Form FDACS-03587 "Lp Gas Indemnity Bond" - Florida

Form FDACS-03587 or the "Lp Gas Indemnity Bond" is a form issued by the Florida Department of Agriculture and Consumer Services.

The form was last revised in August 1, 2018 and is available for digital filing. Download an up-to-date fillable Form FDACS-03587 in PDF-format down below or look it up on the Florida Department of Agriculture and Consumer Services Forms website.

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Download Form FDACS-03587 "Lp Gas Indemnity Bond" - Florida

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Florida Department of Agriculture and Consumer Services
Division of Consumer Services
LP GAS INDEMNITY BOND
ADAM H. PUTNAM
Section 527.04, Florida Statutes
COMMISSIONER
Bond amount:
$300,000 Category 3 (Cylinder Exchange Operator)
$1,000,000 Category 1 (Dealer), Category 2 (Dispenser), Category 5 (Installer) and Category 6 (Miscellaneous)
STATE OF FLORIDA
COUNTY OF _________________________
Bond No. __________________________________
KNOW ALL MEN BY THESE PRESENTS:
That we,
as principal,
and
, as surety authorized to do business in
Florida, are held and firmly bound to pay unto
as Commissioner of
the Florida Department of Agriculture and Consumer Services, and his/her successors in office, the penal sum of as elected
above), for the payment whereof, well and truly to be made, we bind ourselves, our heirs, executors, administrators,
successors and assigns, jointly and severally, firmly by these presents; provided however, that the aggregated liability of the
surety to all persons shall in no event exceed the said penal sum of as elected above.
Signed, sealed, and delivered on this
day of
, AD 20______.
The condition of this bond is such that, whereas, the above bounden principal has applied to the Department of
Agriculture and Consumer Services of the state of Florida for a license to be issued by said Department to engage in the
business of ____________________________________________, in pursuance of the provisions of Chapter 527, Florida
Statutes, such Act being a law regulating such aforesaid business:
________________________________
Now therefore, if the above bounden principal shall well and truly comply with the provisions of the aforesaid Act and all
such rules and regulations as said Department of Agriculture and Consumer Services may prescribe with respect to the
conduct of the aforesaid business: _____________________________________________ for which such principal seeks a
license and shall indemnify and save harmless any and all persons from loss of damage by reason of the above principal's
failure to comply with any of such provisions of said Act or any of such rules and regulations, then this obligation to be null
and void, otherwise to be and remain in full force, virtue and effect.
FDACS-03587 08/18
Page 1 of 2
Florida Department of Agriculture and Consumer Services
Division of Consumer Services
LP GAS INDEMNITY BOND
ADAM H. PUTNAM
Section 527.04, Florida Statutes
COMMISSIONER
Bond amount:
$300,000 Category 3 (Cylinder Exchange Operator)
$1,000,000 Category 1 (Dealer), Category 2 (Dispenser), Category 5 (Installer) and Category 6 (Miscellaneous)
STATE OF FLORIDA
COUNTY OF _________________________
Bond No. __________________________________
KNOW ALL MEN BY THESE PRESENTS:
That we,
as principal,
and
, as surety authorized to do business in
Florida, are held and firmly bound to pay unto
as Commissioner of
the Florida Department of Agriculture and Consumer Services, and his/her successors in office, the penal sum of as elected
above), for the payment whereof, well and truly to be made, we bind ourselves, our heirs, executors, administrators,
successors and assigns, jointly and severally, firmly by these presents; provided however, that the aggregated liability of the
surety to all persons shall in no event exceed the said penal sum of as elected above.
Signed, sealed, and delivered on this
day of
, AD 20______.
The condition of this bond is such that, whereas, the above bounden principal has applied to the Department of
Agriculture and Consumer Services of the state of Florida for a license to be issued by said Department to engage in the
business of ____________________________________________, in pursuance of the provisions of Chapter 527, Florida
Statutes, such Act being a law regulating such aforesaid business:
________________________________
Now therefore, if the above bounden principal shall well and truly comply with the provisions of the aforesaid Act and all
such rules and regulations as said Department of Agriculture and Consumer Services may prescribe with respect to the
conduct of the aforesaid business: _____________________________________________ for which such principal seeks a
license and shall indemnify and save harmless any and all persons from loss of damage by reason of the above principal's
failure to comply with any of such provisions of said Act or any of such rules and regulations, then this obligation to be null
and void, otherwise to be and remain in full force, virtue and effect.
FDACS-03587 08/18
Page 1 of 2
Provided further, that in the event of any claim and/or claim payment by the surety under this bond the surety shall
forthwith notify the Chief of the Bureau of Compliance, Department of Agriculture and Consumer Services of the state of
Florida at Tallahassee, Florida, of said claim and/or claim payment; and provided further that either the principal or the
surety may cancel this bond by giving thirty (30) days written notice to the Department of Agriculture and Consumer
Services at Tallahassee, Florida, and if cancelled by the surety, a copy of said cancellation notice shall be sent by mail to the
principal at his business address. In case of such cancellation, no further obligation shall be incurred under this bond by the
surety after the expiration of said thirty (30) days, but the liability of the surety shall apply as above set out as to any acts or
omissions which may have occurred prior to the effective date of such cancellation.
Witness as to execution by Principal
Principal (Attorney-in-Fact)
Countersigned/Licensed Florida Agent
Principal Signature (Attorney-in-Fact)
Agent Identification Number
Surety
FDACS-03587 08/18
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