Date Company Address City State Zip ATTN: Contact ... - RR Simmons

BOND NO.______________
PAYMENT BOND
BY THIS BOND, We Company, Address, City State Zip ("Principal") and
_____________________________________________________________, a corporation organized and existing
under the laws of the State of ______________________ and authorized to do business in the State of Florida,
("Surety"), are held and firmly bound unto ("Obligee"), in the sum of $Price(Price in Words Dollars), for the
payment of which sum well and truly to be made, the Principal and Surety bind themselves, and their respective
heirs, administrators, executors, successors and assigns, jointly and severally.
WHEREAS, Principal has entered into a written agreement with Obligee dated the day of ,
2010, a copy of which is by reference made part hereof, consisting of the design and construction of Trade in
connection with the Project known as Premier Beverage (“Subcontract”).
NOW, THEREFORE, THE CONDITION OF THIS BOND IS THAT IF THE PRINCIPAL:
1. Promptly makes payment to all lienors as defined in Section 713.01, Florida Statutes, supplying
labor, materials or supplies, as used directly or indirectly by the Principal in the prosecution of the WORK provided
for in the Subcontract; and
2. Pays the Obligee all loss, damage, expense, costs, and attorneys' fees, including appellate
proceedings, which the Obligee sustains because of default by the Principal under Paragraph 1 of this Bond;
then this Bond is void; otherwise this Bond remains in full force and effect.
BE IT FURTHER KNOWN: Any changes in or under the Subcontract and compliance or noncompliance
with formalities connected with the Subcontract or with the changes shall not affect the obligation of the Principal
and the Surety, or either of them under this Bond.
THIS BOND DATED THE _____ DAY OF ________________, 200___.
Signed, sealed and delivered in the presence of:
Witnesses as to Principal
_____________________________
PRINCIPAL
Company
By:__________________________________
Printed Name:_________________________
Title:_________________________________
STATE OF ________________
COUNTY OF ______________
The foregoing instrument was acknowledged before me this ____ day of ____________, 2010, by
______________________________________, as__________________________________________ of
_____________________________________________________, on behalf of the corporation. He/she is
personally known to me OR has produced ___________________ as identification.
My Commission Expires:
____________________________________
(Signature of Notary)
Name:_______________________________
(Legibly Printed)