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Home My WebLink AboutS_Check_Request_Wetland_LUA16-000527_20230203AP Check Request Form City of Renton ‐ Finance Department 1055 South Grady Way – 5th Floor Renton, WA 98057 FinanceAP@rentonwa.gov Instructions: This form is to be used for customer refunds, employee reimbursements, recording a payment made via Wire or EFT __________________________________________________ ________________________________________ Requestor’s Name Ext. Requestor’s Department/Division __________________________________________________ ________________________________________ Payable To Date _____________________ _______________________________________________________________________ Detailed Check Description Total Check Amount __________________________________________________________________________________________________ Address for Check City State Zip Please check all that apply: □Employee Reimbursement □Customer Refund □Wire/EFT Payments (If wire attach instructions) □Other _____________________________________________ Check handling instructions: ________________________________________________________ Emergency Check (outside normal check run) Date Needed __________________________________ _______________________________________________________________________ _____________________ GL Account Number to Charge Amount _______________________________________________________________________ _____________________ GL Account Number to Charge Amount _______________________________________________________________________ _____________________ GL Account Number to Charge Amount _______________________________________________________________________ _____________________ Signature Printed Name Date Finance Accounts Payable Team Natalie Wissbrod, Accounting Asst. Casaundra Sauls, Accounting Asst. (425) 430‐6919 (425) 430‐6930 nwissbrod@rentonwa.gov csauls@rentonwa.gov Jen Hughes, Finance Manager (425) 430‐6935 jhughes@rentonw.gova Check Information Type of Check Request Account Numbers Approver Authorization (Department Administrator, Director, or designee) BILLING INVOICE EG00133075 1055 South Grady Way, Renton, WA 98057 Transaction Date: February 03, 2023 AR: Eden Invoice: DEPARTMENT: System Administrator BILLING CONTACT Jonathan Bartels JK Monarch LLC PO Box 188 Puyallup, WA 98371 REFERENCE NUMBER PAYMENT METHODFEE NAME TRANSACTION TYPE AMOUNT PAID LUA16-000527 Refund Finance APENG - Special Deposit Refund $(12,250.00)650.000000.000.237.00.00.000 ($12,250.00) SUB TOTAL $(12,250.00) $(12,250.00)TOTAL Page 1 of 1Printed On: February 03, 2023 Prepared By: Stacy Tucker DEPARTMENTOFCOMMUNITYOFANDECONOMICDEVELOPMENT——“‘RentonRECEIPTFORCASHDEPOSITApplicant’sNameandAddressCHelanCreekLLCPERFORMANCEASSURANCEPCBox188PuyallupWA98188TOCITYOFRENTONProjectNo.(PR)/ConstructionPermitNo.fU)ProjectName08-067/U15005174ChelanCreekPUDCashDepositL...UAI527SiteLocation$12,250.00924ChelanAVETheCityofRenton,hereinaftercalledtheCITY,herebyacknowledgesreceiptfromtheabovenamedapplicant,hereinaftercalledAPPLICANT,oftheamountnotedabove.TheAPPLICANTherebyauthorizesthatthesumreferencedabovebekeptondepositwiththeCityofRentonFinanceDepartmentforthepurposeofguaranteeingthattheabove-referencedprojectwillbecompletedinaccordancewithapprovedplansandconditionsandapplicableCitystandardsnolaterthan_______________________________Theseimprovementsinclude,butarenotlimitedto:MaintenanceIMonitoringSeeattachedagreements$8,300.00LandscapeMaintenance$1,500.00PlantingIReplacementIRestorationTOTAL$9,800.00@125%$12,250.00THECONDITIONOFOBLIGATIONisthat:1.UntilwrittenreleaseofthisobligationbytheCITY,thiscashfinancialguaranteemaynotbeterminatedorcancelledbytheAPPLICANTforanyreason.2.TheobligationsoftheAPPLICANTshallnotbedischargedoraffectedbyanyamendmentoftheengineeringplansusedforconstructionoftheproject.3.UponfailureoftheAPPLICANTtoperformanyofthetermsoftheAGREEMENT,theCITYmayusethefundstocompletetheworkandpayoutstandingfeesandotheramounts.TheAPPLICANTshallhavenodutyorrighttoevaluatethecorrectnessorappropriatenessoftheCITY’Sdeterminationthatrequirementshavenotbeensatisfactorilycompleted.AnyunexpendedfundsshallbereturnedtothepartydesignatedbelowuponcompletionofthetermsoftheAgreement.4.TheAPPLICANT’Sobligationtoperformtheworkorpayfeesandotheramountsisnotlimitedtotheamountofthiscashdeposit.111/04/2016 ProjectNo.(PR)/ConstructionPermitNo.(U)ProjectName08-0677U15005174ChelanCreekPUDItistheAPPLICANT’SresponsibilitytonotifytheCITYofanychangeinaddress,telephonenumberorchangeofownershipoftheproperty.ItistheAPPLICANT’Sresponsibilitytoarrangeforreplacementofany/allfinancialguaranteespriortoanychangeofownership.APPLICANT:APPLICANTSMAILINGADDRESS:ChelanCreekLLCPCBox188PuyallupWA98371(PhoneNumber)StateofWashington,CountyofKingIcertifythatIknoworhaveseensatisfactoryevidencethatJb-%z—Lc(APPLICANT)signedthisinstrumentandacknowledgesittobehis/herfreeandvoluntaryactfortheusesandpurposesmentionedinthisinstrument.Dated:__ _ _ __ _ __ _ _SignatureofNotaryPublic:Title:Myappointmente%ires:I.-t•t)UReceivedforCityofRentonByDateJbNkfl-(PrintName)(NotarySealorStampfor211/04/2016 CASLYWAtLkLock?SECUFTYFATUHESLtSTEOOgACKjDiCATENØTAMpERiNWQRCQPyjNQ:ColumbiaStateBank2100ChelanCreek,LLC34-827/1251PaBox188Puyallup,WA983719/8/2017CftyofRentonIizo.ooTwelveThousandTwoHundredFiftyand00/100**DOLLARSCityofRentoncashwetlandbondChelanCreek,LLC2100CityofRenton9/8/201712,250.00)ColumbiaBankcashwetlandbond12,250.00 RECEIPTEG00074629BILLINGCONTACTJonathanBartelsJKMonarchLLCPCBox188Puyallup,WA98371—“Renton01055SGradyWay,Renton,WA98057TransactionDate:September08,2077REFERENCENUMBERFEENAMELUA16-000527IENG-SpecialDepositTRANSACTIONPAYMENTAMOUNTPAIDTYPEMETHODSUBTOTALTOTAL14DU.UUPrintedOn:March07,2018PreparedBy:DianaHiattPage1of1