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