The One Application

Please complete all required fields!

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Are you an insurance agent?

YesNo

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Agency Address If a PO Box, STE/Apt#

Below is the start of your client's information.

date format xx/xx/xxxx

Company Address If a PO Box, STE/Apt#

Have you had a surety claim?

YesNo

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License & Permit
Are you trying to obtain a license or a permit from a government agency?

YesNo

For example a Car Dealer license, Contractors license, Mortgage Broker license, Sales Tax Permit, Utility Service etc.,

Bid, Payment & Performance
Do you need a BID, PERFORMANCE, and PAYMENT bond for contract work?

YesNo

For example a contractor performing a contract for a government entity

Tell us how you want to proceed:

Ballpark pricing (only a few quick questions)

Yes No

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Official Quote (full application now)

YesNo

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Business Service
Are you a service orientated business and you wanted to say you’re bonded, but there is no requirement?

YesNo

For example an Accounting Firm, Dog Walker, Janitorial, Courier, or Other

Fidelity
Is this bond being required by your company in order to protect against dishonest acts of an employee? Fidelity and/or ERISA coverage

YesNo

For example if you have an employee that is caught stealing and is convicted of that crime there is coverage for you to recoup your losses.

ERISA
Do you need ERISA Coverage?

YesNo

Lost Instrument
Is this bond being required in order to replace a valuable document?

YesNo

For example if you lost the title to your car, the deed to your house, a cashier check or stocks

Probate
Is this bond being required in order to satisfy a PROBATE court requirement?

YesNo

For example if you are being appointed an administrator to an estate or guardian over someone

Notary
Is this bond being required to become a Notary?

YesNo

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More / General App
If you have answered No to all of the previous questions click here

More Options

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Have you sustained any employee Dishonesty losses in the last 6 years?
YesNo

Is the Plan for a Union?
YesNo

Is the company address the same as your home address

YesNo

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Owner Address If a PO Box, STE/Apt#

Personal Credit

Discribe your credit history?

Excellent
Poor

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Currently, or in the past 5 years:

Consumer Authorization

I authorize Platinum Insurance and Bonds, Inc. / and the Surety and/or Surety broker of their choice to make inquiries as necessary concerning or pertaining to the Owner(s), applicant(s), and third party indemnitor(s) listed in this application financial standing, credit report, character or manner of meeting obligations to verify the accuracy of the statements made and to determine their credit worthiness.
Please click to read FCRA disclosure and Terms of Use

Click here to acknowledge you have read and accept the Consumer Authorization

I accept

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Click to add an additional owner

Yes

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Have you spoken with one of our team members? If so please enter their name here

*Not all bonds are sent electronically, because some Obliges require originals to be mailed. Financing is available only via certain programs, not all bonds are able to be financed.