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INDEMNITY BOND ON LOST INSTRUMENT <br /> <br /> Carol Kirchof f <br /> Whereas,. ...................................................................................................................... hereinafter designated as claimant, <br /> <br /> claims to be the owner and entitled to the payment of a ..... :_ State Bank FArgo ck#20157 <br /> dated February 19, 2003 , February 19, 2003 <br /> <br /> Carol Kirchof f <br /> payable to <br /> <br /> Cass County Government <br />executed by .......................................................................................................................... <br />but is unable to produce or surrender said instrument upon such payment on account of its loss, destruction, or <br />otherwise. <br /> <br />designated as obllgee, will pay or cause to be paid to said clalmafltv, or order, the amount demanded by him by virtue <br />thereof, w% the undersigned, do jointly and severally promise, undertake and agree to and with said obllgee, his or <br />its successors~ heirs, admlni~trators and assigns, that we will save said obligee, his or its successors, heirs, admlnlstra- <br />tots and assign% harmless from any aud all claims of any person or persons in and to said instrument, or to the pay- <br />ment thereot, in whole or in part, and from any and all damages, remote or proxi~nat% sustained by virtue of sa~d <br />payment, includingall attorney's fees, co~% expenses, charges, or liabilities assumed, incurred or expended, and will <br />at any time upon demand pay or cause to be paid to said obligee, in addition theret% the amount so paid to said <br />claimant by said obligee with accrued interest thereon horn the date of such payment at the rate of ............ per cent <br />per annum and undertake and perform auy and all steps, actions or proceedings which said obllgee may deem necessary <br />or requisite to save said obligee harmles~ from furtber liability, cost, expense or damage in the premises. <br /> <br /> Dated thls <br /> ~.. <br /> S~ ned and Dehv <br /> 'g ' ~red in the~Pre?ence of ........... ~ ................. (SEAL) <br /> / ~ .... / ~ ........ <br /> <br /> STATE OF NORTH DAKOTA <br /> <br /> 4 x~t~ {" . -' <br />personally appeared d~ ~ <br /> ........................... 7 'T' .............................................................................................. <br /> <br />known to me to be the persons who are described in and who executed the within iuatrument, and, who, each for <br /> <br /> STATE OF NOR'FI! DAKO'FA ] <br /> SS. <br />County of .................................................. <br /> <br />and ........................................................................................................ being first duly sworn, upon oath, each for himself <br />doth say: The he is one of the sureties on, and who executed the within and foregoing bond. That he is a freeholder of <br /> <br />the State of North Dakota and a resident of the said County of_ ............................................................... , North Dakota. <br />That he is worth the sum of ............................................................................................................................................ Dollars <br />in propert]/within this state over and above all his debts and liabilities and exclusive of all his property exempt by <br />the laws of this State from levy and sale on execution or attachment. <br /> <br />SUGGESTED MOTION: <br />Move to receive and file the Indemnity Bond on LOst Instrument for Carol Kirchoff, and authorize the <br />county treasurer and the county auditor to issue a duplicate check. <br /> <br /> <br />