Please go to the Bond Applications page and select the surety bond or undertaking you are interested in. Once you have found your application:
- Fill out the PDF form online, print it, and sign it. Then please fax, mail, or scan/email the form to us:
Fax: (661) 325-2322
Mail: 1401 19th Street, Suite #117, Bakersfield, CA 93301
– If you are applying for a bond on behalf of a company, please attach a business financial statement for all bonds over $10,000.
– By completing one of our online forms, you hereby authorize the surety or its representatives to have the right to examine the credit history of the named applicant.
– If the bond and/or bond application you are seeking is not available on our website, please contact us directly so that we can expedite it to you as quickly as possible.
– Permit/License/Misc Bonds. If you are applying for a permit bond, any license bond, or a miscellaneous bond, please make sure to fill out the personal financial statement at the end of the application.
– Medicare: Durable Medical Equipment, Prosthetics, Orthotics, and Suppliers Surety Bonds (DMEPOS).
- For entities with one (1) or two (2) National Provided Identifier (NPI), please complete the one page application.
- For entities with three (3) or more National Provider Identifier (NPI) Numbers, provide the following additional information:
- Year – end business financial statements;
- Personal financial statements
- Copy of completed Medical Enrollment Application from CMS-855s.
- Important Signature Instructions:
- If Sole Proprietorship, Owner must sign as authorized representative and as indemnitor. Spouse must sign as indemnitor.
- If Partnership, Managing Partner must sign as authorized representative and as indemnitor. All partners and spouses must sign as indemnitor.
- If Coproration, President must sign as authorized representative and as indemnitor. All stockholders of 10% of more and spouses must sign as indemnitor.
- If the DMEPOS Bond Amount is over $50,000, each signature must be notarized.