HomeMy WebLinkAboutSurety - Cash Surety Deposit Performance Assurance for credit card payment.pdf
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
Page 1 of 2 | Published: 2/1/2018
CASH SURETY DEPOSIT -
PERFORMANCE ASSURANCE
APPLICANT Name and Mailing Address (please print clearly)
Name:
Address 1:
Address 2:
Phone Number:
Project No./Permit No. Project Name
/
Cash Surety Deposit Site Location
$
The City of Renton (the “CITY”), hereby acknowledges receipt from the above-named APPLICANT, who has paid the cash
surety deposit amount noted above.
The APPLICANT hereby authorizes that the sum referenced above be kept on deposit with the City of Renton Finance
Department for the purpose of guaranteeing that the above-referenced project will be completed in accordance with
approved plans and conditions and applicable City standards no later than ____________________. These improvements
are described on the above referenced permit(s).
THE CONDITION OF OBLIGATION is that:
1. Until written release of this obligation by the CITY, this cash financial guarantee may not be terminated or cancelled
by the APPLICANT for any reason.
2. The obligations of the APPLICANT shall not be discharged or affected by any amendment of the engineering plans
used for construction of the project.
3. Upon failure of the APPLICANT to perform any of the terms of the AGREEMENT, the CITY may use the funds to
complete the work and pay outstanding fees and other amounts. The APPLICANT shall have no duty or right to
evaluate the correctness or appropriateness of the CITY’S determination that requirements have not been
satisfactorily completed. Any unexpended funds shall be returned to the above-named APPLICANT upon completion,
to the CITY’S sole satisfaction, of the terms of the Agreement.
4. The APPLICANT’S obligation to perform the work or pay fees and other amounts is not limited to the amount of this
cash surety deposit.
It is the APPLICANT’S responsibility to notify the CITY of any change in address, telephone number or change of
ownership of the property. It is the APPLICANT’S responsibility to arrange for replacement of any/all financial
guarantees prior to any change of ownership.
APPLICANT:
(Print Name) (Signature) (Date)
PR18000030 C18000328 156th Ave SE Sewer Extension
38,000 on 156th Ave SE ROW (north of SE 132nd Street)
1/30/21
Page 2 of 2 | Published: 2/1/2018
CASH SURETY DEPOSIT - PERFORMANCE ASSURANCE (CONT’D)
Project No./Permit No. Project Name
/
(Choose One)
INDIVIDUAL ACKNOWLEDGEMENT:
State of Washington, County of King:
I certify that I know or have seen satisfactory evidence that _________________________________________
(APPLICANT) signed this instrument and acknowledges it to be his/her free and voluntary act for the uses and purposes
mentioned in this instrument.
CORPORATE/LLC ACKNOWLEDGEMENT:
State of Washington, County of King:
I certify that I know or have satisfactory evidence that _____________________ is the _____________________ of
_________________________, a Washington limited liability company/corporation (APPLICANT), and acknowledged this
instrument to be the free and voluntary act and deed of said limited liability company/corporation, for the uses and
purposes therein mentioned, and on oath stated that he/she was authorized to execute this instrument on behalf of said
limited liability company/corporation.
(Notary Seal or Stamp) Dated:
Signature:
Printed Name:
My appointment expires:
Received for the City of Renton By:
(Print Name) (Signature) (Date)
C18000328PR18000030 156th Ave SE Sewer Extension