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HomeMy WebLinkAboutFolder - Documents After recording return document to:
City of Renton
City Clerk's Office
1055 South Grady Way
Renton, WA 98057
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE
Grantor(s): Robert E. Fricks, Robert E. Fricks Jr., Terresa L. George, Ronald E. Fricks, Raymond E.
Fricks,and Richard E.Fricks
Grantee(s): City of Renton
Legal Description: N275FT OF W '/2 OF E '/2 OF NE 'A OF NW '/4 OF SEC. 10, T. 23N., R. 05 E., W.M.,
KING COUNTY,SUBJ TO CM&ST P TRANS LN ESMT LESS CO RD
Assessor's Tax Parcel Number: 102305-9081-09
Reference Number of Related Documents: N/A
TEMPORARY CONSTRUCTION EASEMENT
Duvall Avenue NE Project
This Temporary Construction Easement (the "Construction Easement"), is made and
entered into this day of ,20 ,by and between Robert E.Fricks,Robert
E. Fricks Jr., Terresa L. George, Ronald E. Fricks, Raymond E. Fricks and Richard E.
Fricks, as their respective separate property, and as tenants in common, ("Grantor"), and the
City of Renton, a municipal corporation("City" or"Grantee"), its successors and assigns.
For Good and Valuable Consideration, receipt of which is hereby acknowledged,
Grantor, as the owner of that certain real property legally described on Exhibit "A" — Entire
Parcel ("Property"), attached hereto and incorporated by this reference, does hereby grant to
the City, two thousand and forty-two (2,042) square foot temporary easement area for minor
clearing and grubbing and excavation and fill and construction purposes in, on, over, through
and across that portion of the Property described on Exhibit "B" (Easement "Area") and
depicted on Exhibit "C", which are attached hereto and incorporated by this reference, for the
purpose of Temporary Construction Easement; protecting existing public and private
improvements in the immediate vicinity of the Project area; and repairing, restoring and/or
reestablishing any improvements disturbed while undertaking the Project activities described
above.
The temporary rights granted in this Construction Easement shall be effective upon
execution by the parties. Grantee and/or its contractors shall provide forty-eight (48) hours
Page 1 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
notice to the Grantor of its intent to commence construction. The temporary rights granted to
the Grantee shall automatically terminate and be null and void(i)twenty four(24)months after
the execution of this easement or(ii) upon restoration of any existing improvements disturbed
by the Grantee within the temporary easement area,whichever is later,but in no event later than
December 31, 2023.
The Grantee agrees to hold harmless, indemnify and defend the Grantor from and
against any and all claims,losses or liability,for injuries,sickness or death of persons,including
employees of the Grantee,or damage to property, arising out of the exercise of Grantee's rights
under this Construction Easement or any willful misconduct or negligent act, error, or omission
of the Grantee, its officers, agents, contractors, subcontractors, licensees, or employees, in
connection with the Grantee's activities authorized by this Construction Easement, provided,
however,that:
(a) The Grantee's obligations to indemnify, defend and hold harmless shall not
extend to injuries, sickness, death or damage caused by or resulting from the
sole willful misconduct or sole negligence of the Grantor; and
(b) The Grantee's obligations to indemnify, defend and hold harmless for injuries,
sickness,death or damage caused by or resulting from the concurrent negligence
or willful misconduct of the Grantee and the Grantor, or of the Grantee and a
third party other than an officer, agent, contractor or employee of the Grantee,
shall apply only to the extent of the negligence or willful misconduct of the
Grantee(including an officer, agent, contractor or employee of the Grantee).
Grantee shall, at its sole cost and upon completion of the work within the Easement
Area, fully restore the surface and subsurface of the Easement Area and any public or private
improvements disturbed by or destroyed during the execution of the work, as nearly as
practicable,to the conditions as of the effective date of this easement.
It is the intention of the parties that this document be strictly limited to and for the
purposes expressed.
This Construction Easement and covenants herein shall be recorded with the King
County Recorder,shall run with the land described herein,and shall be binding upon the parties,
their successors, heirs and assigns.
Grantor covenants that it is the lawful owner of the above-described property and has
authority to convey such easement.
It is understood and agreed that delivery of this Construction Easement is hereby tendered
Page 2 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
and that the terms and obligations hereof shall not become binding upon the City of Renton,
unless and until accepted and approved hereon in writing by the City of Renton.
Dated: , 20
Grantor:
er ricks
o ert E.Fricks Jr.
Teresa L. George
R nald E. ricks
Raymo+d .Fricks
G Lam .
' chard E.Fricks
Accepted and Approved
City of Renton
By
Its
Date
Page 3 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
and that the terms and obligations hereof shall not become binding upon the City of Renton,
unless and until accepted and approved hereon in writing by the City of Renton.
Dated: , 20
Grantor:
Robert E.Fricks
Robert E.Fricks Jr.
Teresa L. George
Id E. Fricks
aymond E.Fricks
Richard E. Fricks
Accepted and Approved
City of Renton
By
Its
Date
Page 3 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E. Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this 1/ day of Pkty ,20d. .
(SEAL)
u 1c
1'
....,.,,q c64
S - sd69 Printed/Name
NoTARy
�''•�— s Residing at jtkietilei
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1 uF WASN
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STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E. Fricks Jr., to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
mayDATED this / day of ay ,20 ,
(SEAL) (/ •" ��i.
� ary P e lic
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NOTAR j, ,, ,
�' PUBLIC ti"'' Residing at /�/p/c/
-40 f'PIRES�� r O:'
,,,, ��= My appointment expires /p of
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Page 4 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Teresa L. George, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
AL
DATED this g day of Pat/ ,20 a
(SEAL) �1/
'��%%‘‘‘, � eirts.ry " blic
NJA Witt
O 2011
V1OTAMy ,,0 Printt1 Name
Cr)%,,' PUBLIC ti' 0 Residing at /G/rkfa'
df
�I � XPIRES My appointment expires /2f 20f 22
��` F •\,,
O
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Ronald E. Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this g' day of ,20
(SEAL)
:Si;; :)
yblic
NJA D ''', S/4 Dav/S
GAO_••13269S,9!!/sj��� Print Name
NOTAR), y$ Residing at ,e/t- tali—el
i .may• i or
N,6 pUsLIGo s % My appointment expires /a'/g°/j-3
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Page 5 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me 'aymond E. Fricks, to me known to be the individual(s)
described in and who executed the within and fore:.mg instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act an. teed,for the uses and purposes therein mentioned.
DATED this day of 20 .
(SEAL)
Notary Public
Printed Name
Residing at
My appointment expires
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Richard E. Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this (S day of /Vltr ,20
(SEAL Of� ary Public
A al
1'3269S1h,(r,�1 Slt/A DIWT
N�T�Y�'�•y� ��� Printed Name /�
- P G ,94./7 N � UBL� s Residing at /�
,;PIRE0:14,('�?
r4 My appointment expires /off/�4/3
Page 6 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
STATE OF WA-Sice-T-ON 1
ss.
COUNTY OF
0,---c,..(Naie__
On this day personally appeared before me Raymond E. Fricks,to me known to be the individual(
described in and who executed the within and foregoing instrument,and acknowledged that he/ e/4hA•,signed the
same as his/he.'ltheir.free and voluntary act and deed,for the use and purposes``therein mentioned.
DATED this Z2-day of 20�. I
(SEAL) �, ►.
, . aryPblic v ... -
t .....oP- Printed Name YX
�• MIKE LEE
(12 .• COMM...2165192 W �!� �
may„ �l 04110S
c] :; , ' ;) NOTARY PUBLIC-CALIFORNIA —1 Residing at 2'Z kw c7 oLe_ I� S—�
m 'Y,. ) ORANGE COUNTY W
\,` o_. My Term Exp.October 17,2020
r n ..�, .,.� My appointment expires ll3k1k'>s-)'2.3'Y-'
STATE OF WASHINGTON
ss.
COUNTY OF KING
s
On this day personally appeared before me Richard /Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instru (nt,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the ,ses and purposes therein mentioned.
DATED this day of ,20 .
(SEAL)
Notary Public
Printed Name
' Residing at
``/ My appointment expires
//
G
Page 6 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
EXHIBIT A
PROPERTY DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
(PER QUIT CLAIM DEED, RECORDED UNDER AUDITOR'S FILE NO. 20081215000432)
THE NORTH 275 FEET OF THE WEST HALF OF THE EAST HALF OF THE NORTHEAST
QUARTER OF THE NORTHWEST QUARTER IN SECTION 10, TOWNSHIP 23 NORTH,
RANGE 5 EAST, W.M.
SITUATE IN THE COUNTY OF KING, STATE OF WASHINGTON.
