HomeMy WebLinkAboutS_Check_Request_Cash_Surety_LUA21-000017_20210803Document2 Online Typeable Form, July 2007
Check Request for Non Vendor Refund or Reimbursement
This form is to be used only for one time vendors. Please contact Accounts Payable if you have
any questions regarding one time vendors.
Check will be included in the next scheduled A/P check run and mailed after Council approval.
Check Request Info: Date of request:
8/3/2021
Requestor’s name: Requestor’s department/division: Requestor’s ext. #:
Stacy Tucker CED/Planning 7282
Payable to:
LS PropDrop, LLC
Mail address for check:
c/o Matt Hannigan; PO Box 5350; Bend, OR 97708
Check amount: Account number(s) to charge: Amount per account #:
$11,889.77 650.000000.000.237.00.00.0000 $11,889.77
Reason for refund or reimbursement:
Applicant has complied with the conditions of the parking related easement, project manager
requested cash surety bond to be released.
Check handling request:
Please mail check directly to payee. CHECK MEMO: CASH SURETY BOND RELEASE FOR
PR21-000028 / LUA21-000017
*Approval Signature:
Requestor’s Department Administrator,
Division Director or designee:
Signature:
Vanessa Dolbee
type name of signer on above line
Date: August 3, 2021
*The person approving this check request must be an authorized signer.
BILLING INVOICE EG00119273
1055 South Grady Way, Renton, WA 98057
Transaction Date: August 03, 2021
AR:
Eden Invoice:
DEPARTMENT: System Administrator
BILLING CONTACT
LS Propdrop LLC
P.O. Box 5350
Bend, OR 97708
REFERENCE NUMBER PAYMENT
METHODFEE NAME TRANSACTION
TYPE AMOUNT PAID
LUA21-000017 Refund Finance APSpecial Deposit Refund
$(11,889.77)650.000000.000.237.00.00.000
($11,889.77)
SUB TOTAL $(11,889.77)
$(11,889.77)TOTAL
Notes:
Created By Date NoteStacy Tucker 08/03/2021 Per project manager, Angelea Weihs, release parking easement cash surety
Page 1 of 1Printed On: August 03, 2021 Prepared By: Stacy Tucker
—Renton 0
CASH SURETY DEPOSIT —APPLICANT Name and Mailing Address (please print clearly)
.LS PropDrop,LLC,0/0 Matt Hannigan
PERFORMANCE ASSURANCE Name.
Address 1:P0 Box 5350
Address 2:Bend,OR 97708
Phone Number:541.416.5238
Project No./Permit No.Project Name
PR21 -000028 /Les Schwab Remodel
Cash Surety Deposit Site Location
$1 1 ,889.77 354 Union Ave NE,Renton,WA
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 7/1/22 .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.
DEPARTMENT OF COMMUNITY
AND ECONOMIC DEVELOPMENT
APPLICANT:
David R.Gibson,Corporate Counsel
(Print Name)(Signature)(Date)
Page 1 of 2 Published:2/1/2018
CASH SURETY DEPOSIT -PERFORMANCE ASSURANCE (C0NT’D)
Project No./Permit No.Project Name
PR21 -000028 /Les Schwab Remodel
STATE OF OREGON
)ss.
County of Deschutes
This instrument was acknowledged before me on July 1,2021,by David Gibson in his capacity as the
authorized Corporate Counsel of LS PropDrop,LLC.
_______
r.1otary Public -State of Oregon j
.SUSANNAMAIAECKERLE
I NOTARY PUBLIC -OREGON
I ‘-‘COMMISSION NO:996601
COMMISSION EXPIRES FEBRUARY 10,2024.
Received for the City of Renton By:
(Print Name)(Signature)(Date)
Page 2 of 2 Published:2/1/2018
RECEIPT EG00117869
BILLING CONTACT
LS Propdrop LLC
P.O.Box 5350
Bend,OR 97708
1055 South Grady Way,Renton,WA 98057
Transaction Date:July 02,2021
REFERENCE NUMBER FEE NAME TRANSACTION PAYMENT AMOUNT PAID
LUA21-000017 Special Deposit Fee Payment Check Number:81
$11,889.77
SUB TOTAL S11,889.77
TOTAL $11,889.77
Printed On:July 02,2021 Prepared By:Diana Hiatt Page 1 of 1