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Presidential Insurance Service LLC: Providing Bonds Insurance in Florida & California.

Bond Insurance

Bond insurance is a service where issuers of a bond can pay a premium to a third party, who will provide interest and capital repayments as specified in the bond in the event of the failure of the issuer to do so. The effect of this is to raise the rating of the bond to the rating of the insurer. At the same time, a bond insurer's credit rating must really be almost perfect. Please call one of our associates to assist you with the purchase of a bond insurance policy.

We can be reached via phone at 305-244-3971 or via E-mail at info@insurancequotelive.com.

Agency Contact:

Agency Phone: -

Agency Fax:

Agency E-mail:

Agency Address:

SECTION I: BOND APPLIED FOR

Type of Bond:

Type of Company:

Bond Amount:

(Obligee):

Obligee Address:

Effective Date:

Expiration Date:

SECTION II: GENERAL INFORMATION

Applicant's Name:

Social Security #:

Spouse Name:

Social Security #:

Home Phone: -

Residence Address:

Business Name:

Business Phone: -

Business Fax:

Business E-mail:

Business Address:

Date Business Begain Under Present Individual or Film Name:

Business Tax ID:

Has Any Company Refused to Issue Bonds for Any Purpose? Yes No

If Yes - Explain

Has Applicant Ever Failed in Buisness? Yes No

If Yes - Explain

Has Applicant Ever Filed Bankruptc? Yes No

If Yes - Explain

Do You have Any Liend, Claims of Judgment Against You? Yes No

If Yes - Explain

PERSONAL FINANCIALS (IF MORE THAN ONE OWNER, EACH HAS TO FILL OUT THIS APPLICATION)

STATEMENT OF ASSETS AND LIABILITIES AS OF

ASSETS			LIABILITIES
CASH ON HAND			NOTES PAYABLE TO BANKS
STOCKS AND BONDS			NOTES TO OTHERS (EXCL. OF EQUIPMENT)
ACCOUNTS RECEIVABLE			ACCOUNTS PAYABLE
NOTES RECEIVABLE			FEDERAL & STATE INCOME TAX DUE
INVENTORY			ALL OTHER TAXES
CASH VALUE LIFE INSURANCE			ACCRUALS, PAYROLLS, ETC .
EQUIPMENT
REAL ESTATE			DUE ON EQUIPMENT
OTHER ASSETS			DUE ON REAL ESTATE
			OTHER LIBAILITIES
			CAPITAL STOCK (IF A CORPORATION)
			SURPLUS AND UNDIVIDED PROFITS

TOTAL ASSETS			TOTAL LIABILITIES
			NET WORTH

Name of Owners	Name and Title of Officers	% of Ownership in Company

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