L,,I%JI//
a OM. ke,
t. ��¢�OF wASUj4Co/�
•
?'p 46889 �e
�Fss�BClSTSO'c J�
i ONAL LAR1a
y-9-zozo
Page 7 of(9)Pages Parcel No. 102305-9081-09 I
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
FTEMPORARY CONSTRUCTION EASEMENT
EXHIBIT B
TEMPORARY CONSTRUCTION EASEMENT DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
A PORTION OF THAT PROPERTY DESCRIBED IN QUIT CLAIM DEED,
RECORDED UNDER AUDITOR'S FILE NO. 20081215000432, KING
COUNTY RECORDS, SAID PORTION BEING MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT—OF—WAY LINE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 88'37'32" EAST 5.00 FEET ALONG THE
NORTH LINE OF SAID PROPERTY; THENCE SOUTH 00'00'52" WEST
42.84 FEET; THENCE SOUTH 89'59'08" EAST 5.00 FEET; THENCE
SOUTH 00'00'52" WEST 40.50 FEET; THENCE NORTH 89'59'08" WEST
5.00 FEET; THENCE SOUTH 00'00'52" WEST 112.49 FEET; THENCE
SOUTH 44'59'08" EAST 23.33 FEET; THENCE SOUTH 00'00'52" WEST
27.00 FEET; THENCE SOUTH 45'00'52" WEST 23.33 FEET; THENCE
SOUTH 00'00'52" WEST 21.92 FEET TO THE SOUTH LINE OF SAID
PROPERTY; THENCE NORTH 89'00'27" WEST 5.00 FEET ALONG SAID
SOUTH LINE TO SAID RIGHT—OF—WAY LINE; THENCE NORTH 00'00'52"
EAST 40.33 FEET ALONG SAID RIGHT—OF—WAY LINE; THENCE SOUTH
89'59'08" EAST 5.00 FEET; THENCE NORTH 00'00'52" EAST 23.00
FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT—OF—WAY LINE; THENCE NORTH 00'00'52" EAST 136.00 FEET
ALONG SAID RIGHT OF WAY LINE; THENCE SOUTH 89'59'08" EAST 5.00
FEET; THENCE NORTH 00'00'52" EAST 30.50 FEET; THENCE NORTH
89'59'08" WEST 5.00 FEET TO SAID RIGHT—OF—WAY LINE; THENCE
NORTH 00'00'52" EAST 47.96 FEET TO THE TRUE POINT OF
BEGINNING.
CONTAINING 2,042 SQUARE FEET, MORE OR LESS.
M KF
ciO p$HASUj'�/
46889 Boa
oSS�4'GIST8R�9JQ,�
°NA L L AND
Y-B-ZoZo
Page 8 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
TEMPORARY CONSTRUCTION EASEMENT
EXHIBIT C
TEMPORARY CONSTRUCTION EASEMENT
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
S88'37'32°E
T.P.O.B.
- ,Lor __5.00' __ NE 12th ST(PRIVATE)
SO0'OO'52'W
N00'00'52°E 1140r °
42.84' —-` -_
47.96' S89'59'08E
,d l
5.00'
ig I N89'S9'08'W
1 5.00' �`.
1 0 S00'00'521W
N00'00'52°E 40.50'
30.50' JJ0
S89'59'081 Fil
5.00' N89'59'08%1
5'00 ( APN 1023059081 )
FRICKS ROBERT E SR
W r
- 1160 DUVALL AVE NE 98059
Z
W N00'00'52°E 0;
Q 136.00' 1 n
0
I _ / N
I < 4
D / S44'59'08'E
23.33'
N89'59'08'W I
5.00' hi
900'00'52°w
iN00'00'52°E / 27.00'
-- — 23.00' /
I 1111
989'59'08'E
5.00' ,pll S45'00'52'W
23.33'
N00'00'52'E Id / 0 �0'
TOTAL AREA 40,33' IN soo 00'S2°w
I I N __ 21.92' 1"=50'
2,042 SQ. FT. I I N89'00'27°W Parametrix
5.00'
LEGEND M. KE,,
a
T.P.0.8. TRUE POINT OF BEGINNING .. ]'R Q of Ansq/',co/ ,� s
TEMPORARY CONSTRUCTION
���/��������/� EASEMENT AREA III, ' ' I • TF'
s E:
— — EXISTING RIGHT OF WAY LINE Po W6889 yok a
--- - - CENTERLINE 3 'Fss�4.Gl S T SP \jR.
— PROPERTY UNE $ �ONAi. LAND
( APN XXXXXXXXXXX ) KING COUNTY TAX PARCEL NUMBER y it Z/nN
Page 9 of(9)Pages Parcel No. 102305-9081-09
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
INSTRUCTIONS FOR DISBURSEMENT OF PROCEEDS TO
PROPERTY OWNERS
RE: City of Renton
Project Name: Duvall Avenue NE Project
Tax Parcel No: 102305-9081-09
Property Address: 1160 Duvall Ave NE
Project Parcel No: 12
FROM: Robert E. Fricks,Robert E.Fricks Jr., Terresa L George, Ronald E. Fricks,Raymond E. Fricks
and Richard E. Fricks
TO: City of Renton,
Proceeds due at closing from the above referenced real property transaction,are to be disbursed to the
undersigned parties and reported to the IRS (1099-S)as follows:
50%to: Robert E. Fricks($5,150)
10%to Robert E.Fricks Jr. ($1,030)
10%to Terresa L. George($1,030)
10%to Ronald E.Fricks($1,030)
10%to Raymond E.Fricks($1,030)
10%to Richard E. Fricks($1,030)
R . ricks
o ert E. ricks Jr.
064.12,/
T esa L. George
Ot‘6A,
na E. Fricks
Raymon . Fricks
'char . Fric s
( l
INSTRUCTIONS FOR DISBURSEMENT OF PROCEEDS TO
PROPERTY OWNERS
RE: City of Renton
Project Name: Duvall Avenue NE Project
Tax Parcel No: 102305-9081-09
Property Address: 1160 Duvall Ave NE
Project Parcel No: 12
FROM: Robert E.Fricks,Robert E.Fricks Jr.,Terresa L George,Ronald E. Fricks,Raymond E. Fricks
and Richard E.Fricks
TO: City of Renton,
Proceeds due at closing from the above referenced real property transaction, are to be disbursed to the
undersigned parties and reported to the IRS (1099-S)as follows:
50%to:Robert E.Fricks($5,150)
10%to Robert E.Fricks Jr.($1,030)
10%to Terresa L. George($1,030)
10%to Ronald E.Fricks($1,030)
10%to Raymond E.Fricks($1,030)
10%to Richard E. Fricks($1,030)
Robert E.Fricks
Robert E.Fricks Jr.
Teresa L. George
Ronald E.Fricks
rfr
Raymond E.Fricks
Richard E.Fricks
REAL ESTATE PURCHASE AND SALE AGREEMENT
This Real Estate Purchase and Sale Agreement ("Agreement") is made as of the date this
instrument is fully executed by and between Robert E. Fricks, Robert E. Fricks Jr., Terresa L.
George, Ronald E. Fricks, Raymond E. Fricks and Richard E. Fricks, as their respective separate
property, and as tenants in common, ("Seller"), and the City of Renton, a municipal corporation
("Buyer" or"City"), for purchase and sale of a permanent right of way easement and a temporary
construction easement over a portion of that certain real property situated in King County,
Washington, legally described on Exhibit"A", attached hereto (the "Property").
The permanent right of way easement consists of 268 square feet and is legally described
on Exhibit`B", attached hereto (the "Easement"). The temporary construction easement consists
of 2,042 square feet and is depicted on Exhibit "C", attached hereto (the "TCE"). Collectively,
the portions of the Property encumbered by the Easement,Wall Easement and the TCE are referred
to as the`Basement Areas."
1. PURCHASE PRICE: The total purchase price for the easements is Ten thousand three
hundred and No/100 Dollars ($10,300.00) ("Purchase Price"). The Purchase Price consists of the
Easement valued at$2,680.00,the TCE valued at$6,534.40,and$1,000.00 for any improvements
located within the easement areas. The Purchase Price is payable at closing in cash.
2. CONVEYANCE OF TITLE:
2.1 Easements: At closing, Seller will execute and deliver,in a form acceptable to Buyer,the
Easement, conveying and warranting good and marketable title to the Easement and clear of all
defects or encumbrances except for the lien of real estate taxes and drainage service charges not
yet due and payable and those defects and/or encumbrances (if any) identified on Exhibit "D"
attached hereto (collectively, "Permitted Exceptions"). Additionally, the Seller will execute and
deliver to Buyer a temporary construction easement for a period of twenty-four (24) months
commencing forty-eight (48) hours after City of Renton and/or its contractors provide written
notification to Seller of its intent to commence construction.
2.2 Title Insurance: At closing, Buyer shall receive (at Buyer's expense) an owner's
Standard ALTA policy of title insurance, dated as of the closing date and insuring Buyer in the
amount of the Purchase Price against loss or damage by reason of defect in Buyer's title to the
Easement subject only to the printed exclusions appearing in the policy form and any Permitted
Exceptions.
3. CONTINGENCIES:
3.1 This Agreement is subject to the following contingencies:
A. None
B. None
3.2 Removal of Contingencies: Buyer shall have a period of 60 days from the date all parties
have signed this Agreement to remove all contingencies. Buyer may remove such contingencies
Parcel No. 102305-9081-09 Page 1 of 13
by sending written notice thereof to Seller pursuant to Paragraph 7 herein. If the contingencies are
not removed within this period, this Agreement shall be null and void.
4. RISK OF LOSS: Seller will bear the risk of loss of or damage to the Easement Areas
prior to closing. In the event of such loss or damage to the Easement Areas, Seller shall promptly
notify Buyer thereof and Buyer may, in its sole discretion, terminate this Agreement by giving
notice of termination to the Seller.
5. SELLER'S REPRESENTATIONS, WARRANTIES AND COVENANTS: Seller
represents, warrants, and covenants to the Buyer at the date of execution of this Agreement and
the date of closing that:
5.1 Authority: Seller, and the person(s) signing on behalf of Seller, has full power and
authority to execute this Agreement and perform Seller's obligations,and if Seller is a corporation,
all necessary corporate action to authorize this transaction has been taken.
5.2 Leases: The Easement Areas are subject to a lease between N/A
and N/A , recorded N/A , and any unrecorded
leaseholds, rights of vendors and holders of security interest on personal property installed upon
said property, and right of tenants to remove trade fixtures at the expiration of the term.
