"Prepaid Service Plan Qualifying Bond" - Kansas

Prepaid Service Plan Qualifying Bond is a legal document that was released by the Kansas Insurance Department - a government authority operating within Kansas.

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PREPAID SERVICE PLAN QUALIFYING BOND
KNOW ALL MEN BY THESE PRESENTS, THAT _____________________________
Of _________________________, ____________________________, as principal, and
(City)
(State)
_________________________________________, of ______________________________,
(City)
___________________________, as surety, are held and firmly bound to the Commissioner of
(State)
Insurance of the State of Kansas, and his successors, and on behalf of all persons whose
application for Kansas membership in the above named principal has been accepted by such
principal or his representative, in the penal sum of __________________________ for payment
of which, well and truly to be made, we do jointly and severally bind ourselves, our heirs,
personal representatives, successors and assigns for the protection of Kansas members in this
plan.
The above named principal has made application to the Commissioner of Insurance for a
Certificate of Registration to operate a prepaid service plan in Kansas as provided by K.S.A. 40-
4201, et seq. This obligation shall be for the benefit of any person or persons sustaining an
actionable injury due to the failure of the prepaid service plan to faithfully perform its obligations
to its members or those providers with whom it has contracted, and shall be subject to action
thereon by any such person or persons for such purposes in the event of insolvency or impairment
of the prepaid service plan.
Now, therefore, if such Certificate of Registration is issued, and if the above named
principal, his agents, servants and employees shall comply with the prepaid service plan and shall
faithfully furnish and render any and all of the prepaid services sold or offered for sale by it, and
shall pay any fines, fee, or penalties imposed upon it pursuant to K.S.A. 40-4201, et seq., then
this obligation shall be void; but, otherwise to remain in full force and effect until cancelled
pursuant to the provisions of K.S.A. 40-4211 (e).
Witness our hands this __________ day of ___________________________, __________.
_______________________________________
_______________________________________
_______________________________________
(Principal)
_______________________________________
(Surety)
By: ___________________________________
(Attorney –In-Fact)
BOND Page 1 of 2
PREPAID SERVICE PLAN QUALIFYING BOND
KNOW ALL MEN BY THESE PRESENTS, THAT _____________________________
Of _________________________, ____________________________, as principal, and
(City)
(State)
_________________________________________, of ______________________________,
(City)
___________________________, as surety, are held and firmly bound to the Commissioner of
(State)
Insurance of the State of Kansas, and his successors, and on behalf of all persons whose
application for Kansas membership in the above named principal has been accepted by such
principal or his representative, in the penal sum of __________________________ for payment
of which, well and truly to be made, we do jointly and severally bind ourselves, our heirs,
personal representatives, successors and assigns for the protection of Kansas members in this
plan.
The above named principal has made application to the Commissioner of Insurance for a
Certificate of Registration to operate a prepaid service plan in Kansas as provided by K.S.A. 40-
4201, et seq. This obligation shall be for the benefit of any person or persons sustaining an
actionable injury due to the failure of the prepaid service plan to faithfully perform its obligations
to its members or those providers with whom it has contracted, and shall be subject to action
thereon by any such person or persons for such purposes in the event of insolvency or impairment
of the prepaid service plan.
Now, therefore, if such Certificate of Registration is issued, and if the above named
principal, his agents, servants and employees shall comply with the prepaid service plan and shall
faithfully furnish and render any and all of the prepaid services sold or offered for sale by it, and
shall pay any fines, fee, or penalties imposed upon it pursuant to K.S.A. 40-4201, et seq., then
this obligation shall be void; but, otherwise to remain in full force and effect until cancelled
pursuant to the provisions of K.S.A. 40-4211 (e).
Witness our hands this __________ day of ___________________________, __________.
_______________________________________
_______________________________________
_______________________________________
(Principal)
_______________________________________
(Surety)
By: ___________________________________
(Attorney –In-Fact)
BOND Page 1 of 2
Countersigned in Kansas
By__________________________________
Title_________________________________
Address_____________________________
APPROVAL
The above and foregoing bond is hereby approved and filed in the office of the
Commissioner of Insurance, this ________ day of ____________________, __________.
_______________________________________
Commissioner of Insurance State of Kansas
By: ___________________________________
(This bond must be accompanied by a Power of Attorney from the Surety to the Attorney-In Fact
specifying his authority).
BOND Page 2 of 2
Page of 2