DATE BOND EXECUTED (Must be same or later than date of

PERFORMANCE BOND contract) OMB Number: 9000-0045

(See instructions on reverse) Expiration Date: 5/31/2013
Date of Arraignment
Public reporting burden for this collection of information is estimated to average 25 minutes per response, including the time for reviewing instructions, searching existing data
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aspect of this collection of information, including suggestions for reducing this burden, to the FAR Secretariat (MVR), Federal Acquisition Policy Division, GSA, Washington,
DC 20405
PRINCIPAL (Legal name and business address) TYPE OF ORGANIZATION ("X" one)

JOHN DOE INDIVIDUAL PARTNERSHIP

1111 VINEYARD DRIVE JOINT VENTURE CORPORATION

CONYERS, GEORGIA [30013]
STATE OF INCORPORATION
UNITED STATES
SURETY(IES) (Name(s) and business address(es) PENAL SUM OF BOND
JOHN DOE MILLION(S) THOUSANDS HUNDRED(S) CENTS

DEPOSITORY TRUST COMPANY

55 WATER STREET CONTRACT DATE CONTRACT NO.
NEW YORK, NEW YORK 10041
Date of Birth Birth Certificate Number
OBLIGATION
We, the Principal and Surety (ies), are firmly bound to the Unites States of America (hereinafter called the Government) in the above penal sum. For
payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the
Sureties are corporations acting as co-sureties, bind ourselves in such sum "jointly and severally" as well as "severally" only for the
purpose of allowing a joint action against any or all of us. for all other purposes, each Surety binds itself, jointly and severally with the
Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount
of the penal sum.
CONDITIONS
The Principal has entered into the contract identified above.
THEREFORE
The above obligation is void if the Principal-
(a)(1) Performs and fulfills all the undertaking, covenants, terms, conditions, and agreements of the contract during the original term of the
contract and any extensions thereof that are granted by the Government, with or without notice of the Surety(ies) and during the life of any guaranty
required under the contract, and (2) performs and fulfills all the undertakings, covenants, terms conditions, and agreements of any and all duly
authorized modifications of the contract that hereafter are made. Notice of those modifications to the Surety(ies) are waived.

(b) Pays to the Government the full amount of the taxes imposed by the Government, if the said contracts is subject to the Miller Act, (40 U.S.C.
270a-270e), which are collected, deducted, or withheld from wages paid by the Principal in carrying out the construction contract with respect to
which this bond is furnished.
WITNESS
The Principal and Surety(ies) executed this performance bond and affixed their seals on the above date.
PRINCIPAL
1. 2. 3.
SIGNATURE(S)
(Seal) (Seal) (Seal)
Corporate
1. 2. 3.
NAME(S) & Seal
TITLE(S) John Doe
(Typed) As Surety
INDIVIDUAL SURETY(IES)
1. 2.
SIGNATURE(S)
(Seal) (Seal)

NAME(S) 1. 2.
(Typed) JOHN DOE
CORPORATE SURETY(IES)
NAME & STATE OF INC. LIABILITY LIMIT ($)
ADDRESS
SURETY A

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S
(Typed)

AUTHORIZED FOR LOCAL REPRODUCTION STANDARD FORM 25 (REV. 5/1996)

Previous edition not usable
Prescribed by GSA-FAR (48 CFR) 53.228 (b)
 CORPORATE SURETY(IES) (Continued)

NAME & STATE OF INC. LIABILITY LIMIT ($)

ADDRESS
SURETY B

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)
STATE OF INC. LIABILITY LIMIT ($)
NAME &
ADDRESS
SURETY C

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)
STATE OF INC. LIABILITY LIMIT ($)
NAME &
ADDRESS
SURETY D

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)

NAME & STATE OF INC. LIABILITY LIMIT ($)

ADDRESS
SURETY E

SIGNATURE(S)
1. 2. Corporate
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)

STATE OF INC. LIABILITY LIMIT ($)

NAME &
ADDRESS
SURETY F

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)

NAME & STATE OF INC. LIABILITY LIMIT ($)

ADDRESS
SURETY G

1. 2. Corporate
SIGNATURE(S)
Seal
NAME(S) & 1. 2.
TITLE(S)
(Typed)

RATE PER THOUSAND ($) TOTAL ($)

BOND
PREMIUM

INSTRUCTIONS

1. This form is authorized for use in connection with Government SURETY(IES)." In the space designated "SURETY(IES)" on the
contracts. Any deviation from this form will require the written face of the form, insert only the letter identification of the sureties.
approval of the Administrator of General Services.
(b) Where individual sureties are involved, a completed Affidavit
2. Insert the full legal name and business address of the Principal in of Individual Surety (standard Form 28) for each individual surety,
the space designated "Principal" on the face of the form. An shall accompany the bond. The Government may require the surety
authorized person shall sign the bond. Any person signing in a to furnish additional substantiating information concerning their
representative capacity (e.g., and attorney-in-fact) must furnish financial capability.
evidence of authority if that representative is not a member of the firm,
partnership, or joint venture, or an officer of the corporation involved. 4. Corporation executing the bond shall affix their corporate seals.
Individual shall execute the bond opposite the word " Corporate
3. (a) Corporations executing the bond as sureties must appear on Seal", and shall affix an adhesive seal if executed in Maine, New
the department of the Treasury's list of approved sureties and must Hampshire, or any other jurisdiction requiring adhesive seals.
act within the limitation listen therein. Where more than one corporate
surety is involved, their names and addresses shall appear in the 5. Type the name and title of each person signing this bond in the
spaces (Surety A, Surety B, etc.) headed "CORPORATE space provided.

STANDARD FORM 25 (REV. 5/1996) BACK