5.3 No Material Defect: Seller is unaware of any material defect in the Property. To the best
of Seller's knowledge, the information regarding the Property as provided by Seller is complete,
accurate,true and correct and does not fail to state any fact without which such information would
be misleading.
5.4 Debris and Personal Property: Seller will remove all debris and personal property,prior
to each closing, located on the Easement Areas (if any) at Seller's cost and expense, and Seller
will indemnify and hold Buyer harmless from all claims and expenses arising from such removal.
5.5 Contamination: Seller represents and warrants that he/she/it has not caused or allowed
the generation,treatment, storage, or disposal of hazardous substances on the property,nor caused
or allowed the release of any hazardous substance onto, at, or near the Easement. Seller is in
compliance with all applicable laws, rules, and regulations regarding the handling of hazardous
substances,has secured all necessary permits, licenses and approvals necessary to its operation on
the Easement Areas, and is in compliance with such permits. Seller has not received notice of any
proceedings, claims, or lawsuits arising out of its operations on the Easement Areas and, to the
Seller's knowledge, the property is not, nor has it ever been subject to the release of hazardous
substances.
5.6 Fees and Commissions: Seller shall pay for any broker's or other commissions or fees
incurred by the Seller in connection with the sale of the Easement and Seller shall indemnify and
hold Buyer harmless from all such claims for commission and/or fees.
5.7 Indemnification: Seller agrees to indemnify, defend and hold harmless Buyer, its
employees,agents,heirs and assigns,from and against any and all damage,claim,liability,or loss,
Parcel No. 102305-9081-09 Page 2 of 13
including reasonable attorney's and other fees,arising out of or in any way connected to the breach
of any representation or warranty contained herein. Such duty of indemnification shall include,
but not be limited to damage, liability, or loss pursuant to all federal environmental laws,
Washington State environmental laws, strict liability and common law.
5.8 Ownership; Non-Foreign Status: Seller owns the Property and has the right to sell the
Property, and is not a foreign person as defined by the Foreign Investment in Real Property Tax
Act, IRS Section 1445(b)(2) ("FIRPTA"), as amended.
6. CLOSING:
6.1 Time for Closing and Closing Agent: The sale will be closed in the office of the Closing
Agent not later than twenty-one (21) days from the date all contingencies set forth in Paragraph 3
herein have been removed, or as soon thereafter as practicable.
Buyer and Seller shall deposit in escrow with the Closing Agent all instruments, documents and
moneys necessary to complete the sale in accordance with this Agreement. As used in this
Agreement, "closing" and "date of closing" means the date on which all appropriate documents
are recorded and proceeds of the sale are available for disbursement to Seller. The Closing Agent
shall be:
Chicago Title Insurance Company
701 5th Ave, Suite 2700
Seattle, WA 98104
6.2 Prorations: Closing Costs: Seller will pay real property taxes prorated through the date
of closing. Buyer will pay the premium for its owner's title insurance policy,the cost of recording
the Easement, Wall Easement and TCE from the Seller, real estate excise taxes (if any are due)
and the Closing Agent's escrow fees.
6.3 Possession: Buyer shall be entitled to possession of the Easement, TCE and Wall
Easement at Closing.
6.4 Closing Obligations of Buyer: On or before Closing the Buyer shall deliver to the Closing
Agent the following:
6.4.1 All funds required to be paid by Buyer under this Agreement, in cash.
6.4.2 A Closing Statement in form and content reasonably satisfactory to the parties.
6.4.3 A Real Estate Excise Tax Affidavit executed by the Buyer in the form required by law.
6.4.4 Any other documents necessary to effect the transaction contemplated in this
Agreement.
Parcel No. 102305-9081-09 Page 3 of 13
6.5 Closing Obligations of Seller: At Closing, Seller shall deliver to Escrow Agent the
following duly executed and acknowledged documents (where appropriate):
6.5.1 The Easement, Wall Easement, and TCE required under Paragraph 2.1 of this
Agreement.
6.5.2 A Closing Statement in form and content reasonably satisfactory to the parties.
6.5.3 A FIRPTA certification.
6.5.4 A Real Estate Excise Tax Affidavit executed by Seller in the form required by law.
6.5.5 Any other documents necessary to effect the transaction contemplated in this
Agreement.
7. NOTICES: All notices, demands, consents, approvals and other communications which
are required or desired to be given by either party to the other under this Agreement shall be in
writing and shall be hand delivered or sent by United States regular mail, postage prepaid, return
receipt requested, or by email transmission, addressed to the appropriate party at its address set
forth below,or at such other address as such party shall have last designated by notice to the other.
Notices, demands, consents, approvals, and other communications shall be deemed given when
delivered, or three days after mailing, or on the day that an email transmission is received,to or at
the following addresses:
TO SELLER: TO BUYER:
Robert E. Fricks et al City of Renton
1621 Camas Ave NE Public Works Department
Renton, WA 98056 Attn: Flora Lee
425-235-0336 1055 South Grady Way
Renton, WA 98057
Telephone: (425)430-4303
Email: FLee@Rentonwa.gov
8. GENERAL: This is the entire agreement of the Buyer and Seller with respect to the
Easement and supersedes all prior or contemporaneous agreements between them, written or oral.
This Agreement may be modified only in writing, signed by Buyer and Seller. Any waivers under
this Agreement must be in writing. A waiver of any right or remedy in the event of a default will
not constitute a waiver of such right or remedy in the event of any subsequent default. This
Agreement is for the benefit of, and binding upon, Buyer and Seller and their heirs, personal
representatives,successors and assigns. The invalidity or unenforceability of any provision of this
Agreement will not affect the validity or enforceability of any other provision. Time is of the
essence in this Agreement. This Agreement may be executed in one or more counterparts, each of
which will be considered an original instrument and all of which together will be considered the
same agreement.
Parcel No. 102305-9081-09 Page 4 of 13
9. WASTE; ALTERATION OF EASEMENT: Seller shall not commit waste on the
Easement Areas;nor shall Seller remove trees or other vegetation, coal,minerals or other valuable
materials nor shall Seller substantially alter the surface or subsurface of the Easement Areas
without the express written consent of Buyer.
10. SURVIVAL OF WARRANTIES: The terms, covenants,representations and warranties
shall not merge in the deed of conveyance,but shall survive closing.
11. TERMINATION OF OFFER: This offer shall terminate if not accepted by Seller on or
before
12. EFFECTIVE DATE: The Effective Date is the date of the last Parties' signature below.
Signed in duplicate original.
BUYER: City of Renton, a municipal Corporation
By:
Its
Date
SELLER:
e.?
Fricks
Robert E. Fricks r.
resa L. George
R2))1
onald E. Fricks
Raym . Fecks
'chard E. Fricks
Dated
Parcel No. 102305-9081-09 Page 5 of 13
9. WASTE; ALTERATION OF EASEMENT: Seller shall not commit waste on the
Easement Areas,nor shall Seller remove trees or other vegetation,coal,minerals or other valuable
materials nor shall Seller substantially alter the surface or subsurface of the Easement Areas
without the express written consent of Buyer.
10. SURVIVAL OF WARRANTIES: The terms, covenants, representations and warranties
shall not merge in the deed of conveyance,but shall survive closing.
11. TERMINATION OF OFFER: This offer shall terminate if not accepted by Seller on or
before
12. EFFECTIVE DATE: The Effective Date is the date of the last Parties' signature below.
Signed in duplicate original.
BUYER: City of Renton, a municipal Corporation
By:
Its
Date
SELLER:
Robert E. Fricks
Robert E. Fricks Jr.
Teresa L. George
Ilona E.Fric
c_
Ra mo . ecks
Richard E. Fricks
Dated
Parcel No. 102305-9081-09 Page 5 of 13
EXHIBITS: Exhibit A, Property Legal Description
Exhibit B, Right of Way Easement Legal Description
Exhibit C, Temporary Construction Easement Depiction
Exhibit D, Permitted Exceptions
Parcel No. 102305-9081-09 Page 6 of 13
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E.Fricks,to me known to be the individual(s)described
in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as
his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this ,/ day of V ,20
(SEAL)
t ryPu ic
NSA D,0++ amp r-- ad/S
,,,, � Prmte ame
132696.ihi,(r 14
NOTARY Residing at /fieredalid
�, ,o�PUBL(k '�s My appointment expires /a/�193
I`9�h,,XPIRES�4�'�A
+t k WASH;4
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E. Fricks Jr., to me known to be the individual(s)
described in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this 12. day of ,20
(S&4i1130""•%11.
\,,‘,1A..0,9��+► N to ic
Gj_:'V32695'h ���(P +4�
SdU a sir
NOTARY Printed Name
pUBL1G ti' Residing at ,6
..
IIItil , ``RES,,,,, d My appointment expires /01-/910 I
ik WAS\` ••
Parcel No. 102305-9081-09 Page 7 of 13
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Teresa L.George,to me known to be the individual(s)described
in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as
his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this day of Q 20 O.
(SEA=)0,NsA%`. 111F
NJA D�A"► I--1, ��L' blic
i� �O`'•1326gS 1,vo�l
OvA DUwS
f NOTARY '', Printe ame
i —•••.—
j u�°'�,CC; PUBLIC, ,�= i Residing at /�,k/ �G q
4.
Iaj 9 I EXPIRES‘'1:4r 0=.'
1 , F,••••••• ,, . a My appointment expires l /�/ -
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Ronald E.Fricks,to me known to be the individual(s)described
in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as
his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this O day of Mall ,20 .
