Forms > This page
4081 Insurance Guarantee
This is a specimen-only copy of 4081 Insurance Guarantee that can be used in all of our financing programs.
Your insurance company's format for the 4081 Insurance Guarantee may vary from agency to agency, but should include these points in substance. Insurance agency must be AA+ rated or better.
(ON INSURANCE COMPANY'S LETTERHEAD)
From: (Name of AA+ rated or better insurance company)
Place of Issue:
Date of Expiry:
Place of Expiry: (Agency or agency bank's counters)
We (insurance company's name and address) hereby issue our irrevocable guarantee number (guarantee number) in your favour by order of (client/beneficiary's name), up to an aggregate amount of $(number of dollars in 0,000,000.00 number format, e.g., "100,000,000.00" followed by number of dollars spelled out, e.g. "two-hundred million U.S. dollars exactly").
This guarantee covers credit facilities you have already granted or you may grant in the future to our customer, (customers's name and address).
This guarantee is available for payment at sight upon receipt by us at our counters of your statement in writing demanding payment hereunder and certifying that the amount claimed id due but unpaid to you in respect of the credit facilities granted to (customer's name) in connection with the transaction described as (short name of project being funded).
This guarantee is effective as of (date) and expires automatically at our offices in (location of insurance company or insurance company's bank) on (date of expiry).
We hereby undertake to effect payment if the terms and if all other conditions of this credit are fulfilled.
This guarantee is subject to the Uniform Customs and Practices for Documentary Credits (1993 revision) number 500 of the International Chamber of Commerce.
Name, title, signature, of Insurance Company officer 1:
Phone, Fax, and Email address of Insurance Company officer 1
Name, title, signature, of Insurance Company officer 2:
Phone, Fax, and Email address of Insurance Company officer 2