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Indemnity Bond on Lost Instrument <br /> NDCC 21-06-03 <br /> BOEHM, SANDI JOANN, claims to be the owner and entitled to payment of a certain <br /> warrant number 274389 dated 10/25/2013 for the sum of$ 34.00, executed by Cass <br /> County Government but is unable to produce or surrender said instrument on account of <br /> its loss, destruction, or otherwise. <br /> I/We, BOEHM, SANDI JOANN,as principal,jointly and severally undertake, promise <br /> and 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$ 34.00, 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 x`i day of Noiz-1 , 20 q. <br /> Signature/Title <br /> STATE OFOV t(4/K-a <br /> ) SS <br /> COUNTY OF &SC <br /> On this c29 ay oft , 20 /y, before me personally appeared a representative <br /> of BOEHM,SANDI JOANN,known to me to be the person(s) described in and that executed <br /> the within instrument and severally acknowledged to me that they executed the same. <br /> ci&blgigr71 <br /> Notary Public <br /> DIANE JOHNSTON <br /> Notary Public <br /> State of North Dakota <br /> 1 My Commission Expires February 13,2016 <br />