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Indemnity Bond on Lost Instrument <br /> NDCC 21-06-03 <br /> ROESCH, MARIA, claims to be the owner and entitled to payment of a certain warrant <br /> number 267231 dated 11/23/2012 for the sum of$ 29.00, 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, ROESCH, MARIA,as principal,jointly and severally undertake, promise and agree <br /> to pay any amount of loss that may be sustained by Cass County by reason of the issuance <br /> of a duplicate in the said sum of$ 29.00, 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 day of AAci , 20�y. <br /> Signature/Title --J <br /> l!/14 G— 6 `C <br /> STATE OF Ak( D ,_ ) <br /> ) SS <br /> COUNTY OF 4/" ) <br /> On this S day of/2 7 , 20/L/ , before me personally appeared a representative <br /> of ROESCH, MARIA, 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 /> PAMELA J. HEYEN <br /> Notary Public <br /> 1 State of North Dakota <br /> My Commission Expires Mar, 21, 2018 o <br /> Notary Public <br />