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WebLinkAboutS_Check_Request_DEF21003104_20221213.pdfAPCheckRequestFormCityofRenton-FinanceDepartment1055SouthGradyWay—55hFloorRenton,WA98057FinanceAPrentonwa.govInstructions:Thisformistobeusedforcustomerrefunds,employeereimbursements,recordingapaymentmadeviaWireorEFTCheckInformationStacyTucker7282CED/EconomicDevelopmentRequestor’sNameExt.Requestor’sDepartment/DivisionBonafideProperties2,LLC12/13/2022PayableToDatePerprojectmanager,JonathanChavezreleasedeferralcashsurety$90,000.00DetailedCheckDescriptionTotalCheckAmount302490thPlaceSEMercerIslandWA98040AddressforCheckCityStateZipTypeofCheckRequestPleasecheckallthatapply:DEmployeeReimbursementCustomerRefundDWire/EFTPayments(Ifwireattachinstructions)DOtherCheckhandlinginstructions:CHECKMEMO:DEFERRALCASHSURETYREFUNDFORPERMITDEF21003104flEmergencyCheck(outsidenormalcheckrun)DateNeededAccountNumbers650.000000.000.237.00.00.000GLAccountNumbertoCharge90,000.00AmountGLAccountNumbertoChargeAmountSinatureU/-FinanceAccountsPayableTeamNatalieWissbrod,AccountingAsst.(425)430-6919nwissbrodrentonwa.govCasaundraSauls,AccountingAsst.(425)430-6930csauls@rentonwa.govJenHughes,FinanceManager(425)430-6935fhughes@rentonwa.govGLAccountNumbertoChargeAmountBrianneBannwah12/13/2022PrintedNameDate BILLING INVOICE EG00131880 1055 South Grady Way, Renton, WA 98057 Transaction Date: November 16, 2022 AR: Eden Invoice: DEPARTMENT: System Administrator BILLING CONTACT DIANNE DOUGHERTY BonaFide Properties 2, LLC 3024 90th Pl SE Mercer Island, WA 98040 REFERENCE NUMBER PAYMENT METHODFEE NAME TRANSACTION TYPE AMOUNT PAID DEF21003104 Refund Finance APSpecial Deposit Refund $(90,000.00)650.000000.000.237.00.00.000 ($90,000.00) SUB TOTAL $(90,000.00) $(90,000.00)TOTAL Notes: Created By Date Note Stacy Tucker 11/16/2022 Per project manager, Jonathan Chavez release (refund) deferral cash surety Page 1 of 1Printed On: December 13, 2022 Prepared By: Stacy Tucker DEPARTMENTOFCOMMUNITYANDECONOMICDEVEOPMENTCASHSURETYDEPOSITAPPLICANTNameandAddressDEFERRALASSURANCEName:1’JfIt’?P0P7a172U-CAddress:)1’j’cPC-(’.4‘&/‘Phone#:(1_V)---iiojProjectNo.IPermitNo.ProjectNamePR16-000504!DEF21003104BethanyCornerShortPlatCashSuretyDepositSiteLocation$90,000.0016433111thAveSETheCityofRenton(the“CITY”),herebyacknowledgeshaspaidthecashsuretydepositamountnotedabove.receiptfromtheabove-namedAPPLICANT,whoTheAPPLICANTherebyauthorizesthatthesumreferencedabovebekeptondepositwiththeCityofRentonFinanceDepartmentforthepurposeofguaranteeingthattheabove-referencedprojectwillbecompletedinaccordancewithapprovedplansandconditionsandapplicableCitystandardsnolaterthan2Z,o2-Z-.Theseimprovementsaredescribedontheabovereferencedpermit(s).TheCityofRenton(the“CITY”),herebyacknowledgesreceiptfromtheabove-namedAPPLICANT,whohaspaidthecashsuretydepositamountnotedabove.TheAPPLICANTherebyauthorizesthatthesumreferencedabovebekeptondepositwiththeCityofRentonFinanceDepartmentforthepurposesofguaranteeingthattheabove-referencedprojectwillbemaintainedinaccordancewiththe-(“AGREEMENT”)fortheproject.THECONDITIONSOFOBLIGATIONisthat:1.UntilwrittenreleaseofthisobligationbytheCITY,thiscashfinancialguaranteemaynotbeterminatedorcancelledbytheAPPLICANTforanyreason.2.TheobligationsoftheAPPLICANTshallnotbedischargedoraffectedbyanyamendmentoftheengineeringplansusedforconstructionoftheproject.3.UponfailureoftheAPPLICANTtoperformanyofthetermsoftheAGREEMENT,theCITYmayusethefundstocompletetheworkandpayoutstandingfeesandotheramounts.TheAPPLICANTshallhavendutyorrighttoevaluatethecorrectnessorappropriatenessoftheCITY’SdeterminationthatrequirementshavenotbeentotheCITY’Ssolesatisfaction,ofthetermsoftheAgreement.4.TheAPPLICANT’Sobligationtoperformtheworkorpayfeesandotheramountsisnotlimitedtotheamountofthiscashsuretydeposit.Page1of3IPublished:2/1/2018 ItistheAPPLICANTSresponsibilitytonotifytheCITYofanychangesinaddress,telephonenumberorchangeofownershipoftheproperty.ItistheAPPLICANTSresponsibilitytoarrangeforreplacementofanylallfinancialguaranteespriortoanychangeofownership.APPLICANT:2/,‘iVNPt’LM(*)a1Y(PrintName)o6’rtz,zcD/wA’(,wA’e71Page2of3Published:2/1/2018 CASHSURETYDEPOSIT-DEFERRALASSURANCE(CONTD)(ChooseOne)INDIVIDUALACKNOWLEDGEMENT:StateofWashington,CountyofKing:IcertifythatIknoworhaveseensatisfactoryevidencethat_________________________________________(APPLICANT)signedthisinstrumentandacknowledgesittobehis/herfreeandvoluntaryactfortheusesandpurposesmentionedinthisinstrument.CORPORATE/LLCACKNOWLEDGEMENT:StateofWashington,CountyofKing:IcertifythatIknoworhaveseensatisfactoryevidencethatTAWAJET’ithistheyl4w,&eyz_ofiJ1-FipP,ei-h’-aWashingtonlimitedliabilitycompany/corporation(APPLICANT),andacknowledgedthisinstrumentto1behefreeandvoluntaryactancdeedofsaidlimitedliabilitycompany/corporation,fortheusesandpurposesthereinmentioned,andonoathstatedthathe/shewasauthorizedtoexecutethisinstrumentonbehalfofsaidlimitedliabilitycompany/corporation.(NotarySealorStamp)Dated:Signature:?/cIPrintedName:MyAppointmentExpires:7t-iEU/cfrr/),q774f96/1’/4fc2ReceivedfortheCityofRentonBy:(LtjL.7Ic)2JProjectNo.IPermitNo.ProjectNamePR16-000504IDEF21003104BethanyCornerShortPlat(PrintName)(Signature)(Date)Page3of3IPublished:2/1/2018 RECEIPTEG00117899BILLINGCONTACTDianneDoughertyBONAFIDEPROPERTIES2LLC302490THP1SEMERCERISLAND,WA980401055SouthGradyWay,Renton,WA98057TransactionDate:July06,2021TRANSACTIONTYPEREFERENCENUMBERFEENAMEDEF21003104PAYMENTAMOUNTPAIDMETHODTOTAL$90,000.00PrintedOn:July06,2021PreparedBy:ElyshaMettlinPage1of1