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<br />, 32S~r-INDEMNITY HOND FOR LOST INSTRUMENT. (Sec. 21-06-03. 32-02-O1. N- D. C. CJ oioee oe: cr*e.w~HreroM. e. o.
<br />INDEMNITY BOND ON LOST INSTRUMENT
<br />Robert K or Mary Jane Carlson
<br />Whereas,...> .--w_--_--- _---- --------------. --•----------_--. ---_-----.-----------------_---.---.--___---hereinafter designated as claimant,
<br />State Bank Fargo check i+~28322
<br />claims to be the owner and entitled to the payment of a certain____________________________________________________________________________________________
<br />April 6, 2009 April 6, 2009
<br />dated----------------------------------•---------------------------------------------------. _ d u e---------- -------- -------------------------------------- --------------------------------------------
<br />Robert K or Mary Jane Carlson
<br />payable to-•-------- -------------------------------------•------------------------•---•------------•-------------
<br />for the sum of___Two _Hundred_ Forty-five and 00/100-------------------°-°--------------
<br />------•-••---------------------------- -------------------------------------------------•-----------------Dollars,
<br />executed by.._-_Cass County Government
<br />but is unable to produce or surrender said instrument upon such payment on account of its loss, destruction, or
<br />otherwise.
<br />NOW, THEREFORE, If---------------------------------------------------------------------------------------------------------------------------------•--hereinafter
<br />designated as obligee, will pay or cause to be paid to said claimant, or order, the amount demanded by him by virtue
<br />thereof, we, the undersigned, do jointly and severally promise, undertake and agree to and with said obligee, his or
<br />its successors, heirs, administrators and assigns, that we will save said obligee, his or its successors, heirs, administra-
<br />tors and assigns, harmless from any and all claims of any person or persons in and to said instrument, or to the pay-
<br />ment thereof, in whole or in part, and from any and all damages, remote or proximate, sustained by virtue of said
<br />payment, including all attorney's fees, costs, 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 thereto, the amount so paid to said
<br />claimant by said obligee with accrued interest thereon from the date of such payment at the rate of-_______-___per cent
<br />per annum and undertake and perform any and all steps, actions or proceedings which said obligee may deem necessary
<br />or requisite to save said obligee harmless from further liability, co~sjt expense or damage in the premises.
<br />Dated this---------~~.--~~,---------------•-----------•------..day of--------------- ~-_ `_-!!~ zv~9
<br />__ ..
<br />igne and D e din the Presence of ___________________ _._.CH~1RLpI:7~-M:-$AB~ER-
<br />%'~ ., NOTARY PUBLIC -MINNESOTA
<br />-•---------------••---•--•----------- -----•-----------------------•--------••--•--•-•-•---•------ •-•------•-------- - ..: ' --------MX_OS~MMISStON------
<br />EXPIRESJAN. 31, 2012
<br />~p,~ ax ~~6ZZ-
<br />- -----------------------= - /r ~~--
<br />....(SEAL)
<br />...(SEAL)
<br />....(SEAL)
<br />STATE OF NORTH DAKOTA
<br />County of------------------------------------------------ ss.
<br />______________________________________in the ear _____._ before me
<br />On this-------•------•--------------------•---------•------•-•----- aY o -•-------•--•--•---•=- Y >
<br />personally appeared---•-----•-----•--------------•----•--------------•----••-----------•-----•---•--•--•--•----------------••--------•-------------------•----•----•
<br />a n d--•------- •--------------------------------•-------------------•--•------• •----• •-•-•-•------------------------------•-•-----•-•------•---------------------•------•-----------•
<br />- -------------------
<br />known to me to be the persons who are described in and who executed- the within instrument, and, who, each for
<br />himself, personally acknowledged to me that they executed the same. -
<br />My commission expires-------------••----------•-----•----•_•----•---•- -------- -•--•----•--••----------------•------•---------•--------•-----•-----------•---------------------
<br />SUGGESTED MOTION:
<br />Move to receive and file Indemnity Bond on Lost Instrument for Robert K. and Mary
<br />Jane Carlson; and authorize the county auditor and county treasurer to issue a
<br />duplicate check.
<br />
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