(S,Aisr •"‘‘ !� /
A
1 , t P c
c'J �••, •
32695I*Ih(31 460 �
aff
NOTAR B. LJ 2J 1 a.Ws
Printed Name
%%PUBLIGo ,eirkla '
Residingat
I� FXPI RES��'� As a:
, A� IA� \� .:� My appointment expires / � 3
1,1,`WASH —
Parcel No. 102305-9081-09 Page 8 of 13
C
STATE OF
ss.
COUNTY OF it-INQL
On this day personally appeared before me Raymond E. Fricks, to me known to be the individual('
described in and who executed the within and foregoing instrument, and acknowledged that he/slreAley.signed the
same as his/tier/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this 'L�day of ``-ka-t-z 1 ,20�. 1/4-k
(SEAL) U
Notary P lic
6•�` :> MIKE LEE P nted Name
m ` , COMM...2165192 A �� 1-.1�,Off- q�s3
F "„",90 NOTARY PUBLIC•CALIFORNIA —I Residing at ?.1:P't2. A401\4
U '" �,°l�' ORANGE COUNTY Id
CA-
2 r 2 pw. My Term.Exp.=._October 17,2020
My appointment expires VO(\ i'3 ).-0.
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Richard E.Fri s,to me known to be the individual(s)described
in and who executed the within and foregoing instrument, and .cknowledged that he/she/they signed the same as
his/her/their free and voluntary act and deed,for the uses ands rposes therein mentioned.
DATED this day of ,20 .
(SEAL)
Notary Public
Printed Name
Residing at
My appointment expires
/
Parcel No. 102305-9081-09 Page 9 of 13
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me 'aymond E. Fricks, to me known to be the individual(s)
described in and who executed the within and fore:,•ing instrument, and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and de-d,for the uses and purposes therein mentioned.
DATED this day of ,20 .
(SEAL)
Notary Public
Printed Name
Residing at
My appointment expires
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Richard E.Fricks,to me known to be the individual(s)described
in and who executed the within and foregoing instrument, and acknowledged that he/she/they signed the same as
his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this /6—day of M ,20 Z4.
(SEAL)
/ / 1
��"\ r"` of ry lic
aVoto
C� O'�32695,,, tr 6p ce4JA U v/S
NOT�y PrintedName
i 4
pUBL�f ry Residing at �rkl
� 04,
�)� iXPIRES���' �✓ My appointment expires /a/2.Q/9.3
°k pF WASN,,
Parcel No. 102305-9081-09 Page 9 of 13
EXHIBIT "A"
PROPERTY LEGAL DESCRIPTION
EXHIBIT A
PROPERTY DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
(PER QUIT CLAIM DEED, RECORDED UNDER AUDITOR'S FILE NO. 20081215000432)
THE NORTH 275 FEET OF THE WEST HALF OF THE EAST HALF OF THE NORTHEAST
QUARTER OF THE NORTHWEST QUARTER IN SECTION 10, TOWNSHIP 23 NORTH,
RANGE 5 EAST, W.M.
SITUATE IN THE COUNTY OF KING, STATE OF WASHINGTON.
`rrrp iwwwuirwwww./ S S�Sw.S w.���qry
• KE
WAs4,,/ '1,7
r
t 46889 v AS)
FsZ.
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Parcel No. 102305-9081-09 Page 10 of 13
EXHIBIT "B"
RIGHT OF WAY EASEMENT LEGAL DESCRIPTION
EXHIBIT B
PERMANENT EASEMENT DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
A PORTION OF THAT PROPERTY DESCRIBED IN QUIT CLAIM DEED,
RECORDED UNDER AUDITOR'S FILE NO. 20081215000432, KING
COUNTY RECORDS, SAID PORTION BEING MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT-OF-WAY LINE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52" WEST 47.96 FEET ALONG SAID
RIGHT-OF-WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
30.50 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT-OF-WAY LINE; THENCE NORTH 00'00'52" EAST 30.50 FEET
ALONG SAID RIGHT-OF-WAY LINE TO THE TRUE POINT OF BEGINNING;
TOGETHER WITH A PORTION OF SAID PROPERTY BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT-OF-WAY LINE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52" WEST 214.46 FEET ALONG SAID
RIGHT-OF-WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
23.00 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT-OF-WAY LINE; THENCE NORTH 00'00'52" EAST 23.00 FEET
ALONG SAID RIGHT-OF-WAY LINE TO THE TRUE POINT OF BEGINNING.
CONTAINING 268 SQUARE FEET, MORE OR LESS.
`ill/NrNriH n N/N. i�H.ti...�wvql
M• j<E
489
Ss IS T
I1TZ4I
Parcel No. 102305-9081-09 Page 11 of 13
EXHIBIT "C"
TEMPORARY CONSTRUCTION EASEMENT DEPICTION
EXHIBIT C
TEMPORARY CONSTRUCTION EASEMENT
NW 114 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
T.P.O.B. S88'37'32'E
_ / __5.00' _ NE 12th ST(PRIVATE) _
S00 00'S2' 1
NO0 00'52"E I 0 42.84'
i 47.96' / S89'59'08"E
5.00'
I N89'59'OS"W lig
1 5.00'
I " 1----40.50S00'00'S2'W
N00'0O'52 E '30.50' �
S89'59'08"E 04
5.00' N89'59'0B"W
5.00' R CKS ROBERT E SR
LLIZ Or 1160 DUVALL AVE NE 98059
��
LU N00'00'52'E
Q136.00' d pt
p
I a
D S44'59'08'EN89'59'08'W 23.33'
I 5.00' ,�
S00'00'521W
*_-H
'NO0'052'E ii
. S89'59'087 11
5.00' 1 S45'00'521WAI
23.33'
N00'00'52'E 4
►' 0 N 50'
TOTAL AREA 40.33' II s00 0o'S21Y
G — 21.92' v.=50'
2,042 SQ. FT. NB9'00'27'W Parametrix
LEGEND i o M• KEM
of WA$ 4' G
�
T.P.0.B. TRUE POINT OF BEGINNING e �r�k. Q Nc ,,v-,
/�/�// // ///� /� EASEMENT
CONSTRUCTION .I ':� -° . to
EXISTING RIGHT OF WAY UNE a P 6889 �o�
—- - - CENTERUNE p-'Fss1'4'GISTt0 sic.
1
—-- - -—--— PROPERTY UNE ioNA I. LAND
( APN XXXXXXXXXXX ) KING COUNTY TAX PARCEL NUMBER
-B-ZoZo
Parcel No. 102305-9081-09 Page 12 of 13
EXHIBIT "D"
PERMITTED EXCEPTIONS/TITLE REPORT
1. Subject to: Electric transmission and/or distribution Easement to Chicago,Milwaukee& St. Paul
Railway Company, under the recoding no. 1254827
2. Subject to: Road Easement,under the recording no. 3244268
3. Subject to: Right to make necessary slopes, cuts, or fill,to King County,under the recording no.
6387727
4. Subject to: Temporary water services agreement with the City of Renton,under the recoding no.
8508081021
5. Subject to: Landscape buffer agreement with Interstate Mobilephone Company, dba Cellular One,
under the recording no. 8508081021
6. Subject to: Easement for vehicular and pedestrian ingress and egress,and utilities to GTE, Wireless of
the Pacific Incorporated,under the recording no.20000614000639
7. Subject to: Easement,right of access and to install and maintain utilities,to Seattle SMSA Limited
Partnership dba Verizon wireless,under the recording no. 20141219000095
8. Subject to: Covenants, conditions,restrictions,recitals,reservation, easement provisions,dedications,
building setback lines,notes, statements, location of improvements in relation to property boundaries
and other matters, if any set forth in a recorded survey under the recording no. 9707259002
9. Subject to: Covenants,conditions,restrictions,recitals,reservation,easement,easement provisions,
dedications,building setback lines,notes, statements, locations of improvements in relation to property
boundaries and other matters, if any and set forth in a recorded survey under the recording no.
9804159002
10. Subject to: notice of possible(present or future)tap or connection charges levied by the City of
Renton.
11. Subject to: General taxes(Easement Acquisition only.)
12. Subject to:Unrecorded lease with Interstate Mobilephone Company dba Cellular One,recorded under
the rerecording no. 9403170694, amended under the recording no.20141219000622
13. Subject to: Unrecorded lease with OneComm Corporation, dba Nextel Communications, under the
recording no. 9702261309, assignment of lease to Tower Parent Corp., under the recording no.
20020920000742,assignment of lease to Tower Asset Sub,Inc, under the recording no.
20020920000743,agreement to amend or modify to American Tower Asset Sub,LLC,under the
recording no. 20080529001975,assignment of lease to American Tower Asset Sub,LLC,under the
recording no. 20091020002088,deed of trust,assignment of leases and rent under the recording no.
20091020002098,assignment of beneficial interest under the recording no.20110527001443,
20110527001444,and 20110527001445, follow by UCC filing under the recording no.
