I have attached a PROVEN self self insurance bond. The reason i am saying "proven" is that i got stopped for expired stickers on the license plates and I showed an unfiled, notarized, original. Because it was not filed with the county clerk, the officer gave me a ticket for "no proof of insurance". When i went to court this morning and finally sat down with the DA chick, she asked me if i had proof of insurance and i gave her a certified copy of the filed bond. The only thing she asked me was "where did you get this??" I asked her what what did she mean and she just repeated the question. I knew better than to say "I got it from __________ or off the the internet" so i said "I wrote it and submitted it to the County Clerk for recording". She asked if i had showed it to the officer and i said i had but it was not recorded at the time. time. She said since it was recorded now, itit was sufficient!! sufficient!! Nov. 2009
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RECORDING REQUESTED BY
upper lower name C/O Street City, Colorado _____________SPACE ABOVE THIS LINE FOR RECORDER’S USE___________ Written Undertaking/Surety Bond — Financial Responsibility Form #mmv-101010-SB #mmv-101010-SB (Private Number was assigned) I, upper lower name, 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 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: That (a) Every provision contained in or made with respect to any obligation which purports to give the obligee a right to require payment in gold or a particular kind of coin or currency, or in an amount of money of the United States measured thereby, is declared to be against public policy; and no such provision shall be contained in or made with respect to any obligation hereafter incurred. Every obligation, heretofore or hereafter incurred, whether or not any such provision is contained therein or made 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 authorizing obligations to be issued by or under authority of the United States, is hereby repealed: Form # _____________ Page 1 of 2 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 10 th month, Two Thousand Nine. ___________________________________ upper lower name Address city, CO Colorado Republic
Jurat State of Colorado
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) County of El Paso ) Subscribed and sworn to at Colorado Springs before me this ________ Day of _____________________, A.D. 20____. Notary public___________________ public______________________ ___ My Commission Expires: ______________ WITNESS my hand and official seal, _________________________________________ Signature of Notary Public Witness___________________________________ Form # ___________ Page 2 of 2
Witness___________________________________ Witness_________________ __________________
