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UNI 1 ED FIRE &CAST JALTY COMPANY LI UNITED LIFE INSURANCE COMPANY <br />118 Second Avenue, SE., Cedar Rapids, Iowa 52407 Phone (319) 399 -5700 <br />GENERAL FORM STATUS INQUIRY <br />r <br />City of Little Canada <br />515 Little Canada Rd. <br />Little Canada, MN 55117, <br />-1 <br />L J <br />Contractor• Edward W. McCttmher <br />Address• St. Paul, MN <br />1 -15 -R2 19 <br />Our Bond No <br />54 17414 <br />Reinsured's No <br />on site landscaping at 608 county rd. D <br />DescriptionoEContract: <br />Owner <br />City of Little Canada, MN <br />3,000.00 3,000.00 4 -7 -80 <br />Contract Price $ Bond(s) 8 Effective Date <br />Without prejudicing your right or effecting our liability under our bond(s) described above, we would appre- <br />ciate such of the following information as is now available. <br />Ve <br />By <br />you <br />WA Jitra- <br />Bond Department <br />1. IF CONTRACT COMPLETED, PLEASE STATE: <br />Approximate date of completion of work(or final delivery) <br />Approximate acceptance date <br />Final Contract Price $ <br />2. IF CONTRACT UNCOMPLETED, PLEASE STATE: <br />Approximate percentage or dollar amount of contract completed or delivered <br />3. Do you know of any unpaid bills for labor or material (Check) Yes — No — <br />4. Remarks: (If any) <br />It is understood that the Information contained herein is furnished as a <br />matter of courtesy for the confidential use of the surety and Is merely <br />an expression of opinion. It Is idso agreed that In furnishing this infor- <br />mation, no guaranty or warranty of accuracy or correctness is made <br />and no reaponsibWty 1s assumed as a result of reliance by the surety, <br />whether such Information is furnished by the owner or by an architect <br />or engineer as the agent of the owner. <br />Date <br />Owner <br />By <br />Title <br />Address <br />The language of this form is acceptable to The Surety Association of America <br />UND -2026b <br />:.)p <br />