HomeMy WebLinkAboutCity of Renton Bond permit Colpitts Sunset,.pdfDEPARTMENT OF COMMUNITY �'rra
AND ECONOMIC DEVELOPMENT --------wo�Renton 0
PERMIT BOND
Bond Number: PBO1649700192 Project Name: Sunset Terrace
KNOW ALL MEN BY THESE PRESENT; that we Colpitts Sunset LLC
of Bellevue, Washington
as Principal,
and Philadelphia Indemnity Insurance Company a Corporation, as Surety, are held and
firmly bound unto the City of Renton, a municipal corporation of the State of Washington, in
the sum of $ 97,138.25
lawful money
of the United States of America, for the payment of which, will and truly to be made, we firmly
bind ourselves, and each of our heirs, executors, administrators and assigns, jointly and
severally by these present.
THE CONDITION OF THE FOREGOING OBLIGATIONS IS SUCH, that WHEREAS, the above named
Principal has applied for a permit, pursuant to the provisions of Ordinance No. 3205, to do
certain work on a City of Renton roadway, street, alley, avenue, or other public place, during a
period ending December 1, 2021
NOW THEREFORE, if the above named Principal shall indemnify and save harmless the City of
Renton, from all claims, actions or damages of every kind and description, which may accrue as
a result of opening and/or working upon a roadway, street, alley, avenue, public easement, or
other public place, by him or those in his employ, in installing or making connections with any
public or private sewer or water system, or any other purpose or object whatever, and that he
will replace and restore such roadway, street, avenue, alley or other public place to as good a
state or condition as at the time of the commencement of said work, and maintain the same in
good order to the decided satisfaction of the City of Renton, and that he will comply with all
provisions of his or their franchise of our permit and all resolutions or instruments relating
thereto, this obligation to be void; otherwise to remain in full force and effect.
The liability under this bond is for a period of one year from July 10, 2020
to July 10, 2021 and may be extended by the surety issuing a Continuation
Certificate.
Sealed with our seals and dated this to day of 20.20..
Colpitts sunset LLC PI , c elphia indemnity ln�i nce Company
By: iCap Pacific NW Management, LLC, its Manager
BY: BY:
Applicant's Signature Jim Christensen, Manager Si at
of Bonding Agent EHZ' ,`b= dl k. Hahn
Attorney -in -Fact
Attach Power of Attorney Form to Bond
3535 Factoria Blvd. SE Ste. 500 Include contact information.
Applicant's Address
Bellevue, WA 98006
City, State, Zip
H:\CED\Data\Forms-Templates\Self-Help Handouts\Development Engineering\PERMIT BOND.docx Rev: 02/2018
DocuSign Envelope ID: 94968E13-B9CB-444B-9C70-6626B22EOCEC
DEPARTMENT OF COMMUNITY CITY OF
AND ECONOMIC DEVELOPMENT
Renton 0
PERMIT BOND
Bond Number: PBO1649700192 Project Name: Sunset Terrace
KNOW ALL MEN BY THESE PRESENT; that we Colpitts Sunset LLC
of Bellevue, Washington
and Philadelphia Indemnity Insurance Company
as Principal,
a Corporation, as Surety, are held and
firmly bound unto the City of Renton, a municipal corporation of the State of Washington, in
the sum of $ 97,138.25
lawful money
of the United States of America, for the payment of which, will and truly to be made, we firmly
bind ourselves, and each of our heirs, executors, administrators and assigns, jointly and
severally by these present.
THE CONDITION OF THE FOREGOING OBLIGATIONS IS SUCH, that WHEREAS, the above named
Principal has applied for a permit, pursuant to the provisions of Ordinance No. 3205, to do
certain work on a City of Renton roadway, street, alley, avenue, or other public place, during a
period ending December 1, 2021
NOW THEREFORE, if the above named Principal shall indemnify and save harmless the City of
Renton, from all claims, actions or damages of every kind and description, which may accrue as
a result of opening and/or working upon a roadway, street, alley, avenue, public easement, or
other public place, by him or those in his employ, in installing or making connections with any
public or private sewer or water system, or any other purpose or object whatever, and that he
will replace and restore such roadway, street, avenue, alley or other public place to as good a
state or condition as at the time of the commencement of said work, and maintain the same in
good order to the decided satisfaction of the City of Renton, and that he will comply with all
provisions of his or their franchise of our permit and all resolutions or instruments relating
thereto, this obligation to be void; otherwise to remain in full force and effect.
The liability under this bond is for a period of one year from July 10, 2020
to ,July 10, 2021 and may be extended by the surety issuing a Continuation
Certificate.
