Free K-WC 131a (Rev. 12-99) - Kansas

Amendatory Rider to Surety Bond No. __________________
That this rider is to be attached to and form a part of Bond No. ___________________________ issued by ______________________________________________________ , a Surety, on behalf of the following named corporations: 1. 2. 3. 4. 5. 6. 7. 8. 9. _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________ _______________________________________________________________________________

10. _______________________________________________________________________________ That the Surety hereby agrees that the above named corporations are covered under and subject to the Surety Bond Agreement for Surety Bond No. ________________________. That the Surety company agrees that their obligations under Bond No. ________________________ extends to each of the above named corporations, subject to the terms set out in this Amendatory Rider. The penal amount of this Bond, that being $ ___________________ , shall be the liability of the Surety under this Bond as to each corporation named above individually, however, liability of the Surety as to all corporations combined shall not exceed the penal amount of $ ____________________. The effective date of this Amendatory Rider to Bond No. ____________________________ shall be _______________________, ______ . In witness whereof, the parties hereto have caused their names to be signed and this instrument to be sealed by the respective parties thereunder duly authorized.

Signed, sealed and delivered this __________ day of ______________________________ , 20_____.

FOR PRINCIPAL SIGNATURE PRINTED NAME ATTEST: ____________________________________ Corporate Secretary of Surety TITLE

FOR PRINCIPAL SIGNATURE

____________________________________ Printed Name

PRINTED NAME TITLE

K-WC 131a (12-99)

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