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<br />OI.OB[ QAUTT[.WAHPtTOH_ N.D.
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<br />==---=~"C='=---==32~INDEMNIfY-BONDFORLOST INS--i-'RU~N~ (S;~~ 21.06.03. 32.02.01. 'N~-n.;:~.---~---'.
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<br />INDEMNITY BOND ON LOST INSTRUMENT
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<br />On this..m__......ou..J.1.i~..m........__.........__day of.ou........m...~f.m'r:;.~....Y'....__......in the year ),P.pJ, before me, [!
<br />p erson ally appeared.... ..........b..i.. ~.~__...n~__r.~j~ .KL.................... ................. .........000.......:__.. ...__.....~........ '.n,. ~... ..00....... ! i
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<br />an d............ -..... --..- -..... -.. ~ ~ --.... ..-- ---.. ------ ----.... ..-.. - -~.. -~. - ..---~ ~-- ...-....- ..-~ - ----_ - -___.. _ ~___.... _ _~~ _ _._ _ _. _ _~.~. _ ~~ ._........__. _~..~.... ..~~....~ ........~ _.. ~ ...... ~.._ _~.. _... ..~.... ~ ~_.. __. ~. .._... _. ..~ _~. .._. ._.. ~.. 1 i
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<br />known to me to be the persons who are described in and who executed the within instrument, and, who, each for II
<br />him,df, pmoually aoknowlodg,d to m, that th,y mou<<d t~o.'a.~::K~..Z;;.:...&:s.Jht_.......... I'
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<br />My commission expires...m{&J....?:...I..?:.~Lb.......... ou-~.~.. '" ...00..............000__ Ii
<br />KAREN E. BLIXT I:
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<br />Notary Public II
<br />Slate 01 North Dakota ii
<br />My Commission Expires May 2, 2012 Ii
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<br />Wh ereas,m.~~......Ja~m.......................m__.... ....... .....................n..h erein after design a ted a s claim an t, I'
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<br />claims to ~ the owner and entitled to the payment of a certain..............~....!!:..jf...1.~O.m...mm...................... ii
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<br />dat,d...... . ~.l,...~~~.t....._..._........._...........dUO.........#"7.../J.<Rf)o..i....................................... i'
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<br />payab!, to.--......(i...d..~...i1Jl1.~..........._................ij!!..................................................:;............... [.
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<br />for tho sum of..~.~f..'l5i-)..~:./.~...."!,.<f.~.~.......::........... noll...., ~!
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<br />,""",<<d by ..........--......................L~.......f!.4................................._....................................................... Ii
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<br />but is unable to produce or surrender said instrument upon such payment on account of its loss, destruction, or II
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<br />Otho;:~, THEREFORE, If..._....ct~.~~.........._.....................__....m.....mm....m.......:......h"Oin.f<<r ! i
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<br />designated as obligee, will payor cause to be paid to said claimant, or order, the amount demanded by him by virtue i~
<br />thereof, we, the undersigned, do jointly and severally promise, undertake and agree to and with said obligee, his or !i
<br />its successors, heirs, administrators and assigns, that we will save said obligee, his or its successors, heirs, administra- Ii
<br />tors and assigns, harmless from any and all claims of any person or persons in and to said instrument, or to the pay- 'il
<br />ment thereof, in whole or in part, and from any and all damages, remote or proximate, sustained by virtue of said I
<br />payment, including all attorney's fees, costs, expenses, charges, or liabilities assumed, incurred or expended, and will !I
<br />at any time up,Ondemand payor eause to be paid to said obligee, in addition thereto, the amount so paid to said !i
<br />claimant by said obligee with accrued interest thereon from the date of such payment at the rate oL..........per cent !I
<br />per annum and undertake and perform any and all steps, actions or proceedings which said obligee may deem necessary II
<br />or requisite to save said obligee harmless from: further liability, cost expej/ or damage in the premises. Ii
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<br />X Dated this.................L1'P:..m................m..day oL.~t!.(0/?j!'................. ~QQ 7 Ii
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<br />........... ........ ......... """""''' .................. ........ m. ............ 00""" ......... ... ..................00............................ ____.... 000........................ (S EAL)
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<br />STATE OF NORTH DAKOTA I
<br />Coun ty of.................................................. ss.
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<br />and...............m....................__...m........m...m.........m..__..................m....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 />the State of North Dakota and a resident of the said County oL.............................................................., North Dakota.
<br />Tha t he is worth th e su m of... ............ ............................. .........000. __000.......................................... ...... ..:......... ...___. ...........DolI ars
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