20091020002099
14. Subject to: Unrecorded lease with GTE Wireless of the Pacific Incorporated,under the recording no.
20000614000638,assignment of lease under the recording no. 20020524000346,assignment of lease
interest under the recording no. 20020524000347
15. Subject to: Unrecorded lease with Seattle SMSA LP dba Verizon Wireless,under the recording no.
20141219000095
Parcel No. 102305-9081-09 Page 13 of 13
REAL PROPERTY VOUCHER AGREEMENT
AGENCY NAME I hereby agree to the terms and conditions listed below and
City of Renton hereby certify under penalty of perjury that the items and
amounts listed herein are proper charges,that the same or
Renton City Hall any part thereof has not been paid,and that I am
1055 S. Grady Way authorized to sign for the Claimant:
Renton,WA 98057 (Sign in Ink)
Phone: (425 430-6400
GRANTOR or CLAIMANT Byt IAtha' '
Robert E. Fricks. et al Owner/Authorized Representative
1621 Camas Ave NE Date:
Renton, WA 98056
Re: City of Renton-Duvall Avenue NE TAX PARCEL NUMBER: 102305-9081-09
PROJECT PARCEL NUMBER: 12
In Full,Complete and Final Payment and Settlement for the Title or Interest
Conveyed or Released,as Fully Set For h in Attached Documents: AMOUNT
ROW Easement Dated:
For All Lands Convey: +$00.00
ROW Utility Easement: 268 SF @$20.00 50% +$2,680.00
Easement: TCE 2,042 SF @ $20.00 @ 16% +$6,534.40
For All Damages: 1 Tree within the Easement area +$ 1,000.00
Less Special Benefits:
Statutory Evaluation Allowance
JUST COMPENSATION $ 10,300.00 (R)
Legal/Administrative: +$
Other Items:
Deductions:
FINAL SETTLEMENT $ 10,300.00
SUBTOTAL $ 10,300.00
TOTAL AMOUNT TO BE PAID: $ 10,300.00
Right-of-Way Agent: Sonja Davis
By. 6—/th
Date
The City of Renton agrees to the terms and conditions listed above.
By:
Date
Request for Taxpayer Give Form to the
Form
(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Reve Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 a e(as shown on your incom eturn).Name is required on this line;do not leave this line blank.
2-Bus e riame/ isr a ed entity name,if different from above
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
ro following seven boxes. certain entities,not individuals;see
a instructions on page 3):
p Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
ai single-member LLC Exempt payee code(if any)
0.3 ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
o ;? Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
in LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is ( y)
'C E another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code if an
a. v is disregarded from the owner should check the appropriate box for the tax classification of its owner.
• ❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.)
co• 5 / idress(numberAtreetk 4nd apt.or quite no.)See instructions. Requester's name and address(optional)
co
6 C ,stat\ d ZIP code ^_ y J
7 List account numbe s)here(optional) h`y1Q
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other5 5 - - C
entities,it is your employer identification number(EIN). If you do not have a number,see How to get a J
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report Ir rest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abando ent of ecured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest d dividend ,you are not quired t.'es]the certification,but you must pro • your correct TIN.See the instructions for Part II,later.
Her Sign ure of ��
Here u.s.p on Date► ( lY
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Vendor Setup Form Y
/
City of Renton—ASD/Finance
1055 South GradyWay5th Floor I _4 r �
Renton, WA 98057 A ;
www.rentonwa.gov .
N T O�'
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email. r
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor Information
Roe\ Fsi C—AS5
Name EIN
Check Payable to if different than above Accounts Receivable Contact
Address Accounts Receivable Phone Number
At—OQcArY-‘ US-Pc �/Y'� Please Provide a Current W-9 form
City State Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
❑ Disadvantaged Business Enterprise Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
❑ Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI #
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer
Account# 6 0, (-3 '2_0 a\b Routing# 3 2,5 oq 1 '10
Please attach a voided check or direct deposit letter from your bank
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
a e nt is to be changed or canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
dress
04B ao CZ,
c�
Signature Printed Name Date
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nwissbrod@rentonwa.gov ccommodore@rentonwa.gov jbecht@rentonwa.gov
W-9Request for Taxpayer Give Form to the
Form
(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
rk._ L— - 6)e.0
r �-
2 usiness name/disregarded entity name,if different from auove
M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
0 following seven boxes. certain entities,not individuals;see
instructions on page 3):
p Individual/sole proprietor or ❑ C Corporation ❑ S Corporation CI Partnership CI Trust/estate
rn ingle-member LLC Exempt payee code(if any)
ci c
4.• 15 ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
p 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
▪ i• n LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any)
'C u another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC thatO.
is disregarded from the owner should check the appropriate box for the tax classification of its owner.
O7
❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.)
In 5 Address(number,street,and apt.or suite no.)Seg instructions. Requester's name and address(optional)
cn
6 City,state,and ZIP code
9s c))______3
7 List account number(s)here(optional)
IMMIL Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other ", 2 - / - -7
entities,it is your employer identification number(EIN). If you do not have a number,see How to get a > tv l
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of - //
Here U.S.person► ��",0 C&- (V�� 1�. Date► J/ e;2-(3 C)
General Instructions `-' •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted. proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Vendor Setup Form Y
L\ ofi
City of Renton—ASD/Finance of
1055 South Grady Way—5th Floor {
Renton,WA 98057 I 145L`';Ay•
r
www.rentonwa.gov
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email. N_T -
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor Information
63Te CA &: rq 6
Name EIN
Check Payable to if different than above Accounts Receivable Contact
-31 W v L3 '' Sr
Andress Accounts Receivable Phone Number
cis 0
efiia l W M �` + � � Please Provide a Current W-9 form
City ate Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
❑ Disadvantaged Business Enterprise Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
❑ Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI#
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer
Account# H O o� l3c A Routing# /Z 0 00
Please attach a voided check or direct deposit letter from your bank
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
agreement is to be changed or canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
address.
Signature Printed Name Date
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nwissbrod@rentonwa.gov ccommodore@rentonwa.gov ibecht@rentonwa.gov
Request for Taxpayer Give Form to the
Form
(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name(as shown on your income tax return).Name is required on this line;do not leave this line blank.
,'?o 4=V4s f , Fr/c>/c,s-
2 Business name/disregarded entity name,if different from above
co
3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
m following seven boxes. certain entities,not individuals;see
a instructions on page 3):
Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
single-member LLC Exempt payee code(if any)
ao
❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
`o 2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
m LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is code(if any)
a c another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that
Y is disregarded from the owner should check the appropriate box for the tax classification of its owner.
y ❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.)
fn 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
62 It S' /G
6 City,state,and ZIP code
7 List account e s ere(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a u
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other 7 — 4. -D ,7 ! 5
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN, later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,/you are not required to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of /`7� ,' — ///J /
Here U.S.person► v t 1�y7 7(1I/Cy�/ Date I. c f/ /3
General Instructions 6 •Form 1099-DIV(dividends,including those from"stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Vendor Setup Form ,r Y-
City of Renton—ASD/Finance f 1
1055 South Grady Way—5th Floor ♦ iq:'° ' + i
Renton, WA 98057
www.rentonwa.gov
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email.
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor Information
e
glO bet4
Name EIN
Check Payable to if different than above Accounts Receivable Contact
/62/ (',tsar Axe_ MJ .
Address �/_ Accounts Receivable Phone Number
"/74,i) L)1/ ?g�✓J f� Please Provide a Current W-9 form
City State Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
❑ Disadvantaged Business Enterprise Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
❑ Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI #
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer
Account# 32 5DrZ z(o , Routing# D 00 (,
Please attach a voided check or direct deposit letter from your bank
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
agreement is to be changed or canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
address.
CA9
Signature Printed Name Date
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nwissbrod@rentonwa.gov ccommodore@rentonwa.gov jbecht@rentonwa.gov
Request for Taxpayer Give Form to the
Form
(Rev.October2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Servi - ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name(.s s own. your income tax return). m is required on is line;do not leave this line blank.
2 Busine n. e/disregarded entity nam i different from above
M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
a)
m following seven boxes. certain entities,not individuals;see
a instructions on page 3):
p Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
w single-member LLC Exempt payee code(if any)
ai c
v ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
p r2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
+' rn LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is ( y)
E another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code if an
D. ° is disregarded from the owner should check the appropriate box for the tax classification of its owner.
ft ❑ Other(see instructions)I. (Applies to accounts maintained outside the U.S.)
to 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
/
/_?srl sr4 02/2m c.v
6 ity,st to-d ZIP bode (4 f
7 List a count number(s)here(optional) •
Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a ^� _W
_����
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other S
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a 1/ /
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to repo ividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandon ent of secured r erty,cancella' n of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you e t required gn he ce ification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of ^ /�
Here U.S.person I, [ Date► -,/2 �(/2
General Instructions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted. proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest),1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Vendor Setup Form y
City of Renton—ASD/Finance
1055 South Grady Way—5m Floor i i* 9
Renton, WA 98057 Li \,\>
www.rentonwa.gov '�N• N T �
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email.
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor inft rmation
Name EIN
Check Payable to if different than above Accounts Receivable Contact
I3S7 2/2 LA/ (A3
Address Accounts Receivable Phone Number
W , Please Provide a Current W-9 form
Ci y State Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
El Disadvantaged Business Enterprise
Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
D Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI#
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer
Account# 533/L c �j ?Z (P Routing# 12560 61,511 I
Please attach a voided check or direct deposit letter from your bank
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
agre is o e nged or cancel d in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
ad ress. /�)
�12„2/
Signatur Printed Name Date
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nwissbrod@rentonwa.gov ccommodore@rentonwa.gov jbecht@rentonwa.gov
Request for Taxpayer Give Form to the
Form
(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Na (as shown on your income tax return).Name is required on this line;do not leave this line blank.
. C(-4 0 C c,K S
2 Bus ess name/disregarded entity name,if different from above
M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
a)
cr following seven boxes. certain entities,not individuals;see
as
a L71 instructions on page 3):
p ndividual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑Trust/estate
c single-member LLC Exempt payee code(if any)
ao
❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
p ._2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
H LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is
another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that code(if any)
O. v is disregarded from the owner should check the appropriate box for the tax classification of its owner.
2
❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.)
y 5 Address(number,street,and apt.or suite no.) ee instruction Requester's name and address(optional)
I� ( 3'E L.K I--)%Y\ (2
6 City state,and ZIP code /
��Vt t J (jJ IeYeOL\2
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other 5 - LA - 4 a / 0
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury,I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross :' item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest and• '.ends o your t turn or r al estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of secur-• p .pery, cell ion f t,c tributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,yo• . e not r 'ed o si ication,but you must provide your correct TIN.See t e instructions for Part II,later.
