APPROVED FORMAT FOR BID SURETY BOND Bid Surety Bond KNOW ALL MEN BY THESE PRESENTS, That we, the undersigned, (A) of, (B) , (C) , as an Active Retail Licensee (“Licensee”), and (D) of (E) , (F) , a corporation organized and existing under the laws of the State of (G) with its principal office in the City of (H) , as Surety, are held and firmly bound unto The State of West Virginia, as Obligee, in the penal sum of (I) ($ (J) ) for the payment of which, well and truly to be made, we jointly and severally bind ourselves, our heirs, administrators, executors, successors and assigns. The Condition of the above obligation is such that the Licensee has submitted to the West Virginia Alcohol Beverage Control Administration an executed Letter of Intent and Purchase Option Form indicating their clear intent to exercise the Purchase Option for their existing retail liquor license for the ten (10) year period beginning July 1, 2010. . NOW THEREFORE. (a) If the Purchase Option is rejected, or (b) If the Purchase Option is accepted, the Licensee shall complete an application and be approved for licensure in accordance with the terms outlined in the Letter of Intent attached hereto, and shall in all other respects perform the agreement created by the execution of said Letter of Intent then this obligation shall be null and void, otherwise this obligation shall remain in full force and effect. It is expressly understood and agreed that the liability of the Surety for any and all claims, violations of Chapter 60 of the West Virginia Code or the applicable Rules shall, in no event, exceed the penal amount of this obligation as herein stated The Surety for value received, hereby stipulates and agrees that the obligations of said Surety and its bond shall be in no way impaired or affected by any extension of time within which the Obligee may accept such bid: and said Surety does hereby waive notice of any such extension. IN WITNESS WHEREOF, Licensee and Surety have hereunto set their hands and seals, and such of them as are corporations have caused their corporate seals to be affixed hereto and these presents to be signed by their proper officers, this (K) day of (L) , 20 (M) . American LegalNet, Inc. www.FormsWorkFlow.com APPROVED FORMAT FOR BID SURETY BOND Licensee Corporate Seal (if applicable) (N) (Name of Licensee) (O) By: (P) (Must be President or Principal/Managing Owner) (Q) Title (R) Surety Corporate Seal (S) (Name of Surety) (T) Attorney-in-Fact IMPORTANT – Surety executing bonds must be licensed in West Virginia to transact surety insurance. Raised Corporate Seals must be affixed and a Power of Attorney must be attached. (A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K) Your Company Name City, Location of your Company State, Location of your Company Surety Corporate Name City, Location of Surety State, Location of Surety State of Surety Incorporation City of Surety Incorporation Minimum amount of acceptable bid bond is 25% of the Purchase Option amount. Amount of bond in figures Day of the month (L) Month (M) Year (N) Name of Corporation (O) Raised Corporate Seal of Principal (P) Signature of President or Vice President (Q) Title of person signing (R) Raised Corporate Seal of Surety (S) Corporate Name of Surety (T) Signature of Attorney in Fact of the Surety NOTE: Dated, Power of Attorney with Raised Surety Seal must accompany this bid bond. American LegalNet, Inc. www.FormsWorkFlow.com