Form F207-134-000 "Surety Rider" - Washington

What Is Form F207-134-000?

This is a legal form that was released by the Washington State Department of Labor and Industries - a government authority operating within Washington. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2000;
  • The latest edition provided by the Washington State Department of Labor and Industries;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form F207-134-000 by clicking the link below or browse more documents and templates provided by the Washington State Department of Labor and Industries.

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Download Form F207-134-000 "Surety Rider" - Washington

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STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
SURETY RIDER
TO BE ATTACHED TO AND FORM A PART OF BOND NUMBER ___________________
EXECUTED BY
AS PRINCIPAL,
___________________________________________________________
AND BY _____________________________________________, AS SURETY, IN FAVOR
OF THE STATE OF WASHINGTON, DEPARTMENT OF LABOR AND INDUSTRIES
In consideration of the mutual agreements herein contained, the Principal and the Surety hereby
consent to ( INCREASE / DECREASE ) the AMOUNT OF PENAL SUM OF SAID BOND
FROM:
TO:
The Surety undertakes and agrees that the obligation of this endorsement and the above
referenced bond shall cover and extend to all past, present, existing and potential liabilities of
said Principal, as a self-insurer, to the penal sum herein named, without regard to specific
injuries, date or dates of injuries, happenings or events. The aggregate liability for all acts and
defaults, whenever committed, shall in no event exceed the last sum named; it being the intent
hereof to preclude cumulative liability.
Nothing herein contained shall vary, alter or extend any provision or condition of this bond
except as herein expressly stated.
This rider is effective____________________________________________________________
Signed and sealed this ____________day of _________________________________________
PRINCIPAL
ACCEPTED BY:
DEPARTMENT OF LABOR AND INDUSTRIES
:
BY
BY: Program Manager for Self-Insurance
SURETY
:
BY
DATE
RESET
F207-134-000 SU-5 bond rider 10-00
STATE OF WASHINGTON
DEPARTMENT OF LABOR AND INDUSTRIES
SURETY RIDER
TO BE ATTACHED TO AND FORM A PART OF BOND NUMBER ___________________
EXECUTED BY
AS PRINCIPAL,
___________________________________________________________
AND BY _____________________________________________, AS SURETY, IN FAVOR
OF THE STATE OF WASHINGTON, DEPARTMENT OF LABOR AND INDUSTRIES
In consideration of the mutual agreements herein contained, the Principal and the Surety hereby
consent to ( INCREASE / DECREASE ) the AMOUNT OF PENAL SUM OF SAID BOND
FROM:
TO:
The Surety undertakes and agrees that the obligation of this endorsement and the above
referenced bond shall cover and extend to all past, present, existing and potential liabilities of
said Principal, as a self-insurer, to the penal sum herein named, without regard to specific
injuries, date or dates of injuries, happenings or events. The aggregate liability for all acts and
defaults, whenever committed, shall in no event exceed the last sum named; it being the intent
hereof to preclude cumulative liability.
Nothing herein contained shall vary, alter or extend any provision or condition of this bond
except as herein expressly stated.
This rider is effective____________________________________________________________
Signed and sealed this ____________day of _________________________________________
PRINCIPAL
ACCEPTED BY:
DEPARTMENT OF LABOR AND INDUSTRIES
:
BY
BY: Program Manager for Self-Insurance
SURETY
:
BY
DATE
RESET
F207-134-000 SU-5 bond rider 10-00