This government document is issued by Somerset County for use in Maryland
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https://www.google.com/url?client=internal-element-cse&cx=e1d61c8eb0aa21666&q=https://www.somersetmd.us/document_center/Department/Public%2520Works/Check%2520in%2520lieu%2520of%2520Bond%2520Form.pdf&sa=U&ved=2ahUKEwjy7KrrseKGAxXmhf0HHRN6BbM4ChAWegQIAxAB&usg=AOvVaw1FrvbNsUNqZa6aXREN7LMR&arm=e&fexp=72519171,72519168