Encl. 1 - Attachment 6 Payment Bond dated

PROCUREMENT AND PROPERTY MANAGEMENT DIVISION

BROOKHAVEN NATIONAL LABORATORY

Managed by Brookhaven Science Associates, LLC
under contract to the U.S. Department of Energy

Form No. AMS-Form-025
Revision No. 0.2

APPROVED BY:

L. McKnight / 12/14/2020

ACQUISITION MANAGEMENT SYSTEM FORM

PPM Manager/Date

Payment Bond
Date Bond Executed (Must be later than date of contract): PRINCIPAL (Legal name and business address)
Legal Name:
Address:
City, St. Zip

Type of Organization (“X” one)
Individual
Partnership
Joint Venture
Corporation

,
State of Incorporation:

PENAL SUM OF BOND

SURETY(IES) (Name and business address)
Name:
Address:
City, St. Zip

Million(s)

Thousand(s)

Hundred(s)

Cents

Contract Name/Title

,

Contract Date

Contract Number

OBLIGATION:

We, the Principal and Surety(ies) are firmly bound to the Brookhaven Science Associates L.L.C. and any successor Contractor to operate Brookhaven National Laboratory, (hereinafter called the Obligee) in the above penal sum. For payment of the penal sum, we bind ourselves, our heirs, executors, administrators, and successors, jointly and severally. However, where the Sureties are corporations acting as cosureties, we, the Sureties, bind ourselves in sum “jointly and severally,” as well as “severally” only for the purpose of allowing a joint action or actions against any or all of us. For all other purposes, each Surety binds itself, jointly and severally with the Principal, for the payment of the sum shown opposite the name of the Surety. If no limit of liability is indicated, the limit of liability is the full amount of the penal sum.

CONDITIONS:

The Principal has entered into the contract identified above.

THEREFORE:

The above obligation is void if the Principal promptly makes payment to all persons having a direct relationship with the Principle or a subcontractor of the Principle for furnishing labor, materials, or both in the prosecution of the work provided for in the contract identified above and any authorized modifications of the contract that are subsequently made. Notice of those modifications to the Surity(ies) are waived.

WITNESS:

The Principal and Surety(ies) executed this bid bond and affixed their seals on the above date.

PRINCIPAL

Signature(s)

1.

Name(s) and
Title(s) typed

1.

2.

3.

(Seal)

Date Printed 4/14/2023

(Seal)
2.

(Seal)
3.

Corporate
Seal

Date Approved 12/14/2020

PROCUREMENT AND PROPERTY MANAGEMENT DIVISION

Form No. AMS-Form-025

ACQUISITION MANAGEMENT SYSTEM FORM

Payment Bond (Continued)

INDIVIDUAL SURETY(IES)