Sign Signature of
Here U.S.person► ' .st."---/(.4
Date► ; / (fa
_s-A
General Instr tions •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted.
proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
Vendor Setup Form
City of Renton—ASD/Finance t —�•.�
1055 South Grady Way—5th Floor r + , ? + 1
Renton, WA 98057 11,U vv' \>
www.rentonwa.gov
NTH
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email.
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor Information
Name EIN
Check Payable to if different than above Accounts Receivable Contact
x / ©� SF LK I�
Address r I Accounts Receivable Phone Number
?e 2 Please Provide a Current W-9 form
City State Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
❑ Disadvantaged Business Enterprise Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
❑ Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI#
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer —Dal)
Account# 3© Routing#/ —Dal) y
Please attach a voided check or direct deposit letter from your bank
I/we hereb ;roe the City ton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
agreeme s to be cha j, . canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
addres• /
J _ _
/
Si:nature Printed Name Da
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nissbrod@rentonwa.gov ccommodore@rentonwa.gov jbecht@rentonwa.gov
W-9Request for Taxpayer Give Form to the
Form
(Rev.October 2018) Identification Number and Certification requester.Do not
Department of the Treasury send to the IRS.
Internal Revenue Service ►Go to www.irs.gov/FormW9 for instructions and the latest information.
1 Name s shown on Your income tax return).Name is required on this line;do not leave this line blank.
2.
2 Business name/disregarded entity name,if different from above
M 3 Check appropriate box for federal tax classification of the person whose name is entered on line 1.Check only one of the 4 Exemptions(codes apply only to
a)
c following seven boxes. certain entities,not individuals;see
as
a instructions on page 3):
o Individual/sole proprietor or ❑ C Corporation ❑ S Corporation ❑ Partnership ❑ Trust/estate
ai Ingle-member LLC Exempt payee code(if any)
0.u ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=Partnership)►
`p w2 Note:Check the appropriate box in the line above for the tax classification of the single-member owner. Do not check Exemption from FATCA reporting
+' H LLC if the LLC is classified as a single-member LLC that is disregarded from the owner unless the owner of the LLC is
'C c ( y)
codeif an another LLC that is not disregarded from the owner for U.S.federal tax purposes.Otherwise,a single-member LLC that
a o is disregarded from the owner should check the appropriate box for the tax classification of its owner.
w
ai ❑ Other(see instructions)► (Applies to accounts maintained outside the U.S.)
y 5 Address(number,street,and apt.or suite no.)See instructions. Requester's name and address(optional)
a -;7 , Pc 6 uX �5 -5s w
6 City,state,and ZIP code
7 List account number(s)here(optional)
Part I Taxpayer Identification Number(TIN)
Enter your TIN in the appropriate box.The TIN provided must match the name given on line 1 to avoid Social security number
backup withholding.For individuals,this is generally your social security number(SSN).However,for a
resident alien,sole proprietor,or disregarded entity,see the instructions for Part I,later.For other 13 -
entities,it is your employer identification number(EIN).If you do not have a number,see How to get a `)c r �� Z���
TIN,later. or
Note:If the account is in more than one name,see the instructions for line 1.Also see What Name and Employer identification number
Number To Give the Requester for guidelines on whose number to enter.
Part II Certification
Under penalties of perjury, I certify that:
1.The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me);and
2.I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue
Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am
no longer subject to backup withholding;and
3.I am a U.S.citizen or other U.S.person(defined below);and
4.The FATCA code(s)entered on this form(if any)indicating that I am exempt from FATCA reporting is correct.
Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because
you have failed to report all interest dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,
acquisition or abandonment of se red property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments
other than interest and dividends,you re uired to sign the certification,but you must provide your correct TIN.See the instructions for Part II,later.
Sign Signature of �/J
Here U.S.person► 1" ° Date S. 2-� '
ti
General Instructions v •Form 1099-DIV(dividends,including those from stocks or mutual
funds)
Section references are to the Internal Revenue Code unless otherwise •Form 1099-MISC(various types of income,prizes,awards,or gross
noted. proceeds)
Future developments.For the latest information about developments •Form 1099-B(stock or mutual fund sales and certain other
related to Form W-9 and its instructions,such as legislation enacted transactions by brokers)
after they were published,go to www.irs.gov/FormW9.
•Form 1099-S(proceeds from real estate transactions)
Purpose of Form •Form 1099-K(merchant card and third party network transactions)
An individual or entity(Form W-9 requester)who is required to file an •Form 1098(home mortgage interest), 1098-E(student loan interest),
information return with the IRS must obtain your correct taxpayer 1098-T(tuition)
identification number(TIN)which may be your social security number •Form 1099-C(canceled debt)
(SSN),individual taxpayer identification number(ITIN),adoption •Form 1099-A(acquisition or abandonment of secured property)
taxpayer identification number(ATIN),or employer identification number
(EIN),to report on an information return the amount paid to you,or other Use Form W-9 only if you are a U.S.person(including a resident
amount reportable on an information return.Examples of information alien),to provide your correct TIN.
returns include,but are not limited to,the following. If you do not return Form W-9 to the requester with a TIN,you might
•Form 1099-INT(interest earned or paid) be subject to backup withholding.See What is backup withholding,
later.
Cat.No.10231X Form W-9(Rev.10-2018)
RAY FRICKS 19-8140/3250 19223
CHERIE FRICKS
20933 SE 322ND ST. N.
�
AUBURN,WA 98092 DATE
PAY TO
ORDER OFE I
DOLLARS I I w,a�'°""`�e.n"'°°"
PO.Bo 9705/
more than Seattle, A 9:124-9750
just money" 800-233- 428 206-439-5700
www.becu.•rg
MEMO AP
1: 32508L4031: 356L86L7710 223
Vendor Setup Form �\ Y o
•
City of Renton—ASD/Finance
1055 South Grady Way—5th Floor
Renton, WA 98057 ma ti
www.rentonwa.gov `.
C)�
Instructions:Complete all sections of this form and return this form by fax(425)430-6957,U.S.Mail or email. _
Failure to submit a W-9 can create a delay in our payments to you,and your payment(s)could be subject to the
IRS required back up withholding
Vendor Information
1 el\y Fri cic
Name EIN
Check Payable to if different than above Accounts Receivable Contact
Address Accounts Receivable Phone Number
\,1``'` / " ' ( ' 7 Please Provide a Current W-9 form
City State Zip https://www.irs.gov/pub/irs-pdf/fw9.pdf
Business Information
Please check all that apply: City of Renton Business license is required by City of
El Disadvantaged Business Enterprise Renton municipal code, Business regulation#5-5-3.
❑ Minority Business Enterprise
D Women Business Enterprise Renton Business license#
Who is your contact person at the City of Renton?
Flora Lee / 425-430-7303 State of Washington UBI#
Questions?Contact Business Licensing at
City of Renton Department you are working with? https://rentonwa.gov/businesslicensing
Public Works Department
Electronic Funds Transfer
Account# 3 / / Routing# S z$CC o�
Please attach a voided check or direct deposit letter from your bank
I/we hereby give the City of Renton the authority to make EFT direct deposits to the bank account described above.I/we understand that if this EFT
agreement is to be change r canceled in any way that I/we must provide 30 day advance written notice to the City of Renton at the above
address. / ;
2
Signature/ Printed Name' Date
Finance Accounts Payable Team
Natalie Wissbrod,Accounting Asst. Casaundra Commodore,Accounting Asst. Jen Becht, Finance Supervisor
(425)430-6919 (425)430-6930 (425)430-6935
nwissbrod@rentonwa.gov ccommodore@rentonwa.gov jbecht@rentonwa.gov
, Group
Northwest
Acquisition and Relocation Services
Transmittal Memo
To: Flora Lee,Project Manager,City of Renton
CC: Cindy Clark,P.E.Parametrix
From: Sonja Davis RES Group NW
Date: June 11,2020
Project: Duvall Avenue NE
Parcel No.: 12
Owner: Robert E.Fricks. et al
Ms. Lee,
Enclosed in this transmittal are the following documents:
1. Purchase and Sale Agreement
2. ROW Easement
3. Real Estate Excise Tax Affidavit(required for recording)
4. Temporary Construction Easement
5. Instructions for disbursement of Proceeds
6. Real Property Voucher
7. W-9(x6)
8. Vendor form(x6)
Sincerely,
t :-/Dm.........,
ov
Sonja Davis,WA/RAC
RES Group NW
1913 6th Street
Kirkland,WA 98033
After recording return document to:
City of Renton
City Clerk's Office
1055 South Grady Way
Renton, WA 98057
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE
Grantor(s): Robert E. Fricks, Robert E. Fricks Jr., Terresa L. George, Ronald E. Fricks, Raymond E.
