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Get your Bid or Contract Bond online today.

Step 1 of 5

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What type of Contract Bond do you require?*
Which state is the bond for?*
Do you require a bond amount larger than $400,000?*
- Yes
- No
What is the bond amount?*
Is this bond for a company or individual?*
- Company
- Individual
Bond amount cannot exceed $400,000
Contact info@suretysolutions.com and request assistance for your bond. Please include the state, bond type and bond amount you require in your email. Thank you.

Individual Personal Information
Name*
First Last
Do you have a middle name?*
- Yes
- No
What is your middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
County
Is the mailing address the same?*
- Yes
- No
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Last
Does your spouse have a middle name?*
- Yes
- No
What is your spouse's middle name?*
Spouse's Email*
Enter Email Confirm Email
Company Information
Company Name*
Does your company have a DBA?*
DBA = "Doing Business As"
- Yes
- No
Company's DBA*
Number of Owners*
Company Type*
- CCorp
- LLC
- Partnership
- Proprietorship
- SCorp
Phone*
Primary Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Is the mailing address the same?*
- Yes
- No
Mailing Address*
Street Address Address Line 2 City State ZIP Code
Date Company was Established*
MM slash DD slash YYYY
FEIN*
Number of Employees*

Owner #1 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email
Owner #2 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email
Owner #3 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email
Owner #4 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email
Owner #5 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email
Owner #6 Information
Name*
First Last
Does he/she have a middle name?*
- Yes
- No
What is her/his middle name?*
Email*
Enter Email Confirm Email
Home Phone*
Date of Birth*
MM slash DD slash YYYY
Social Security Number*
Address*
Street Address Address Line 2 City State ZIP Code
Marital Status*
- Single
- Married
Spouse's Name*
First Middle Last
Spouse's Email*
Enter Email Confirm Email

Contractors areas of operation*
Type of work to be performed*
Contractor job description*
Largest job completed in last 5 years*
Company: Any change in ownership since last bond issued?*
- Yes
- No
Any owner / indemnitor: Any change in ownership since last bond issued?*
- Yes
- No
Company: Ever failed in business or declared bankruptcy?*
- Yes
- No
Any owner / indemnitor: Ever failed in business or declared bankruptcy?*
- Yes
- No
Company: Ever failed to complete a project?*
- Yes
- No
Any owner / indemnitor: Ever failed to complete a project?*
- Yes
- No
Company: Ever caused a surety a loss or have an open claim?*
- Yes
- No
Any owner / indemnitor: Ever caused a surety a loss or have an open claim?*
- Yes
- No
Company: Do you have an open lien, suit or judgement?*
- Yes
- No
Any owner / indemnitor: Do you have an open lien, suit or judgement?*
- Yes
- No
Starting Date of Work*
MM slash DD slash YYYY
Job Liquidated Damages*
Job Maintenance Term*
Job Site Address*
Street Address Address Line 2 City State ZIP Code
Job Completion Date*
MM slash DD slash YYYY
Bid Bond Date*
MM slash DD slash YYYY
Bid Bond Percentage*
Bid Bond Estimated Bid Amount*
Bid Bond Amount Subcontracted (Percentage)*
Bid Bond Expected Completion Date*
MM slash DD slash YYYY
Bid Bond Status of Outstanding Bids*
Bid Bond Project 1:*
Bid Bond Project 2:*
What is the desired effective date for the bond?*
MM slash DD slash YYYY
Name Printed on Bond:*

Obligee Information
The Obligee is the entity requiring you to have this bond.
Obligee Name*
Obligee Physical Address*
Street Address Address Line 2 City State ZIP Code
Obligee Physical County
Is the Obligee's mailing address the same?*
- Yes
- No
Obligee Mailing Address*
Street Address Address Line 2 City State ZIP Code
Obligee Phone
Obligee Fax
Obligee Email*
Enter Email Confirm Email
Contact 1:
Contact 2:
Contact 3:
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Contact Surety Solutions, A Gallagher Company

Email: customercare@suretysolutions.com

4285 Commercial Street SE
Suite 110
Salem, OR 97302

(866) 722-9239

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