Sealed with our seals and dated this l— day of July . 20 20
Colpitts Sunset LLC
By: i{'a Ya �ifc NW Management, LLC, its Manager Phila . fti Indemnity Insurance Company
�a�w r
BY: BY: Z a&M e #
ffcarrtds Signature Jim Christensen, Manager t �oE^Bonding Agent Eliorl,cth R. art
Attach Power of Attorney FormtoyBondt
3535 Factorial Blvd. SE Ste. 500 Include contact information.
Applicant's Address
Bellevue, WA 98006
City, State, Zip
H:\CED\Data\Forms-Templates\Self-Help Handouts\Development Engineering\PERMIT BOND.docx Rev: 02/2018
PHILADELPHIA INDEMNITY INSURANCE COMPANY
One Bala Plaza, Suite 100
Bala Cynwyd, PA 19004-0950
Power of Attorney
KNOW ALL PERSONS BY THESE PRESENTS: That PHILADELPHIA INDEMNITY INSURANCE COMPANY (the Company), a corporation organized and existing under the
laws of the Commonwealth of Pennsylvania, does hereby constitute and appoint ChriStln_M. Hub¢le, Oelnna M. French, Elizabeth R. Hahn. Guy Arrnfield. Jana M.
Ray, Maria Sansone John R. Clae Ma He 1. Matetich Mlndee L. Rankin Roger Kaltenbach Ronald J. Lane Sandy L. Boswell Scott Fisher Scott MCGIlyrd
Susan B. Larson, Nicholas Fredrickson, Andrew P. Larsen, Scott Garcia, and Carty C. Fehringer of Parker, Smith & Feek. [nc., its true and lawful Attorney -in -fact with
full authority to execute on its behalf bonds, undertakings, recognizances and other contracts of indemnity and writings obligatory in the nature thereof, issued in the
course of its business and to bind the Company thereby, in an amount not to exceed $50,000,0(1 .
This Power of Attorney is granted and is signed and sealed by facsimile under and by the authority of the following Resolution adopted by the Board of Directors of
PHILADELPHIA INDEMNITY INSURANCE COMPANY on the 14"' ofNovemher_ 2016,
RESOLVED: That the Board of Directors hereby authorizes the President or any Vice President of the
Company: (1) Appoint Attorney(s) in Fact and authorize the Attorney(s) in Fact to
execute on behalf of the Company bonds and undertakings, contracts of indemnity and
other writings obligatory in the nature thereof and to attach the seal of the Company
thereto; and (2) to remove, at any time, anv such Attorney -in -Fact and revoke the
authority given And, be it
FURTHER
RESOLVED; That the signatures of such officers and the seal of the Company may be affixed to any
such Power of Attorney or certificate relating thereto by facsimile, and any such Power of
Attorney so executed and certified by facsimile signatures and facsimile seal shall be
valid and binding upon the Company in the future with respect to any bond or
undertaking to which it is attached.
IN TESTIMONY WHEREOF, PHILADELPHIA INDEMNITY INSURANCE. COMPANY HAS CAUSED "fI-IIS INSTRUMENT TO BE SIGNED AND ITS
CORPORATE SF_ALTO BE AFFIXED BY ITS AUTHORIZED OFFICE THIS 27"' DAY OF OCTOBER, 2017,
_i
(Seal)
Robert D. O'Leary Jr., President & CEO
Philadelphia Indemnity Insurance Company
On this 27°i day of October, 2017, before me came the individual who executed the preceding instrument, to me personally known, and being by me duly sworn said
that he is the therein described and authorized officer of the PHILADELPHIA INDEMNITY INSURANCE COMPANY, that the seal affixed to said instrument is
the Corporate seal of said Company, that the said Corporate Seal and his signature were duly affixed.
Notary Public;
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sr, c+.�...w. nrrn sue. n
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residing at:
(Notary Seal)
My commission expires:
lyllnti�p
Bala Cynwyd. PA
Scpleg3�r 25_ 2021
I, Edward Sayago, Corporate Secretary of PHILADELPHIA INDEMNITY INSURANCE COMPANY, do hereby certify that the foregoing resolution of the Board of
Directors and the Power of Attorney issued pursuant thereto on the 27°' day of October, 2017 are true and correct and are still in full force and effect. I do further certify
that Robert D. O'Leary Jr., who executed the Power of Attorney as President, was on the date of execution of the attached Power of Attorney the duly elected President
of PHILADELPHIA INDEMNITY INSURANCE COMPANY.
In Testimony Whereof I have subscribed my name and affixed the facsimile seal of each Company this 10 day of _ MY - . 20 2-0—
Edward Sayago, Corporate Secretary
r PHILADELPHIA INDEMNITY INSURANCE COMPANY"
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