Alabama Automobile Club Bond

COMMISSIONER OF INSURANCE
STATE OF ALABAMA

AUTOMOBILE CLUB SURETY BOND

KNOW ALL MEN BY THESE PRESENTS, That _____________________________________,
Merchants Bonding Company (Mutual)
AS PRINCIPAL, (Hereinafter referred to as "the Principal"), and _________________________________
____________________________, AS SURETY, (Hereinafter referred to as "the Surety"), are held and
firmly bound unto _____________________________________________, Commissioner of Insurance of
Alabama, and his successors in office, in the sum of TWENTY-FIVE THOUSAND DOLLARS ($25,000)
in lawful money of the United States, to the payment whereof we hereby bind ourselves, jointly and
severally, and our successors, assigns and representatives.

THE CONDITION OF THE ABOVE OBLIGATION IS THAT:

WHEREAS, by virtue of Section 802 of Act No. 407, Acts of Alabama 1971, the above bounden
Principal is required to make a deposit of Twenty-five Thousand Dollars in cash or approved securities
with the Commissioner of Insurance of the State of Alabama, or in lieu thereof, to give and file with the
said Commissioner of Insurance a surety bond in the amount of Twenty-five Thousand Dollars of a surety
company authorized to do business in the State of Alabama, said bond and company to be approved by said
Commissioner of Insurance to be held by the said Commissioner of Insurance to assure the faithful
performance of its obligations to its members and subscribers by said Principal herein named, in the State
of Alabama, and

WHEREAS, the above bounden, the Principal herein named, has elected to give such surety bond
with the Surety above named:

NOW, THEREFORE, If the said Principal named herein shall faithfully perform its obligations to its
members or subscribers and shall pay each, every, and all of its liabilities to its members or subscribers in
the State of Alabama, after the said liabilities shall have been adjusted between the Principal and its
members or subscribers in the mode prescribed by the contract between the Principal and its members or
subscribers, if a mode be prescribed, or by judgment, order, or decree of a Court having jurisdiction of the
subject, and shall fully and faithfully respond to and settle all said obligations to its members or subscribers
resting upon it by virtue of its said contracts with its members or subscribers and the Principal, or imposed
upon it by the laws of the State of Alabama, then and in that event this bond shall be null and void.

IT IS FURTHER expressly understood and agreed by and between the parties hereto that this bond
may not be cancelled or released until after 30 days notice in writing to the Commissioner of Insurance of
the State of Alabama.

IN WITNESS WHEREOF, the said parties hereunto have caused to be set the hands of their
respective proper officers and to be affixed their respective corporate seals.

Signed and sealed in the presence of: FOR THE PRINCIPAL

_______________________ ____________ _________________________________________
Date President

_________________________________________
Secretary

FOR THE SURETY

Merchants Bonding Company (Mutual)
_______________________ ____________ _________________________________________
Date

Countersigned _________________________________________
Attorney-in-Fact

LP 2963 AL (8/11)

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