Fricks,and Richard E. Fricks
Grantee(s): City of Renton
Legal Description: N275FT OF W /2 OF E '/2 OF NE 'A OF NW '/4 OF SEC. 10,T. 23N., R. 05 E., W.M.,
KING COUNTY,SUBJ TO CM&ST P TRANS LN ESMT LESS CO RD
Assessor's Tax Parcel Number: 102305-9081-09
Reference Number of Related Documents: N/A
RIGHT OF WAY EASEMENT
Duvall Avenue NE Project Project
The Grantor(s), Robert E. Fricks, Robert E. Fricks Jr., Terresa L. George, Ronald
E. Fricks, Raymond E. Fricks and Richard E. Fricks, as their respective separate property,
and as tenants in common, for and in consideration of$10.00 and other valuable consideration,
receipt of which is hereby acknowledged, does hereby grant and convey unto the City of
Renton, a municipal corporation, and its successors and assigns (the Grantee), for use by the
public forever, from the property legally described on Exhibit "A" — Entire Parcel (the
"Property"), attached hereto and incorporated by this reference, a permanent right of way
easement, for the purposes described below, over, in, on, along, across, through, below and j
upon, the portion of the Property legally described on Exhibit "B", (the "Right of Way
Easement") and depicted on Exhibit "C", which are attached hereto and incorporated by this
reference.
The Grantee and its agents,designees and/or assigns,and the public,shall have the right
at such times as deemed necessary by Grantee, to enter upon, over, under and across the Right
of Way Easement to inspect, construct, reconstruct, operate, use, travel on, maintain, repair,
replace and enlarge the public rights-of-way for all public purposes, including but not limited
to, motorized and nonmotorized vehicular travel lane, landscaping, sidewalks, street lights,
Parcel No. 102305-9081-09
Page 1 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
utilities (including without limitation water, sewer, storm water, electric, gas,
telecommunications, cable and fiber optics, either owned or operated by Grantee or those
utilities which provide service to Grantee or its citizens and are operated by permission of
Grantee through franchise or permit)appurtenant slopes, cuts,fills and retaining walls,together
with the right of ingress and egress thereto without prior institution of any suit or proceedings
and without incurring any legal obligation or liability therefore.
THIS EASEMENT is executed and delivered and said easement is granted upon the followin
conditions to wit:
1. The Grantor,its heirs,executors,administrators, successors and assigns,hereby releases
the Grantee, its agents and employees, assigns and successors from any and all liability fo
damage to the remaining lands resulting from this conveyance, and construction and'
maintenance of the right of way, provided the Grantee, its agents and employees, assigns and/
successors shall, as soon as practicable, after construction of the retaining wall and all
subsequent alterations and repairs thereto, restore all property to the Grantor to a neat and
presentable condition.
2. Grantor shall not interfere in any manner with the easement rights granted to Grantee
and the public in this Right of Way Easement. Without limitation, Grantor shall not (1) erectI
or maintain any buildings, structures, or improvements within the Right of Way Easement; (2),
disturb the lateral or subjacent support of the roadway, sidewalks, utilities and other,
improvements and uses of the Right of Way Easement by Grantee, or undertake any form o
construction or other activity that may disturb or damage the roadway, sidewalks, utilities, o
other improvements or uses of the Right of Way Easement by Grantee;or(3)plant trees,shrubs
or other vegetation having deep root patterns that may cause damage to or interfere with the use
of the streets, sidewalks, or utilities.
3. The rights granted herein shall not be construed to interfere with or restrict the Grantor,
its heirs, executors, administrators, successors and assigns from the use of the Property outside
of the Easement Area for the construction and maintenance of property improvements outside
of the Easement Area.
4. This Right of Way Easement and the rights, obligations and covenants stated in,
this Right of Way Easement shall run with the land and shall be binding upon and shall inure
to the benefit of the Grantor and Grantee. This Right of Way Easement shall be recorded with!
the King County Recorder's Office.
5. It is understood and agreed that delivery of this Right of Way Easement is hereby
tendered and that the terms and obligations hereof shall not become binding upon City o'
Renton unless and until approved hereon in writing by City of Renton.
Parcel No. 102305-9081-09
Page 2 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
Dated: , 20 .
Grantor:
eA4L,Ifrcztkei/2.0
. Fricks
Robert E. Fricks Jr.
Teresa L.George
onald E.Fricks
Raym .Fricks
'chard E.Fricks
Accepted and Approved
City of Renton
By
Its
Date
Parcel No. 102305-9081-09
Page 3 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
Dated: 20
Grantor:
Robert E. Fricks
Robert E.Fricks Jr.
Teresa L. George
Rbna E.Fricks
� V
Ra on ric s
Richard E.Fricks
Accepted and Approved
City of Renton
By
Its
Date
Parcel No. 102305-9081-09
Page 3 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E. Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this // day of 20
(SEAL)
No blic
SAD °,
2L I/i
rb '?2695 h�(f\t•1 Printed hdame•
C
NOTARY
; —►.�--- i Residing at
' o
PUBL1Co
i 'it+ PIRES�� �0 My appointment expires / a—
4it OE w AS*
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Robert E. Fricks Jr., to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed th
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this /2day of My ,20 .
(SEAL
°, otary Public •
�_J'13269g •
����j Sn/i DU or
i •
NOT }, , �� Printed Name
N , PUBLIC ti' g Residing at //r/`(/
I EXPIRES 1;41 �° /P/a /
,,,,,,,,,,.. My appointment expires
/°°° OF WAS\A\\C-s
Parcel No. 102305-9081-09
Page 4 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Teresa L. George, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed th
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this day of A ,20 O .
""‘
D4��, 'ubli
CO.'13269s'44,� Ij
NOTARY 's 11; fan/A Z a 7
Printed 11ame
c+ P G
II N,�4 UBL1 r_S Residing at il/r�Cla td
IIA II lk f\"RES'titi.FQ�=
/�' �F WASN���� My appointment expires /a/ /a
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Ronald E. Fricks, to me known to be the individual(s1
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed thee
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this fay of ,20
(SEAL) !/1
'•••"" 1 ary Pu lic
a. �O1A D,q� Si* ulrls
CO �32695�\#' II
NOTARY y%
PrintecTlame
• •_..I— s
- Residing at
PUBUC
Nio ti.
IIII,9 •I eXPfRES�ti =�� My appointment expires /d—
.iOFWASN\
Parcel No. 102305-9081-09
Page 5 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Raymon, E. Fricks, to me known to be the individual(sj
described in and who executed the within and foregoing instr, ent,and acknowledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for t p e uses and purposes therein mentioned.
DATED this day of ,20 .
(SEAL)
Notary Public
Printed Name
Residing at
My appointment expires
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Richard E. Fricks, to me known to be the individual(s)
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they signed the'
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this l6-day of ,20 I.
(S` l%olk.�1 / H / C.
JA D '�► ,ry P .lic
NOTA/,� It',,I'�" ,��� PriStedvame%DGt'/S
•
• u, ,�-' PUBLIC '_ Residing at �//'f(/
•
•I "9 I�� FXPIRES ��' ��
� OF*%%%%%% 41 f My appointment expires /p1/c D/
Parcel No. 102305-9081-09
Page 6 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
STATE OF
ss.
COUNTY OF Ktht6—
On this day personally appeared before me Raymond E. Fricks, to me known to be the individual
described in and who executed the within and foregoing instrument,and acknowledged that he/she/they—signed the
same as his/her/their free and voluntary act and deed,for the uses and purposes therein mentioned.
DATED this 2R-- day of ,20?—o.\
(SEAL) ` *I i
otary 'ublic
•
es.Of MIKE LEE GJ Printed Name
COMM...2165192 \ Qt16S3
r1 n �" ?a aQo NOTARY PUBLIC-CALIFORNIA —IResiding �'\ nn
(] ;�r,tw•, at�i ZZ a C�.� L-1k CA
.
_ �Jr ORANGE COUNTY G)
'Zit! My Term Exp.October 17,2020
My appointment expires ‘k \r>r\)-31-•
STATE OF WASHINGTON
ss.
COUNTY OF KING
On this day personally appeared before me Richard E. Fricks, to known to be the individual(s)
described in and who executed the within and foregoing instrument,and ackv ledged that he/she/they signed the
same as his/her/their free and voluntary act and deed,for the uses and pu a 6ses therein mentioned.
DATED this day of ,20
(SEAL)
Notary Public
Printed Name
Residing at
My appointment expires
Parcel No. 102305-9081-09
Page 6 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT
EXHIBIT "A"
ENTIRE PARCEL
EXHIBIT A
PROPERTY DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
(PER QUIT CLAIM DEED, RECORDED UNDER AUDITOR'S FILE NO. 20081215000432)
THE NORTH 275 FEET OF THE WEST HALF OF THE EAST HALF OF THE NORTHEAST
QUARTER OF THE NORTHWEST QUARTER IN SECTION 10, TOWNSHIP 23 NORTH,
RANGE 5 EAST, W.M.
SITUATE IN THE COUNTY OF KING, STATE OF WASHINGTON.
M. KE
���0g BASg14l//,A
>\ LI
,0 /ff
y 'Po� 46889 e•
y «6 iihi
4'GISTT.0c I,
DNAL LW
Li-8-20ZA
Parcel No. 102305-9081-09
Page 7 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
RIGHT OF WAY EASEMENT 1
EXHIBIT `B"
RIGHT OF WAY LEGAL DESCRIPTION
EXHIBIT B
PERMANENT EASEMENT DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
A PORTION OF THAT PROPERTY DESCRIBED IN QUIT CLAIM DEED,
RECORDED UNDER AUDITOR'S FILE NO. 20081215000432, KING
COUNTY RECORDS, SAID PORTION BEING MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT—OF—WAY UNE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52 WEST 47.96 FEET ALONG SAID
RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
30.50 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT—OF—WAY LINE; THENCE NORTH 00'00'52" EAST 30.50 FEET
ALONG SAID RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING;
TOGETHER WITH A PORTION OF SAID PROPERTY BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT—OF—WAY UNE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52" WEST 214.46 FEET ALONG SAID
RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
23.00 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT—OF—WAY UNE; THENCE NORTH 00'00'52" EAST 23.00 FEET
ALONG SAID RIGHT—OF—WAY UNE TO THE TRUE POINT OF BEGINNING.
