HomeMy WebLinkAboutBill of Sale & Cost DataTYPE OF DOCUMENT:
GRANTOR(S):
GRANTEE:
NAME OF PROJECT:
ADDRESS OF PROJECT:
PROJECT FILE NUMBERS:
LEGAL DESCRIPTION:
PERSONAL PROPERTY DESCRIPTION:
Reference Number(s) of Documents assigned or released:
Additional reference #’s on page _____ of document
By By
Its Its
Paul Miller
The Grantor, as named above, for, and in consideration of mutual benefits, hereby grants, bargains, sells and
delivers to the Grantee, as named above, the following described personal property as described in Exhibit B
of this document.
City of Renton, a Municipal Corporation
ABBREVIATED LEGAL
DESCRIPTION:a portion of the SW1/4 of the NW 1/4 of Section32-24-05
ASSESSOR TAX PARCEL I.D. NUMBERS: 344270-0440
3731 Park Ave N Water Extension
3731 Park Ave N
LUA0, UU18005570, PLR-4033
See Attached Exhibit A of this Document
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
BILL OF SALE
Please make no mark in the margin space - Reserved for County Auditor's Use Only
Bill of Sale
See Attached Exhibit B of this Document
By this conveyance, Grantor will warrant and defend the sale hereby made unto the Grantee against all and
every person or persons, whomsoever, lawfully claiming or to claim the same. This conveyance shall bind
the heirs, executors, administrators and assigns forever.
IN WITNESS WHEREOF, said Grantor(s) has caused this instrument to be executed this ________ day of
_______________________ 20 _____ .
INDIVIDUAL FORM OF ACKNOWLEDGEMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that ___________________
__________________________________________ signed this instrument and
acknowledged it to be his/her/their free and volumtary act for the uses and purposes
mentioned in this instrument.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
REPRESENTATIVE FORM OF ACKNOWLEDGEMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
I certify that I know or have satisfactory evidence that ___________________
__________________________________________ signed this instrument, on
oath stated that he/she/they was/were authorized to execute the instrument
and acknowledge it as the ______________________________ and
__________________________ of _______________________ to be free and
voluntary act of such party/parties for the uses and purposes mentioned in the
instrument.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
CORPORATE FORM OF ACKNOWLEDGEMENT
Notary Seal must be within box STATE OF WASHINGTON ) SS
COUNTY OF KING )
On this ____ day of ____________ , 20 _____ , before me personally appeared
_______________________________________________ to me known
to be _____________________________________ of the corporation that
executed the within instrument, and acknowledge the said instrument to be the free
and voluntary act and deed of said corporation, for the uses and purposes therin
mentioned, and each on oath stated that he/she was authorized to execute said
instrument and that the seal affixed is the corporate seal of said corporation.
Notary Public in and for the State of Washington
Notary (Print): ___________________________________________________
My appointment expires: __________________________________________
Dated: _________________________________________________________
BILL OF SALE
Page 2
Project File Number: LUA0, UU18005570, PLR-4033
BILL OF SALE
EXHIBIT A
Legal Description
Project File Number: U18005570, PLR-4033
WTR ‐4033
WWP ‐ N/A
SWP ‐ N/A
TRO ‐ N/A
TED ‐ 4033
PROJECT NAME:
CONSTRUCTION PERMIT NO.
PROJECT FILE NUMBER:
WATER SYSTEM IMPROVEMENTS
QTY UNIT SIZE TYPE TOTAL COST
458 L.F. 8" DI Water Main Pipe and Fittings 27,480.00$
1 EA. 8" Gate Valve Assembly 800.00$
1 EA. 6" Fire Hydrant Assembly 4,000.00$
1 EA. Permanent Blow-Off Assembly 1,800.00$
Subtotal 34,080.00$
Sales Tax 3,237.60$
Grand Total Water System Improvements 37,317.60$
SANITARY SEWER SYSTEM IMPROVEMENTS
QTY UNIT SIZE TYPE TOTAL COST
Subtotal ‐$
Sales Tax ‐$
Grand Total Sanitary Sewer System Improvements ‐$
Per the request of the City of Renton the following information is furnished concerning final costs for
improvements installed and turned over to the City for the referenced project.
ITEM
DESCRIPTION
(City Staff Use Only)
EXHIBIT "B"
Contributary Assets
City Project Numbers:
3731 Park Ave N Water Extension
U18005570
Return Address:
City Clerk’s Office
City of Renton
1055 South Grady Way
Renton, WA 98057
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4033