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<br />SIGNED and SEALED this <br /> <br />day of <br /> <br />2005. <br /> <br />PRINCIPAL <br /> <br />IMPORTANT NOTICE <br />An individual doing business <br />under a firm name must give both <br />names, and the individual shall <br />designate himself as sole owner. <br /> <br />(SEAL OF PRINCIPAL) <br /> <br />By: <br /> <br />Title: <br /> <br />SURETY <br /> <br />If a partnership, so state, and at <br />least one member of such <br />partnership must sign, <br /> <br />If a corporation, the full corpo- <br />rate name must be used and <br />the execution must be by an officer <br />of the corporation. <br /> <br />COMPLETE MAILING ADDRESS <br /> <br />(SEAL OF SURETY) <br /> <br />By: <br /> <br />Title: <br /> <br />Any other person executing for <br />the principal or surety must at- <br />tach a power of attorney. <br /> <br />COMPLETE MAILING ADDRESS <br /> <br />NOTICE TO SURETY <br />Section 26.1-03-01, N.D.C.C. Provides: <br /> <br />"Limitation on risks acceptable by company. An insurance company transacting an insurance business in this <br />state may not expose itself to loss on anyone risk or hazard to an amount exceeding ten percent of its paid-up capital <br />and surplus if a stock company, or ten percent of its surplus if a mutual company, unless the excess is reinsured." <br /> <br />If excess reinsurance agreements are required on this bond, an affidavit executed by an officer of the surety shall be <br />attached, stating that such reinsurance agreements have been entered into and are in effect at the time the bond is <br />executed, giving the name an address of all companies with whom such agreements have been entered, and that <br />copies of such reinsurance agreements will be furnished to the North Dakota commissioner of insurance. <br /> <br />ACKNOWLEDGMENT OF PRINCIPAL <br /> <br />State of <br /> <br />ss. <br /> <br />County of <br /> <br />On this <br /> <br />day of <br /> <br />2005, before me a notary public in and for the state of <br />, personally appeared , known to me to <br />be (title) of the principal described in the within instrument and who executed the <br />same and acknowledged to me that the same v.as executed for and on behalf of said principal. <br /> <br />Notary Public, State of <br /> <br />(Notary Public must print or type name here,) <br /> <br />(NOTARY SEAL) <br /> <br />My Commission expires <br /> <br />2 of3 <br />