Fill and Sign the Indemnity Agreement with Form

Indemnity Agreement in Connection with Warehouse Receipt Warehouse Receipt No.       issued from       , (Name of Warehouse) at       has been lost or misplaced and after (Street Address, City, County, State, Zip Code) diligent search cannot be found. Owner,       , has applied (Name of Owner) for a duplicate receipt issued as No.       to take the place of the lost receipt and       , as principal, and       , (Name of Principal) (Name of Surety) as surety, stand firmly bound to       , as its successors (Name of Warehouse) and/or assigns, in the full sum of $       as an indemnity bond if       should become liable for any loss occasioned due (Name of Warehouse) to the issuance of duplicate Receipt No.       or if judgment shall be entered against       , we bind ourselves, our heirs, (Name of Warehouse) administrators, executors, successors and/or assigns severally and jointly, to pay such loss or judgment as well as the costs of any litigation which may ensue, including but not limited to, reasonable attorney's fees incurred. Dated:             (Name of Principal)       (Name of Surety) By: (Signature of Officer of Surety)       (Print or Type Name)       (Title of Officer of Surety) Indemnity Agreement in Connection with Warehouse Receipt Page 1 of 1