALIFORNIA CONTRACTORS INSURANCE SERVICES Sacramento, CA 95827
Tel: (916) 363-2663 Toll Free: (800) 432-2641
Fax: (916) 363-2662 - renewals@ccisbonds.com
www.ccisbonds.com
15000 Contractors License Bond Renewal Submission:
Bond Amount: $15,000 Obligee: Contractors Stale License Board
Principal Information
Company Name:
ERIC D FOX
Individual Indemnitor:
ERIC FOX
Entity Type:
Sole Owner
Phone
(714) 830-9088
License Number:
1004314
Email:
efox7196@gmail.com
Street Address:
2920 PEPPERTREE LANE UNIT A
City/State/Zip:
Costa Mesa, CA 92626
Terms
Bond Number
66251254
Renewal Date 01/03/2022
Term:
01/03/2022-01/03/2023
Rate: $187.50
Payment Terms:
Pay In Full
Amount to be Charged: $187.50
Payment Method:
Visa Ending In 1985
Credit Card Expiration: 8/2025
Indemnity and Payment
Plan Agreement
I, the undersigned, hereby apply for a Contractors License Bond ("bond") to the Sure
("CCIS"), with whom I hereby grant the authority to act on my behalf with respect to tl
statements herein are true and correct. In consideration of the SURETY issuing, ren(
of the bonded entity, hereby understand and agree, as follows: (i) to reimburse, hold
expense, including but not limited to attorneys' fees, expert's fees, investigative fees
incur in defense, adjustment, or settlement of such claims/suits by reason of such su
shall be indisputable proof of my liability to SURETY; (iii) the bond is a credit relation:
necessary credit, employment and other public records for purposes of evaluating wt
continued; (iv) to pay advanced premium as quoted; (v) CCIS reserves the right to &
may deduct such fees from any return premiums; (vi) performance and any form of d
SURETY's office of service; and (vii) a facsimile copy or electronically signed version
shall survive any changes in, substitute to or renewal of the bond(s).
Check, I agree to the terms above
[Indemnitor SSN: XXX -XX -9039]
[IP Address: 172.58.21.165]
Signature
mpany ("SURETY") through California Contractors Insurance Services
nd and assign as my Broker of Record, and declare that the
or substituting said bond(s), I, individually and as the owner or officer
less, and indemnify SURETY upon demand for all loss, liability, claim,
laims handling fees, and any other cost which SURETY shall pay or
tip; (ii) that an itemized statement of loss and expenses by SURETY
nd I hereby authorize SURETY and/or CCIS, to gather such
and at what premium rate such credit should be granted or
me a $50.00 cancellation fee and a $25.00 reinstatement fee and
resolution of this agreement shall take place in the county of
s agreement shall be binding as if it were an original. This agreement
Date Submitted: May 12, 2022 11:48 AM
California Contractors Insurance Services, Inc. - P.O. Box 278238, Sacramento, CA 95827 - (800) 432-2641