The individual named above, who is the owner/officer/related party of the applicant for this bond/policy, requested that this application be submitted to the Company (Construction Capital, Inc./CCI Surety, Inc.) for the purpose of “Underwriting” (determination for acceptability; potential, actual or future pricing; and other related services) of this bond/policy. A copy of such request for “Underwriting” of the bond/policy requested by the above individual was provided to and is maintained by this agent/agency. Further, this agent/agency discussed with the owner/officer/related party named above concerning the use of his/her personal credit history to facilitate the “Underwriting” of the applicant and received consent to use his/her personal credit history for such Underwriting purpose.

Vermont: If the owner/officer/related party of the applicant is a resident of the state of Vermont, the Agent shall obtain the written consent of such individual owner/officer/related party stating that: “The individual owner/officer/related party of the applicant understands and agrees that by submitting the application for the bond or insurance on behalf of the applicant that his/her personal credit history may be obtained and used to facilitate the underwriting process (determination of acceptability; potential, actual or future pricing; and other related services) of this application.” Also, the Agent agrees to retain copy of this written consent for the Surety.