SBA Form 991 Surety Bond Guarantee Agreement Addendum

OMB Control No: 3245-0007
Expiration Date:
U.S. SMALL BUSINESS ADMINISTRATION
SURETY BOND GUARANTEE AGREEMENT ADDENDUM
Business Name
Business Trade Name

SBG Number

Instructions: If work has begun on the project, the small business must complete this form and submit it to the surety agent of choice with
the application. The completed form must include the signatures of the Principal and Obligee in part 3. If the application is submitted
electronically, the pre-populated form can be printed from the E-App system. The paper version is available on the Office of Surety
Guarantees website at www.sba.gov/surety-bonds.
When the work under a contract has actually begun, an SBA official having delegated authority to approve the bond in question (see 13
CFR part 101), may nevertheless guarantee a bond or bonds pursuant to Part 115 of 13 CFR, upon receipt, satisfactory to SBA, of all the
items below.
1. Evidence (certified copy of contract or sworn affidavit) from Principal that the surety bond requirement was contained in the
original job contract, or documentation, satisfactory to SBA, as to why a surety bond was not previously secured and is now
being required is attached hereto.
2. In the spaces below the Principal has certified that all suppliers and subcontractors are paid to date. If additional spaces are
needed attach hereto. A waiver of lien from each, or an explanation satisfactory to SBA why such certification cannot be
produced, is attached hereto.
Waiver of
Bill to
Paid to
Lien Attached
Suppliers
date
date
hereto
1. _________________________________
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2. _________________________________
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3. _________________________________
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4. _________________________________
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5. _________________________________
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Subcontractors
1.
2.
3.
4.
5.

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3. Certifications by Principal and Obligee.
By signing below, I certify on behalf of the Principal or Obligee that all information provided in connection with the application for a surety bond guaranty from SBA is
true, correct and complete to the best of my knowledge. I understand that knowingly making a false statement or submitting false information is a violation of Federal law
and could result in criminal prosecution or civil penalties under 18 U.S.C. §§ 287, 371, 1001, 15 U.S.C. § 645, or 31 U.S.C. § 3729. The Principal also hereby certifies
that all taxes and labor costs in connection with this job are current. The Obligee also hereby certifies that all payments due the Principal under the contract to present
status have been made and that the job has been satisfactorily completed to present status. Please provide reason why bond was not required prior to job starting.

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Signature of Principal

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Type or Print Name

___________________
Date

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Signature of Obligee
Type or Print Name
Date
4. All documents required from the Principal and Obligee are attached hereto and all items on this form have been certified to the SBA’s satisfaction.
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SBA Signature

_________________
Date

PLEASE NOTE: The estimated burden for completing this form is approximatley10 minutes per response. You are not required to respond to any collection of information
unless it displays a currently valid OMB approval number. Comments on the burden should be sent to U.S. Small Business Administration, Chief, AIB, 409 3rd St., S.W.,
Washington, D.C. 20416 and Desk Officer for the Small Business Administration, Office of Management and Budget, New Executive Office Building, Room 10202,
Washington, D.C. 20503. OMB Approval (3245-007). PLEASE DO NOT SEND FORMS TO OMB

FORM 991 (2/16) Previous Editions are Obsolete