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<br />Exhibit C – Page2 of 2 <br />IN WITNESS WHEREOF, the above-bound parties have executed this instrument under their seals this_______________day of ___________________, the name and corporate seals <br />of each corporate party being hereto affixed and these presents duly signed by its undersigned <br />representative, pursuant to authority of its governing body. <br /> (Corporate Seal) Principal <br /> By <br /> Title <br />(Attach Notarial Acknowledgment) <br /> <br /> <br />(Corporate Seal) Surety <br /> Address <br /> <br /> Phone No.: ( ) Fax No.: ( ) <br /> <br /> By Attorneys-in-Fact <br /> <br /> Title <br /> (Attach Notarial Acknowledgment) <br /> NOTE TO SURETY COMPANY: There must be submitted a certified copy of unrevoked <br />resolution of authority for the attorneys-in-fact. <br /> <br /> (Seal) Witness <br /> <br /> Approved as to form: <br /> <br /> <br /> Risk Manager <br />263