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Indemnity Bond on Lost Instrument <br /> NDCC21-06-03 <br /> TOM MOREHOUSE claims to be the owner and entitled to payment of a certain warrant <br /> number 277413 dated 03/31/2014 for the sum of$1,750.00, executed by Cass County <br /> Government but is unable to produce or surrender said instrument on account of its loss, <br /> destruction, or otherwise. <br /> I/We, TOM MOREHOUSE,as principal,jointly and severally undertake, promise and <br /> agree to pay any amount of loss that may be sustained by Cass County by reason of the <br /> issuance of a duplicate in the said sum of$1,750.00, or payment of such obligation. <br /> If there is more than one undersigned any liability hereunder and the representations <br /> and warranties made herein is joint and several and this agreement shall be binding upon <br /> the heirs, personal representatives, successors,and assigns of the undersigned and shall <br /> inure to the benefit of Cass County it's successors and assigns. <br /> In witness thereof, I/we have hereunto set our hands this 11 day of , 20/Y <br /> Signature/Titl <br /> STATE OF Akr-- Dakda ) <br /> Oa ) SS <br /> COUNTY OF ( ) <br /> On this day of 1�1 20 SL/, before me personally appeared a representative <br /> of TOM MOREHOUSE,known to me to be the person(s) described in and that executed the <br /> within instrument and severally acknowledged to me that they executed the same. <br /> alhe; <br /> ALICIA HILDEBRAND Notary Public <br /> State otpNorthh Dakota <br /> M Commisslon Ex•Ires Au•, 28, 2018 <br />