Professional Documents
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1 RECORDING REQUESTED BY
C/O Street
City, Colorado
I, upper lower name, hereinafter “the Undersigned” do hereby promise to pay “pledge”
myself as surety as follows:
Whereas: There exists a requirement in the State of Colorado pursuant to CRS 42-7-103
14(a) that drivers of motor vehicles have evidence of financial responsibility and;
Whereas: The Undersigned may operate a motor vehicle, and or may be subject to Vehicle
Code 42-7-103 14(a) and its related provisions, and;
Whereas: The Undersigned has not been able to locate any lawful money of account in
circulation (Gold or Silver coin or bullion) in this State, and;
Whereas: Public Policy as established with House Joint Resolution 192 of June 5, 1933 states
in part:
with respect thereto, shall be discharged upon payment, dollar for dollar,
in any coin or currency which at the time of payment is legal tender for
public and private debts. Any such provisions contained in any law
Now therefore and in consideration thereof, the Undersigned does hereby promise to pay i.e.
undertakes, “bonds” UPPER CASE NAME'S commercial activity for the following amount: Five
Million Dollars.
In the event that any person is damaged and can demonstrate a bona fide claim of injury or
loss, the Undersigned shall discharge all obligations dollar for dollar by and through tender
of payment pursuant to public policy, HR-192.
Dated the 9th day of the 10th month, Two Thousand Nine.
___________________________________
upper lower name
Address
city, CO
Colorado Republic
Jurat
State of Colorado )
)
County of El Paso )
Notary public______________________
_________________________________________
Signature of Notary Public
Witness___________________________________