CONTAINING 268 SQUARE FEET, MORE OR LESS.
. kCM
F, of Wnsy �,
i 4
po 46689 ��
y ��ss ONq LS r N �J�,�
'l\N ♦.. \SNw ,Mfl'„+,..Nisi/i.•i//,II
y'B,ZoZO
Parcel No. 102305-9081-09
Page 8 of(7)Pages
i I
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY
RIGHT OF WAY EASEMENT
EXHIBIT "C"
GRAPHIC DEPICTION
EXHIBIT C
PERMANENT EASEMENT
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
�f1 __ NE 12th ST(_PRIVATE)
P.O.C. S00 0O'S2'W
47.96'
S89'59'081
5.00'
T.P.O.B. �'� SOO'00'S2'W
NO0'00'52'E 30.50'
�30.50'
Ii
N89'59'08"W
I 5.00'
rl
w
Z
W ( APN 1023059081)
FRICKS ROBERT E SR
Q N 1160 DUVALL AVE NE 98059
J El
Q �I
0 I S89'59'081
5.00'
T.P.O.B. I�'
N00'00'52'E 1 S00 00'S2'W
23.00' I 23.00'
i N89'59'08"W
5.00' Aki
111- 0 rg 50
minwoma
TOTAL AREA — - — — 50'
268 SQ. FT. I Parametrix
LEGEND
P.O.C. POINT OF COMMENCEMENT „!`O •oF'WA EN�,��
T.P.O.B. TRUE POINT OF BEGINNING >QSSA� cloy
V/ / /I PERMANENT EASEMENT AREA ; IN
PROPOSED PERMANENT EASEMENT UNE
EXISTING RIGHT OF WAY UNE r
P 46889 no
- CENTERUNE % �`Fsh't S T RR S�e��
------ —--— PROPERTY LINE 1°NAL LAND
( APN XXXXXXXXXXX ) KING COUNTY TAX PARCEL NUMBER
y-S-Zo2o
Parcel No. 102305-9081-09
Page 9 of(7)Pages
PLEASE MAKE NO MARK IN THE MARGIN SPACE-RESERVED FOR COUNTY RECORDER'S USE ONLY.
Department of reaRevenue REAL ESTATE EXCISE TAX AFFIDAVIT This form is your receipt
Washington State CHAPTER 82.45 RCW-CHAPTER 458-61A WAC when stamped by cashier.
THIS AFFIDAVIT WILL NOT BE ACCEPTED UNLESS ALL AREAS ON ALL PAGES ARE FULLY COMPLETED
Only for sales in a single location code on or after January 1,2020.
0 Check box if the sale occurred PLEASE TYPE OR PRINT
in more than one location code.
0 Check box if partial sale,indicate% sold. List percentage of ownership acquired next to each name.
iEl Name Robert E. Fricks, Sr., et al ©Name City of Renton, a municipal corporation of
the State of Washington
cG w
w H Mailing Address 1621 Camas Ave NE RI H Mailing Address 1055 S. Grady Way
1z � z
City/State/zip Renton,WA 98056 R City/State/Zip Renton,WA 98057
Phone No.(including area code) . Phone No.(including area code)
il Send all property tax correspondence to: ® Same as Buyer/Grantee List all real and personal property tax parcel List assessed value(s)
account numbers-check box if personal property
Name 102305-9081 0 966,200.00
Mailing Address ❑ 0.00
City/State/Zip
❑ 0.00
Phone No.(including area code) ❑ 0.00
NStreet address of property: 1160 Duvall Ave NE
This property is located in Renton
❑ Check box if any of the listed parcels are being segregated from another parcel,are part of a boundary line adjustment or parcels being merged.
Legal description of property(if more space is needed,you may attach a separate sheet to each page of the affidavit)
See Attached
5 Select Land Use Code(s): MI List all personal property(tangible and intangible)included in selling price.
11-Household,single family units
enter any additional codes:
(See back of last page for instructions) YES NO
Was the seller receiving a property tax exemption or deferral ❑ 0
under chapters 84.36,84.37,or 84.38 RCW(nonprofit If claiming an exemption,list WAC number and reason for exemption:
organization,senior citizen,or disabled person,homeowner WAC No.(Section/Subsection) 458-61A-206(2)
with limited income)?
Reason for exemption
Is this property predominantly used for timber(as classified under ❑ ❑✓
RCW 84.34 and 84.33)or agriculture(as classified under RCW Exercise of Eminent Domain
84.34.020)?See ETA 3215
I YES NO
Is this property designated as forest land per chapter 84.33 RCW? ❑ ❑✓ Type of Document Right of Way Easement
Is this property classified as current use(open space,farm and 0 ElDate of Document
agricultural,or timber)land per chapter 84.34 RCW?
Is this property receiving special valuation as historical property ❑ ❑✓
per chapter 84.26 RCW?
If any answers are yes,complete as instructed below. Gross Selling Price $ • 0.00
(1)NOTICE OF CONTINUANCE(FOREST LAND OR CURRENT USE) Personal Property(deduct) $ 0.00
NEW OWNER(S):To continue the current designation as forest land or
classification as current use(open space,farm and agriculture,or timber)land, Exemption Claimed(deduct) $ 0.00
you must sign on(3)below.The county assessor must then determine if the Taxable Selling Price $ 0.00
land transferred continues to qualify and will indicate by signing below.If the
land no longer qualifies or you do not wish to continue the designation or classi- Excise Tax:State
fication,it will be removed and the compensating or additional taxes will be due Less than$500,000.01 at 1.1% $ 0.00
and payable by the seller or transferor at the time of sale.(RCW 84.33.140 or
RCW 84.34.108).Prior to signing(3)below,you may contact your local county From$500,000.01 to$1,500,000 at 1.28% $ 0.00
assessor for more information. From$1,500,000.01 to$3,000,000 at 2.75% $ 0.00
This land ❑ does 0 does not qualify for continuance. Above$3,000,000 at 3.0% $ 0.00
Agricultural and timberland at 1.28% $ 0.00
• Total Excise Tax:State $ 0.00
DEPUTY ASSESSOR DATE 0.0050 Local $
0.00
(2)NOTICE OF COMPLIANCE(HISTORIC PROPERTY) *Delinquent Interest:State $
NEW OWNER(S):To continue special valuation as historic roe 0.00
( ) P property,rty,sign(3)
below.If the new owner(s)does not wish to continue,all additional tax calcu- Local $ 0.00
lated pursuant to chapter 84.26 RCW,shall be due and payable by the seller or *Delinquent Penalty $
transferor at the time of sale. 0.00
(3)NEW OWNER(S)SIGNATURE Subtotal $ 0.00
*State Technology Fee $ 5.00
*Affidavit Processing Fee $ 5.00
PRINT NAME Total Due $ 10.00
A MINIMUM OF$10.00 IS DUE IN FEE(S)AND/OR TAX
*SEE INSTRUCTIONS
8 I CERTIFY UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT
Signature of iS Signature of
Grantor or Grantor's Agent �, 't J j, Grantee or Grantee's Agent
Name(print) Teresa 6 e „c/ Name(print)
�/
Date&city of signing 0-Late L, Date&city of signing
Perjury:Perjury is a class C felony which is punishable by imprisonment in the state correctional institution for a maximum term of not more than five years,or by a
fine in an amount fixed by the court of not more than five thousand dollars($5,000.00),or by both imprisonment and fine(RCW 9A20.020(1 C)).
REV 84 0001a(12/6/19) THIS SPACE-TREASURER'S USE ONLY COUNTY TREASURER
EXHIBIT "B" •
RIGHT OF WAY EASEMENT LEGAL DESCRIPTION
EXHIBIT B
PERMANENT EASEMENT DESCRIPTION
NW 1/4 OF SEC. 10, T. 23 N., R. 05 E., W.M.
CITY OF RENTON, KING COUNTY, WA
A PORTION OF THAT PROPERTY DESCRIBED IN QUIT CLAIM DEED,
RECORDED UNDER AUDITOR'S FILE NO. 20081215000432, KING •
COUNTY RECORDS, SAID PORTION BEING MORE PARTICULARLY
DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT—OF—WAY LINE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52" WEST 47.96 FEET ALONG SAID
RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
30.50 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT—OF—WAY LINE; THENCE NORTH 00'00'52" EAST 30.50 FEET
ALONG SAID RIGHT—OF—WAY LINE TO THE TRUE.POINT OF BEGINNING;
TOGETHER WITH A PORTION OF SAID PROPERTY BEING MORE
PARTICULARLY DESCRIBED AS FOLLOWS:
COMMENCING AT THE NORTHWEST CORNER OF SAID PROPERTY, ALSO
BEING THE EASTERLY RIGHT—OF—WAY LINE OF DUVALL AVENUE
NORTHEAST; THENCE SOUTH 00'00'52" WEST 214.46 FEET ALONG SAID
RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING; THENCE
SOUTH 89'59'08" EAST 5.00 FEET; THENCE SOUTH 00'00'52" WEST
23.00 FEET; THENCE NORTH 89'59'08" WEST 5.00 FEET TO SAID
RIGHT—OF—WAY LINE; THENCE NORTH 00'00'52" EAST 23.00 FEET
ALONG SAID RIGHT—OF—WAY LINE TO THE TRUE POINT OF BEGINNING.
CONTAINING 268 SQUARE FEET, MORE OR LESS.
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Parcel No. 102305-9081-09 Page 11 of 13